The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum

Sarris, Jerome; Kavanagh, David J.; Byrne, Gerard; Bone, Kerry; Adams, Jon; Deed, Gary

doi:10.1007/s00213-009-1549-9

Cited by 107 publications

(74 citation statements)

References 26 publications

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“…This again hampered any evaluation of the causative agent of kava hepatotoxicity [16,17] . For both the United States Food and Drug Administration and the Australian Therapeutic Goods Administration, peeled kava rhizomes were recommended for kava supplements [18,19] . Another point of interest focuses on solvents and solubilizers without regulatory advice [8,11,15,16] , as well as on adulterants, impurities, contaminants, or misidentified herbs [4,7,8,11] .…”

Section: Herbal Product Essentialsmentioning

confidence: 99%

Herbal hepatotoxicity: Challenges and pitfalls of causality assessment methods

Teschke¹,

Frenzel²,

Schulze³

et al. 2013

WJG

156

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totoxicity cases, compared to numerous other causality assessment methods, which are inferior on various grounds. Among these disputed methods are the Maria and Victorino scale, an insufficiently qualified, shortened version of the CIOMS scale, as well as various liver unspecific methods such as the ad hoc causality approach, the Naranjo scale, the World Health Organization (WHO) method, and the Karch and Lasagna method. An expert panel is required for the Drug Induced Liver Injury Network method, the WHO method, and other approaches based on expert opinion, which provide retrospective analyses with a long delay and thereby prevent a timely assessment of the illness in question by the physician. In conclusion, HILI causality assessment is challenging and is best achieved by the liver specific CIOMS scale, avoiding pitfalls commonly observed with other approaches.© 2013 Baishideng. All rights reserved.Key words: Herbal hepatotoxicity; Herb induced liver injury; Herbs; Drug hepatotoxicity; Drug induced liver injury; Causality assessment Core tip: This review focuses on diagnostic causality assessment algorithms that have been used so far in herb induced liver injury (HILI) cases. Detailed information of the various methods with their strengths and weaknesses is provided including their challenges and pitfalls that emerged during the assessing course. For the physician caring for a patient with suspected HILI, the Council for International Organizations of Medical Sciences (CIOMS) scale is the preferred tool for assessing causality compared to numerous other causality assessment methods, which are inferior on various grounds. CIOMS based assessment should start at the day HILI is suspected to ensure completeness of clinical data. AbstractThe diagnosis of herbal hepatotoxicity or herb induced liver injury (HILI) represents a particular clinical and regulatory challenge with major pitfalls for the causality evaluation. At the day HILI is suspected in a patient, physicians should start assessing the quality of the used herbal product, optimizing the clinical data for completeness, and applying the Council for International Organizations of Medical Sciences (CIOMS) scale for initial causality assessment. This scale is structured, quantitative, liver specific, and validated for hepatotoxicity cases. Its items provide individual scores, which together yield causality levels of highly probable, probable, possible, unlikely, and excluded. After completion by additional information including raw data, this scale with all items should be reported to regulatory agencies and manufacturers for further evaluation. The CIOMS scale is preferred as tool for assessing causality in hepa-

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Section: Herbal Product Essentialsmentioning

confidence: 99%

Herbal hepatotoxicity: Challenges and pitfalls of causality assessment methods

Teschke¹,

Frenzel²,

Schulze³

et al. 2013

WJG

156

View full text Add to dashboard Cite

show abstract

“…is classified as "Anxiolytics", and generally have an effect on the GABA-ergic system [15], or operate by controlling the transmission in voltage-dependent ion channels, or by change in membrane conductivity, or by inhibiting GABA transaminase or glutamate decarboxylase or, less commonly by binding to benzodiazepine receptors (e.g. with α-subunit) [20]. The subsequent stimulation of GABA-ergic neurotransmission has the effect of damping, which ultimately provides psychological calming effect [19].…”

Section: Herbal Medicines Affecting Anxietymentioning

confidence: 99%

Herbal Medicines In The Treatment Of Post-Traumatic Stress Disorder: A Review

Vasileva¹

2016

IOSRPHR

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“…Animal studies have demonstrated anti-anxiety activity of kava (Garrett et al, 2003;Bruner and Anderson, 2009). Several randomized double-blind clinical studies in GAD patients showed beneficial effect of kava-kava in reducing anxiety (Watkins et al, 2001;Connor and Davidson, 2002;Boerner et al, 2003;Sarris et al, 2009). Kava-kava was used in numerous controlled clinical studies to treat anxiety disorders, but the subjects included in these studies were heterogeneous i.e., they were diagnosed with agoraphobia, specific phobia, social phobia, adjustment disorder with anxiety (Volz and Kieser, 1997;Malsch and Kieser, 2001;Gastpar and Klimm, 2003;Lehrl, 2004).…”

Section: Kava Kava (Piper Methysticum)mentioning

confidence: 99%