The Pharmacology, Pharmacokinetics, Efficacy, and Adverse Events Associated With Kava

White, C Michael

doi:10.1002/jcph.1263

Cited by 26 publications

(23 citation statements)

References 32 publications

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“…The medicinal use of kava extracts obtained from the root and rhizome parts as anxiolytic preparation has extended around the world since 1990 [404]. However, due to issues related with hepatotoxicity, the use of kava was forbidden by the Federal Institute of Drugs and Medical Devices of Germany in 2002.…”

Section: Biological Activities Piper Plantsmentioning

confidence: 99%

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Piper Species: A Comprehensive Review on Their Phytochemistry, Biological Activities and Applications

et al. 2019

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Piper species are aromatic plants used as spices in the kitchen, but their secondary metabolites have also shown biological effects on human health. These plants are rich in essential oils, which can be found in their fruits, seeds, leaves, branches, roots and stems. Some Piper species have simple chemical profiles, while others, such as Piper nigrum, Piper betle, and Piper auritum, contain very diverse suites of secondary metabolites. In traditional medicine, Piper species have been used worldwide to treat several diseases such as urological problems, skin, liver and stomach ailments, for wound healing, and as antipyretic and anti-inflammatory agents. In addition, Piper species could be used as natural antioxidants and antimicrobial agents in food preservation. The phytochemicals and essential oils of Piper species have shown strong antioxidant activity, in comparison with synthetic antioxidants, and demonstrated antibacterial and antifungal activities against human pathogens. Moreover, Piper species possess therapeutic and preventive potential against several chronic disorders. Among the functional properties of Piper plants/extracts/active components the antiproliferative, anti-inflammatory, and neuropharmacological activities of the extracts and extract-derived bioactive constituents are thought to be key effects for the protection against chronic conditions, based on preclinical in vitro and in vivo studies, besides clinical studies. Habitats and cultivation of Piper species are also covered in this review. In this current work, available literature of chemical constituents of the essential oils Piper plants, their use in traditional medicine, their applications as a food preservative, their antiparasitic activities and other important biological activities are reviewed.

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Section: Biological Activities Piper Plantsmentioning

confidence: 99%

“…Currently, in the USA kava extracts can be found in markets and on the internet. However in Germany, although the decision of court about the banning of kava use was found an inappropriate action in 2014, currently, it can be used only under the order of a referring practitioner [404,406].…”

Section: Biological Activities Piper Plantsmentioning

confidence: 99%

Piper Species: A Comprehensive Review on Their Phytochemistry, Biological Activities and Applications

et al. 2019

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“…There are many instances where the herb named on the bottle was not the same as the herb in the product (tablets, capsules) or where active ingredients in dietary supplements were enriched with higher than normal concentrations of certain natural or synthetic constituents. 14-18…”

Section: Substitution Of Active Plant Variety or Enrichment Of Productmentioning

confidence: 99%

“…The American Kava Association responded with a rigorous new certification program for cultivators and manufacturers of kava as a result. 14…”

Section: Substitution Of Active Plant Variety or Enrichment Of Productmentioning

confidence: 99%

Dietary Supplements Pose Real Dangers to Patients

White

2020

Ann Pharmacother

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The Dietary Supplement Health and Education Act led to a flood of poor-quality dietary supplements. The Food and Drug Administration’s (FDA’s) jurisdiction is limited to removing products proven unsafe, rather than prospectively assessing them for quality manufacturing. With so many products available, there is very little FDA oversight until reports of patient harm occur. Microbial and heavy metal contamination, adulteration with synthetic drugs (including drugs banned from the United States), substituting herbs, and fraudulently specifying ingredients on the label have all occurred. Clinicians should collectively advocate for legislative change, only recommend products tested by outside laboratories for quality, and educate consumers about the risks of using unverified products.

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“…Data on kava’s safety profile obtained from clinical trials in patients with anxiety suggest generally good tolerability and safety for short-term use (1–4 weeks) at therapeutic doses. However, the use of kava at frequent and high doses can cause hepatotoxicity through the modulation of various CYP, which is also the cause of potential drug interactions [ 255 ], dermopathy [ 256 ], and cognitive disorders [ 257 ]. Sedation with drowsiness and dizziness is commonly reported in clinical trials with administration of kava or methysticin ( Table 1 ), which may impair driving performances [ 148 ].…”

Section: Discussionmentioning

confidence: 99%

Pharmacology of Herbal Sexual Enhancers: A Review of Psychiatric and Neurological Adverse Effects

et al. 2020

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Sexual enhancers increase sexual potency, sexual pleasure, or libido. Substances increasing libido alter the concentrations of specific neurotransmitters or sex hormones in the central nervous system. Interestingly, the same pathways are involved in the mechanisms underlying many psychiatric and neurological disorders, and adverse reactions associated with the use of aphrodisiacs are strongly expected. However, sexual enhancers of plant origin have gained popularity over recent years, as natural substances are often regarded as a safer alternative to modern medications and are easily acquired without prescription. We reviewed the psychiatric and neurological adverse effects associated with the consumption of herbal aphrodisiacs Areca catechu L., Argemone Mexicana L., Citrus aurantium L., Eurycoma longifolia Jack., Lepidium meyenii Walp., Mitragyna speciosa Korth., Panax ginseng C. A. Mey, Panax quinquefolius L., Pausinystalia johimbe (K. Schum.) Pierre ex Beille, Piper methysticum G. Forst., Ptychopetalum olacoides Benth., Sceletium tortuosum (L.) N. E. Brown, Turnera diffusa Willd. ex. Schult., Voacanga africana Stapf ex Scott-Elliot, and Withania somnifera (L.) Dunal. A literature search was conducted on the PubMed, Scopus, and Web of Science databases with the aim of identifying all the relevant articles published on the issue up to June 2020. Most of the selected sexual enhancers appeared to be safe at therapeutic doses, although mild to severe adverse effects may occur in cases of overdosing or self-medication with unstandardized products. Drug interactions are more concerning, considering that herbal aphrodisiacs are likely used together with other plant extracts and/or pharmaceuticals. However, few data are available on the side effects of several plants included in this review, and more clinical studies with controlled administrations should be conducted to address this issue.

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The Pharmacology, Pharmacokinetics, Efficacy, and Adverse Events Associated With Kava

Cited by 26 publications

References 32 publications

Piper Species: A Comprehensive Review on Their Phytochemistry, Biological Activities and Applications

Piper Species: A Comprehensive Review on Their Phytochemistry, Biological Activities and Applications

Dietary Supplements Pose Real Dangers to Patients

Pharmacology of Herbal Sexual Enhancers: A Review of Psychiatric and Neurological Adverse Effects

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