Talk:Kava/Archive 1

Archive 1

Archive 2

Untitled

Why isn't the kava dermopathy even mentioned?

Perhaps because no-none like you has put it in yet. WormRunner | Talk 03:41, 26 Dec 2004 (UTC)

OK I'm the person from the first post. I am not a native English speaker and I lack the style to properly edit an encyclopedia article. Otherwise I would already have put the Kava dermopathy in, WormRunner. I think a Kava article can't leave out the dermopathy problem, which is far better known than the liver disease. It should also report the positive side effects this dermopathy may have: since it is reversible, it has been theorized that some skin problems could be corrected by intentionally causing it and letting it heal afterwards. IMO this article reads like an advertisement. An uninformed reader could get the impression that Kava is totally harmless except for the highly hypothetical liver toxicity. --Kavauser 16:08, 26 Dec 2004 (UTC)

I agree it should be in there from what little I have had time to browse on the subject (I don't have much time for this on the Christmas holiday), and I would gladly research it and add something, but from the above I would not agree that you lack the English skills to add to an article. Be bold! -- WormRunner | Talk 17:40, 26 Dec 2004 (UTC)

Dreamless sleep?

The article states that Kava could cause dreamless sleep if taken in sufficient quantities. I searched the web but didn't find a personal confirmation by somebody. Could somebody approve this effect? If yes, in which dosage Kava produce such an effect? — Preceding unsigned comment added by 184.162.71.26 (talk) 05:52, 24 December 2013 (UTC)

kava and parkinson

I found this reference on the (obviously completely biased) page of the dutch food authority. But maybe, if someone could find the article, it might be cool to read it? Meseguer et al 'Life-threatening parkinsonism induced by kava kava' Mov Disord 17(1): 195-196 2002 —Preceding unsigned comment added by 82.95.161.186 (talk) 17:40, 30 October 2009 (UTC)

This is the most resent and detailed study done...

This is the most resent and detailed study done in vivo and vitro; rodent and man, that I have found to date. I 'think', it concludes what the herbalists suggested:, in as much that Kava is generally very safe providing one is careful about what other potent drugs one takes, due to its tendency to inhibit some of the liver enzymes.

When I get time I'll have a go at a proper edit, unless there is a heptologist out there just itching to review the paper and convert it into plain English. As a good article on enzymes exists I suppose it only needs to mention those drugs that could ruin your whole day, so as to give people some honest estimate of the potential danger and in the right context. If everything without a product label is deemed extremely dangerous people will just switch off. JAMES M. MATHEWS, AMY S. ETHERIDGE, JOHN L. VALENTINE, SHERRY R. BLACK, DONNA P. COLEMAN, PURVI PATEL, JAMES SO, AND LEO T. BURKA (July 20, 2005). "PHARMACOKINETICS AND DISPOSITION OF THE KAVALACTONE KAWAIN:INTERACTION WITH KAVA EXTRACT AND KAVALACTONES IN VIVO AND IN VITRO" (PDF). Drug Metabolism and Disposition. Retrieved December 14, 2005. {{cite web}}: line feed character in |author= at position 81 (help)CS1 maint: multiple names: authors list (link) CS1 maint: year (link) --Aspro 17:39, 14 December 2005 (UTC)

It might be interesting to notice that the word kava is similar to the word used for coffee in many languages (Turkish, Arabic, Polish, ...) which may confuse their speakers. Tsferreira 13:02, 17 February 2006 (UTC)

• I believe this may be why it is often referred to as kava kava. Mike19772007 19:28, 19 July 2007 (UTC)

No, Mike. Austronesian languages where kava originates do use reduplicative expressions. But they had absolutely no contact with any of the coffee growing places before the European era. "Madison Avenue" initiated the use of the term kava-kava. —Preceding unsigned comment added by DrKick (talk • contribs) 05:46, 23 February 2008 (UTC)

Arabic speakers won't confuse Kava with Qahwa as one is spelt with 'K' (fulful kawah, or Kava Pepper) and the other is an emphatic 'Q' (qahwa) and is colloquially often pronounced 'gahwa' with a hard 'g'. Not sure about Turkish and Polish, but doubt there is much of an issue there either (at least with Turkish). - Anon —Preceding unsigned comment added by 89.148.28.252 (talk) 13:57, 5 May 2008 (UTC)

I added material on the cause of the skin lesions. TraversBuda 00:36, 3 December 2006 (UTC)

In Persian coffee is pronounced "ghahvehe" with a ending silent e. In Arabic its "qaahwa" with the Aa having the same pronunciation as the start of the name 'Aa'ron. I can assure you K and GH/Q have distinguishably different sounds. 'Q' has a sound similar to a dog making grrrr sound, the Persian pronounciation is softer than the Arabic pronounciation of 'Q'. So I doubt the Kava Kava double is anything to do with Asian pronunciations and the word for coffee. In addition, Kava Kava is virtually unknown in South West Asia. Herbal remedies such as St. Johns Wort, Lavender tea, Valerian extracts, and some local herbal preparations are the most popular. --78.86.159.199 (talk) 00:42, 23 August 2008 (UTC)

Ill Health Effects Information Link Broken and Involves Alcohol

Hi, I read the study that is the basis for the following information on the page : Heavy use of kava appears to lead to malnutrition, weight loss, liver damage (causing elevated serum γ -glutamyl transferase and high-density lipoprotein cholesterol levels), renal dysfunction, rashes, pulmonary hypertension, macrocytosis of red cells, lymphocytopenia, and decreasing platelet volumes. First of all the conclusions drawn in this paper are based on medical cases recorded out of the context of an experimental setting. In all examples, the Kava was either extracted using ethanol or acetone (making it hepatoxic by that process. See this article www.ncbi.nlm.nih.gov/pubmed/20696856), was a supplement or in the case of the Aboriginals, was used by a displaced people known to have an above average dependency on Alcohol. Some of the reports are anecdotal.The study is basically an amalgam of older studies. Such a prominent footing should got to a citation with original research. I think that information on the page linking to citation six should be altered to reflect this as its one of the first things visitors are going to see when they look up Kava. Thanks! The study can be found here http://www.informaworld.com.eproxy.ucd.ie/smpp/section?content=a791234079&fulltext=713240928 —Preceding unsigned comment added by 194.46.188.220 (talk) 11:52, 2 March 2011 (UTC) Hi I eft this up for a few months. I took that information off the mainpage for those reasons. — Preceding unsigned comment added by 194.46.233.56 (talk) 23:45, 2 June 2011 (UTC)

Contradiction

It seems contradictory to state that, "in the Western world, kava is used as an herbal remedy to ease the symptoms of stress, anxiety, and depression," and later on state that kava has been banned in France and Switzerland. It has also been banned in the UK. I'm inclined to edit the quote in the introduction to make it more specific, both chronologically (acknowledging use before bans), and geographically (where kava is banned). What do other people think? 212.32.97.24 20:12, 6 January 2006 (UTC)

How about:

In the Western world, kava is regarded more as an herbal remedy to ease the symptoms of stress, anxiety, and depression rather than a recreational drug.--86.143.163.73 22:25, 9 January 2006 (UTC)

The ban in the UK is temporarily and only concerns Kava Kava with a food intent. In other words, for botanical purposes it's totally legal. --78.86.159.199 (talk) 00:44, 23 August 2008 (UTC)

=

It's true that kava isn't a hallucinogenic drug in general, but it's possible to experience hallucinations after consuming it. Different people will have very different experiences with kava, as with any psychoactive drug. Like marijuana, different strains of kava will have different effects after being consumed. In addition, users of kava will absorb it in different fashions and forms (chewing or brewing, extracts or pure root). It's important to keep this in mind
Litanss 23:04, 3 April 2007 (UTC)

Traditional Use

There's no mention of cold-water infusions versus warm-water infusions and the possible pros and cons of each. I personally, am sitting here writing this entry, enjoying a cup of kava "tea" prepared in the traditional manner, except for the fact that i did the infusion with hot tap water, and i seem to be feeling the "psychoactive" effects as described. Should i make an edit to this effect? Morphine 20:17, 15 February 2006 (UTC)

Traditional boiling water infusions are done because that is what has been found most efficacious - Such as with teas. Cold water infusions have there place too! It is not (one must presume) 'necessary' with Kava to prepare them via a hot infusion. Off hand, I can not think of anything wrong with a hot infusion. It may mean that certain waxes and things are released and consumed, but plant waxes (as far as I know) are usually benign, unless a 56 lb. block of it, drops on you from a great height; yet Kava is 'traditionally' prepared cold. There maybe a reason for this that has not been scientifically observed. The question should be I think: is there any harm from using hot water. To that question, I do not have an authoritative answer and I have not come across anything else that may answer it. As most chemical compounds dissolve in to hot solutions, it can be extrapolated by even the most neurological challenged that hot water will also work. Therefore it is obvious. So, when in doubt - leave it out!

Yes, hot water should not hurt. I looked up several of the kavalactones in the 11th edition of the Merck index. I'm looing at boiling points of 195 ish degrees. Several of the chemicals have decomposition points in the range of 212-261 degrees. Now, I'm assuming that the Merck Index uses Celcius, so: hot (about 100C) degree water should not hurt at all. What is important to note is that the traditional preparation results in a fair amount of fine particulate matter in the beverage. TraversBuda 00:36, 3 December 2006 (UTC)

Kava is an interesting "remedy" to enhance your potency. (aphrodisiac) It relaxe the muscles so that the blood can flow better. The sexual arousal is coming quicker. --Fackel 16:32, 3 June 2006 (UTC)

The difference between hot and cold infusion with most herbal tea preparations carry the same basic principle. A hot water infusion results in more alkaloids/flavanoids etc. due to the higher water molecule activity than with cold water during the same timeframe. Extracting something in hot water decreases the time needed than with cold water, but eventually, it's the same thing. If you need a visual guide to demonstrate the aforementioned, drop one teabag in cold water and one in hot water; if both are left for 1 day, the result is the same, but in a short space of time, the hot cup will perform better. However, some alkaloids/flavanoids/acids instantly mix with the water regardless of the temperature, which is why with some herbals there is little difference between hot and cold. Many people are worried about damaging their extract because of the hot/boiling water, however, most things, even morphine or codeine need far higher temperatures for any damage. Almost all the herbs that are psychoactive are not affected by boiling water, although in detail its more complex than that. Water extractions, can also be enhanced by agitation (take a straw blow bubbles into the mixture) or by chemical assistance such as lemon juice etc. Chemical extractions are the most efficient such as that with ethanol\alcohol and other relative substances. Hope this has helped. --78.86.159.199 (talk) 01:00, 23 August 2008 (UTC)

You are very wrong about hot water not hurting. Anytime you use hot water you want to mix it with half room temp water, as the kava will loose all of its effects at any temp. over 170 degress Farenheit. —Preceding unsigned comment added by 164.49.186.132 (talk) 00:59, 5 May 2009 (UTC)

History?

Does anyone know what the archeological history is of Kava? All I see is that it is "ancient" and some mythological study without any dates. Without it this article is not complete. Nephalim 05:11, 21 October 2006 (UTC)

Given the large uncertainty over the mere origin of the people populating the islands of the western Pacific, and the fact that these people generally created few records, at least not until after several hundred years of European visitation, I hold little hope for kava history from that source. Archeologically, I suppose there's reason to hold out hope. But after about a month in Fiji and another month in French Polynesia, I would guess it unlikely. Both islands experience regular and frequent very heavy rainfall (I'm an Oregonian where we know rain) on steep mountain slopes with fast growing tropical vegetation which the rain frequently washes away, leading to significant landslides. I suppose there's reason to hope that more level areas might have something, perhaps from a time when more level ground was used in a drier climatic cycle...but that seems unlikely. — EncMstr 06:05, 21 October 2006 (UTC)

If they can date back Opium to Stone Age Mesopotamia, and alcohol back to cir. 10,000BC (at least), I am sure they can date Kava archeologically. It seems that it hasn't been done however. Drugs in ancient history, a current topic for the book I am writing, seems to be greeting with indifference rather than the interest it deserves. Kava isn't a very interesting drug, IMHO, however. I tried it once in the US where it is legal (at least it was) and all it did was give me nightmares. But that was Kava extract. Nephalim 02:48, 22 October 2006 (UTC)

It is still legal in the US--Dr.Worm 19:53, 7 November 2007 (UTC)

Might I suggest, that in the long term it might be quicker to ask this question at the University of the South Pacific [1] It would in my opinion save all that time wasted in trying to authenticate leads given by people who 'read it in a book somewhere'. Archeological knowledge about alcohol opium etc. I would think is nearly always the by product of general archaeology. You might have to dig through some archives. (Can you claim research expenses against income tax where you live? If so a trip to the barmy warm South Sea Islands might be in order. After all, someone has to do this mundane data sifting, and perhaps even sampling the local verities to check the psychotropic and physical effects -all in the name of science of course!) Ronald Siegal is the only person I can recall, who has bothered to venture into remote places in an endeavor to find evidence of early coca leaf consumption ect., but he is a psychopharmacologist on a quest. See:Siegel, Ronald K (2005). Intoxication: The universal drive for mind-altering substances. Vermont: Park Street Press. pp. pp vii. ISBN 1-59477-069-7. {{cite book}}: |pages= has extra text (help); Cite has empty unknown parameter: |coauthors= (help)--Aspro 12:56, 22 October 2006 (UTC)

Waqainabete study

I deleted the paragraph referring to Dr. Waqainabete's claims, since they don't bear on the question of toxicity. No one questioned that kava can cause temporary mental impairment. Inhumandecency 20:23, 18 March 2007 (UTC)

Some highlights from US Pharmacist

http://www.uspharmacist.com/index.asp?show=article&page=8_1082.htm

"...a wide variety of biological activities have been attributed to kava, including sedation, local anesthesia, and analgesia (TABLE 1).(7,8) ...kava produces most of these actions via a small number of pharmacological mechanisms, namely blockade of voltage-gated sodium and calcium ion channels, reduced transmitter release, blockade of GABA and benzodiazepine receptors, and reduction in monoamine levels.(7)"

"Of the above mechanisms, voltage-gated cation channel blockade and facilitation of GABA transmission would best account for the antianxiety and sedative properties of kava."

"However, blockade of norepinephrine reuptake in the CNS by kava might be expected to increase alertness by stimulation of central adrenergic mechanisms. This may explain why kava, while sharing anxiolytic and sedative actions with the benzodiazepines, differs from them in having no adverse impact on cognitive functioning.(9,10) In fact, there is historical1 and scientific (10,11) evidence to indicate it may enhance memory and have a positive effect on attention and processing capacity."

"...The recently reported (8) inhibitory effect of some kavalactones on both COX-1 and COX-2 may contribute to the previously observed analgesic property of kava."

This article has a summary of all the good stuff that's missing from this wikipage. I'm not so good at citations, especially the large number that would happen if this could be integrated into the article. Thank You! --x1987x^(talk) 03:14, 20 April 2007 (UTC)

Plant itself needs description

There is no information at all about Piper methysticum, although there is a taxbox. The plant is not described, other than being called a crop, and other than saying it is found in Oceania, there is no indication of habitat. Perhaps this information might make a separate article, but it would be helpful to have a botanical article. NaySay 21:29, 21 May 2007 (UTC)

New Info

This month a WHO report showed there was no connection between KAVA and LIVER DAMAGE.--24.15.10.239 08:07, 28 August 2007 (UTC)

We are more used to reading badly organised medical archives; reading disordered minds is still beyond most of us ;-) Do please try and give a good references when posting info on the talk pages on Wikipedia, so that we don't just ignore it as more bits of nonsense that bored kids have added during the school vacation. Thanks for your interest though all the same.

This I think maybe the report to which you refer. Assessment of the Risk of Hepatotoxicity with Kava Products ISBN- 13 9789241595261--Aspro 09:19, 28 August 2007 (UTC)

Legality should be Noted

A section should be added concerning where it is legal to purchase Kava. I was surprised to find out it is illegal in England right now (But not Wales for some reason...)--Dr.Worm 19:53, 7 November 2007 (UTC)

YES. And some time frames as well. I know from USAID that over 20 years ago they helped to have Kava classified on the GRAS (generally recognised as safe) list. A part of their presentation was film showing HE QEII drinking Kava. —Preceding unsigned comment added by DrKick (talk • contribs) 05:41, 23 February 2008 (UTC)

It would seem that the sale of kava is also prohibited in wales if im not mistaken? -http://www.legislation.gov.uk/uksi/2002/3170/pdfs/uksi_20023170_en.pdf --MattMPh (talk) 19:30, 26 February 2012 (UTC)

Long-term Effects of Kava

Hi, just pointing out that link six is broken. Also if anyone can get it to work, its worth seeing if they used alcohol in their extraction of the Kavalactones, as this renders them hepatoxic and is a different setting to regular Kava use. You can read an example of that hear :http://www.ncbi.nlm.nih.gov/pubmed/20696856 Thanks! —Preceding unsigned comment added by 194.46.188.220 (talk) 11:17, 2 March 2011 (UTC)

There's no information about Kava's long-term effects. I've done some research and a lot of the side-effects are reversible but I havn't found any good general information. Also some side-effects like decreased muscle strength can be attributed to inactivity with heavy kava use etc. I might make an entry latter if I can gather enough information 75.108.232.88 (talk) —Preceding comment was added at 00:05, 28 December 2007 (UTC)

Yeah a lot of "side effects" associated with kava are actually more correlated with kava culture. Like kava drinkers in asia don't eat as well because kava is best consumed on an empty stomach. I don't really think there would be any longterm effects. To the extent that it effects you physically it goes away when you quite drinking kava. Kava is one of those awesome drugs like marijuana or to a lesser extent salvia because it really cant hurt you and to the extent that it has negative side-effects they're only temporary.

I looked at these side effect and fatal cases out of Europe very closely. It is unlikely that these preparations were contaminated with an akaloid that only occurs in peelings because some adverse effects were also noted when pure Kavain was administered. As an approved drug, Kava was used extensively in Western Europe and patients took it over a longer period of time. More likely is that predisponed patients there might show hepatotoxic reactions when Kava is used over a longer duration. Therefore the recommendation should be not to take Kava for longer than a week or two. —Preceding unsigned comment added by 67.171.242.178 (talk) 09:44, 5 August 2010 (UTC)

Drugs similar to Kava

In the article there is this line: "The feeling kava gives is a unique feeling like none other but most closely compared to that of Valium." I don't explicitly disagree with this but maybe if we're comparing it to other drugs that people are more familiar with we should point out it's similarity to marijuana, alcohol, and codine as well. If you read on erowid these are the four drugs it's commonly compared to. "All the benefits of marijuana and alcohol without any of the negatives." "Kind of like a mild codine buzz." "Reminds me of anti-anxiety meds." It's effects are much more than that of valium. In fact it's more often compared to alcohol than it is to valium, and next to alcohol it's compared to marijuana and pain-killers -- valium is probably the least associated drug out of the bunch; the last one that would come to mind when trying to compare it to something else. No biggie I might clarify latter in the article but it's wrong to compare kava explicitly with valium. —Preceding unsigned comment added by 157.182.186.181 (talk) 21:25, 1 February 2008 (UTC)

Alcohol directly impairs all of your central nervous system immediately and even at very low doses. With Kava you have to dribk extremely high amounts to get that intoxicated effect. Kava works more on the spinal column than the higher center of the brain. As a result when taking kava your higher brain functions still work just as well as before, maybe even better. The only association kava has with alcohol is at extremely high doses where it starts to impair motor function, and most people fall asleep before they can drink that much.

Marijuana is a stimulator, kava is a tranquilizer. They really arer two different classes of drugs with completely different effects. Codeine is an opiate, which again has completely different effects.

However, Valium and Kava have very similar effects. A bowl of kava has been associated with taking 3 or 4 Valium pills at once. It stops anxiety, it gives a mild euphoric effect, it relaxes the muscles, and induces sleepiness. In fact it has been marketed as a safer alternative to Valium. Do a search on kava and Valium, you'll see that Valium gives one the closest effects to kava. 67.137.0.9 (talk) 17:51, 27 February 2008 (UTC)

It might be that if you're talking to a chronic drug user who uses Marijuana, mushrooms, cocaine, etc and is just experimenting with kava to get high, they will probably compare it to the drugs they know best. But those in the medical field who look at kava for beneficial reasons will probably compare it more to other tranquilizers such as Valium and Xanax. 67.137.0.9 (talk) 17:57, 27 February 2008 (UTC)

This is not to compare acetamenophin with kava in effect, but rather in liver toxicity. I was reading about acetamenophin is the cause of most drug-induced liver damage, and wondering if there could be some comparison of this over-the-counter drug with overdosing with kava (how much more would one have to take than the "safe" amount identified) as a context for how much of something causes liver damage. Most things one reads about kava make it sound like it's going to jump off the shelf, wrestle you down and kill you, while the "innocent" little bottle of Tylenol lurks in our medicine cabinets. I think the problem with a lot of information out there on drugs vs. supplements and vitamins is that their danger is presented in isolation. One does need to be careful with taking kava, but how careful? As careful as we are with Tylenol or as careful as we are with something more heavy-duty (tho if acetamenophin causes most liver damage...)? --Shmancy (talk) 17:24, 5 February 2008 (UTC)

Most drugs have a euphoria and other aspects as part of their side effects. For example, alcohol does induce euphoria initially, but also carries other side effects such as lack of self control, memory loss, false confidence, talkative etc. I think it's the Euphoria of Kava Kava that is consistently being compared to Valium, Codeine, Marijuana and Alcohol and there is a simple explanation for that: Alcohol is known to induce endorphins and in effect affect dopamine levels, Valium similarly induces endorphins and affects the dopamine levels and THC has also been reported to induce endorphins, Codeine directly attaches to the endorphin receptors and indirectly affecting dopamine levels. (note all drugs have different properties, e.g. Valium affecting the GABA benz. complex etc. but as a result the endorphin is affected too. For those of you who have done medicine or studied neurology, you know what I mean. For those who haven't, the brain works like swiss clockworks, if one thing is affected, it results in reactions on other areas). The reason a Kava Kava euphoria is compared to one of the aforementioned 4 is simply because chemically, the same mechanisms are responsible. The endorphin system and the dopamine system are closely linked with one affecting the other, but please also note this is simply put, the dopamine system is far more complicated and different drugs can affect it differently, however, the increased endorphin levels are a shared trait of the aforementioned drugs. But please also note, the human mind can only relate a feeling to a previously experienced feeling. In other words, the cross analysis of the erowid reports pretty much stipulates on what they have tried in the past, some may have only tried alcohol and marijuana and having no mental recollections of valium, which otherwise might be a closer match. Also, the human mental interpretation of certain feelings are often different although they fall under the same class, so one mans Kava Kava might feel different to another mans Kava Kava. --78.86.159.199 (talk) 01:11, 23 August 2008 (UTC)

How many mg kavalactons in traditional beverages?

Just curious on the main page it says "By comparison [to pills] the typical bowl of traditionally prepared kava beverage has around 250 mg of kavalactones." An average kava drink water infused uses around 5~10 grams of kava for a single drink. I'll admit that I don't know much about kava bowls, which seem to be like shots of kava, but for a drink considering 15% of kava root is kavalactons that would be 750mg - 1500mg. Is a "typical bowl" a relatively small amount of kava or is there some other reason for the 250mg figure? Again just curious I'm not trying to disagree with anyone, I just want to know. I guess most people do filter the large kava root out of drinks I don't lol but considering the root is 'absorbed' so to speak I think this would only be a nominal difference (people say drinks are just as strong whether you filter them or not, and all the fine particles stay in the water). —Preceding unsigned comment added by 157.182.186.219 (talk) 08:19, 10 February 2008 (UTC)

It's just what the drinks seem have been tested out as. There are several sources [2] [3] [4]. I would suggest that although kava powder tends to be around 15% kavalactones, not all of those kavalactones get extracted into the liquid. This may be why pharmacuetical companies use strong solvents instead of water to get a better extraction. 67.137.0.9 (talk) 17:38, 27 February 2008 (UTC)

The amount of kavalactones extracted by water from the root is much less than is in the actual root. This is because water is not nearly 100% efficient at this process. When making kava in a traditional manner, you may get about 15-20% (probably much less) of the kavalactones out of the root (or stump, or whatever kind of kava you are using), the rest is essentially thrown away. Using blenders, hot water and persistence, you can get that number up to around 30% I believe (or some substantially higher percent), but even then, you cannot extract all of the kavalactones out of the root with water, I donʻt think you can even get 100% out with heavy duty solvents which they use in the industry to extract for pills and tinctures. You would be able to consumer 100% of the kavalactones if you were to eat the root, however this tastes horrible (as if the drink wasnt bad enough...to some people) and even then the kavalactones are not 100% bioavailable if you were to do this. —Preceding unsigned comment added by 168.105.213.165 (talk) 22:37, 19 March 2008 (UTC) there has been recent research that kava binds very weakly to gaba a and other gaba receptors-ncbi —Preceding unsigned comment added by 173.175.149.92 (talk) 02:46, 11 November 2010 (UTC)

Link 8 is not directly linking

Its not a link to an article, but to a main page. —Preceding unsigned comment added by 71.194.166.77 (talk) 04:15, 23 March 2008 (UTC)

Citation 8 fixed.--Aspro (talk) 16:58, 23 March 2008 (UTC)

Where's the evidence?

Where is the evidence that kavalectones supposedly build up in your system due to being oil based? Everything medical I have ever read said the exact opposite, that there is no buildup, nor is there tolerance. —Preceding unsigned comment added by 96.240.97.196 (talk) 21:43, 26 March 2008 (UTC)

It's a similar principle with marijuana. It does not mean it will stay active in the body, but perhaps its inactive metabolites do. I think you are understanding this from the wrong end. With THC, if one is a daily user, the build up can get so bad that traces can be found upto 70 days after the last use, however, this is with someone that is a chronic daily user. If you only try THC once, it should normally clear from the body within 2 weeks. Kava Kava, althought slightly different, shares similar properties in its tracebility in the body. This does not mean tolerance will occur etc. --78.86.159.199 (talk) 01:18, 23 August 2008 (UTC)

Was going to make the same point

"Since kavalactones are oil based, the more often kava is drunk the more it builds up in a person's system and the more potent the euphoric effects become." Haven't the research, but if kava has a maoi property that would be more likely to account for the increased response. 68.219.131.83 (talk) 19:48, 15 April 2008 (UTC)

Toxicity section needs work

The articles linked from the toxicity section doesn't agree with the sentence: "Out of the 50 people worldwide taking kava pills and extracts that have had some type of problem, almost all of them had been mixing them with alcohol and pills that could have effects on the liver"

It lists several small groups which have reported liver damage and indicates that several of these reported cases were muddled because of alcohol or drug usage, not "almost all." Also, there's no good reason to think that exactly fifty people have been having problems. --75.71.55.20 (talk) 20:45, 13 July 2008 (UTC)

Deleted paragraph

I deleted the paragraph about oil-based kavalactones building up in the body -- it is absurd. If they did persist in the body at high levels, it would cause a state of permanent intoxication, not an increase in the effect of future sessions. This is just some offshoot of the idea that marijuana accumulates in the body; it persists, at low levels that drug tests detect, but not psychoactive levels. The confused statement about alcohol is also wrong. Combining the two drugs could be dangerous, but not because they work against each other, but because they could produce too strong an effect together. Wingedsubmariner (talk) 22:08, 8 August 2008 (UTC)

It's a similar principle with marijuana. It does not mean it will stay active in the body, but perhaps its inactive metabolites do (once processed by the liver). I think you are understanding this from the wrong end. With THC, if one is a daily user, the build up can get so bad that traces can be found upto 70 days after the last use, however, this is with someone that is a chronic daily user. If you only try THC once, it should normally clear from the body within 2 weeks. Kava Kava, althought slightly different, shares similar properties in its tracebility in the body. This does not mean tolerance will occur, or the effects will start getting more and more and more etc. Simply put, many substances after entering the body are metabolized by the liver, excreted from kidney etc. Sometimes the liver can only convert these chemicals into a fat form which results in high bodily accumulation, but because they now processed into different structured molecules, they are no longer psychoactive. On the other hand, some substances need to be converted in an active form first, by the liver, before they are of any use, such as codeine which needs to be first metabolized by the liver before it can act on the endorphin system. Drugs such as morphine/heroin can by pass the liver as they are already in an active form, however, their excretion may still need the liver. So I do think people need to be aware that Kava Kava's metabolites hang around a while longer than the effects do.

The reason why alcohol and Kava Kava are not recommended is due to the heavy burden they put on the liver. If one is daily using paracetamol/acetaminophen, alcohol and Kava Kava together, my personal judgement will say they don't have long left. Kava Kava, depending on which studies are to be beleived, do but a burden on the liver, but equivalent to typical alcohol or acetaminophen usage, meaning if Kava Kava is dangerous, so is alcohol or paracetamol in their own respect. Regardless of points of views, one thing is for sure, that Kava Kava does need the liver for processing, the arguement has been how much. --78.86.159.199 (talk) 01:18, 23 August 2008 (UTC)

Soon to be delegalized in Poland

This substance is on the list of 18(?) Substances soon to be delegalized (criminalized) in Poland:

Argyreia nervosa - Hawaiian Baby Woodrose, Banisteriopsis caapi - Ayhuasca, Calea zacatechichi - Dream Herb, Catha edulis - Khat, Echinopsis pachanoi - San Pedro (cactus), Piper methysticum - Kava Kava, Leonotis leonurus - Wild Dagga, Mimosa tenuiflora - Jurema, Mitragyna speciosa - Kratom, Nymphaea caerulea, Peganum harmala, Psychotria viridis, Rivea corymbosa, Salvia divinorum, Tabernanthe iboga - Iboga, Trichocereus peruvianus, Benzylpiperazine - BZP, JWH-018 - Spice

the bill (author of the bill: Grzegorz Sztolcman?) was accepted by Polish Sejm (for - 404, against - 5, and 2 abstent)[5] [6], Polish Senat [7] and the President of Poland [8].

Ttg53 (talk) 14:06, 25 March 2009 (UTC)

Is everything "natural" neccesarily healthy?

Having lived both in Fiji and Australia, I find the article and comments on kava rather naive as to the health effects of kava. Kava addiction is a real problem, both in Fiji and even greater among Aborigines and Torres Strait Islanders in Australia, with serous social, economic and health effects. For this reason, kava is banned in Western Australia and Northern Territory, and strictly regulated in the rest of the country.

Among the heavy long term users, there has been numerous cases of liver damage and renal failure, as well as the well known problems with blood cells and -platelets which leads to shortness of breath and chest pains.

No-one is proposing that a cup or two a day will kill you. But heavy, long term use, typically seen in addicts, may do just that. I cannot see how dispersing that kind of information should be seen as "typically biased"? --Liv langberg (talk) 00:45, 13 November 2009 (UTC)

RE. Liver damage incidents and regulation

The study from 2009 in University of Queensland can not be used to document no harm. Liver and renal damage has been reported after heavy use of kava over a three month period or longer. The Queensland study lasted only three weeks. It was a not a study of toxicity but explored wether or not kava has anxiolytic properties. Which it has. But the study does not say anything as to other effects kava might have, good or bad.--Liv langberg (talk) 00:54, 13 November 2009 (UTC)

Relax, this is getting to be really old news now. These anecdotal reports are now dismissed as they were found to have no substance. Of all the evidence that’s left, it points to a scare caused by a single pharmaceutical company, buying very cheaply, the part of the plant, which gets discarded by the farmers for this reason. So, if this study just considered acute liver changes over the sort term, it is still right to include it. They did a pub-med search as well and found nothing to cause them concern. Government sites are seldom written by scientists, so they are unlikely to get updated unless government policy changes, so one must be very wary not to confuse fact with uninformed opinion, when viewing them. The full citation really should be used though:Jerome Sarris, David J. Kavanagh. The Journal of Alternative and Complementary Medicine. August 2009, 15(8): 827-836. doi:10.1089/acm.2009.0066. --Aspro (talk) 15:07, 13 November 2009 (UTC)

Clarity is needed

Is it safe to take kava-kava or not? this article seems to have a two-faced opinion on it. It causes liver damage, but then again it doesn't?

I'm confused. —Preceding unsigned comment added by 71.112.194.94 (talk) 12:27, 10 March 2011 (UTC)

Short term and infrequent use doesnt seem too bad. Studies have shown no real issues using 280mg/day for 4 weeks(http://www.ncbi.nlm.nih.gov/pubmed/15334034), though i am unfamiliar with the doses given in "traditional" preparations. Long duration and high doses seem to be linked with hepatotoxicity (liver damage). --MattMPh (talk) 19:20, 26 February 2012 (UTC)

Kava/Lava Cola advertisement

It seems like mentioning this particular drink in this article is inappropriate promotion or advertising of a single brand. To me, it would be better to mention that various beverages have been commercial produced, but specifying one over any others looks to be against policy. —Torchiest ^talk_edits 19:43, 28 July 2011 (UTC)

I disagree. If you're concerned about mentioning a single brand, rather than deleting possibly useful information ("So, where can I buy a kava-based drink?"), it would be better to add information about other brands/drinks. And this paragraph doesn't read like an advertisement. Frjwoolley (talk) 21:07, 19 December 2011 (UTC)

Proposal to add to relevant companies objectively to this section and remove Mary Jane's Soda as they are no longer relevant. King Kava[9] and Kalm with Kava [10] 2600:100E:B115:8FF0:1DBA:D59:791C:6CBC (talk) 10:24, 9 January 2014 (UTC)

I'd personally prefer to delete the lot on the grounds of insufficient long-term notability, leaving only "Some kava-based soft drinks have been taken to market." and the current references. Does anyone object?

Separately, if we have a reliable source for one brand being no longer relevant then I'd be very happy to delete mention of that brand - and, presumably its own page also. Richard Keatinge (talk) 11:26, 10 January 2014 (UTC)

Agree. Mentioning the existence of kava-based soft drinks is a appropriate, but mentioning specific brands is not. I'm not sure about retaining the New York Daily News reference; the text of the NYDN article is OK, but there are problems with the headline (which calls kava a stimulant) and photo captions (which call it a stimulant again, and label a photo of prepared kava as "mint lemon"). Plantdrew (talk) 16:32, 10 January 2014 (UTC)

Dissagree I believe the way it stands now with deletion is weak and doesn't provide enough information to constitute a separate section on the subject. I believe listing relevant companies with sourced material only adds to valuable information. Agreed NYDN providing misinformation though and that should probably be removed. 2600:100E:B116:E2C6:1973:6E2A:8393:A9ED (talk) 15:13, 13 January 2014 (UTC)

I have yet to see anything which establishes these specific drinks as notable to anyone except their manufacturers. The NYDN piece may establish a minimal degree of notability for the existence of such drinks, but that's about all it's good for. Richard Keatinge (talk) 15:54, 13 January 2014 (UTC)

Notes on saftey

I read quite a bit about Kava safety (and related issues) in July 2011. Here are my notes. I never completed this and I'm not likely to get any farther with it. I have no relevant background e.g. I'm not a toxicologist or epidemiologist. I'm posting this "as is". Apologies for dumping it. Maybe someone will add relevant bits to the article or correct misconceptions.

For those who want the short version: kava does not seem to harm the vast majority of people who use it, but there are rare cases of serious liver damage. The reasons for this are not known. Liver damage may involve genetic differences between people so the same batch may not harm any of your friends but may harm you. Or harm may result from contamination by mold. Or interaction with alcohol or other drugs and herbs. Or excessive use. In short no one knows how safe kava is. This is an active area of research and more should be known in a few years.

Here's the long version.

Safety of drugs, herbs and chemicals

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• The idea that compounds are safe because they're "natural" (whatever "natural" means, exactly) is utter nonsense. See digitalis, poisonous mushrooms as extreme examples. See [3] and http://wikipedia/en/wiki/Digitalis https://secure.wikimedia.org/wikipedia/en/wiki/Hepatotoxicity
  • One could argue herbs are safer because (many) have a long history of apparently safe use. But this is no subsitute for a careful study: traditional use could continue despite rare adverse reactions (see below on idiopathic reactions), and many drugs currently in use were not available in the past (and may interact with herbs)
  • Drug manufacturers are required to meet higher standards in showing safety of their products than suppliers of herbs, suggesting drugs are safer, on the whole
    • "In the United States, testing for acute or chronic toxicity is not required of dietary supplements (Croom & Walker, 1995). " http://ntp.niehs.nih.gov/index.cfm?objectid=03DEC8F2-9993-F0BE-329B1F7DE3968390
  • Herbs often contain many active compounds (valerian has over a dozen) and often little is known about them (partly because they can't be patented, so there's less profit in studying them).
• Use of herbal medicine is increasing in the West, and so are health problems due to the use of herbs "Herbal hepatotoxicity: An expanding but poorly defined problem" Journal of Gastroenterology and Hepatology (2000) 15, 1093–1099 http://sadieo.ucsf.edu/course/old/pre-2005/chitturi.pdf
  • herb-drug interactions are one problem https://secure.wikimedia.org/wikipedia/en/wiki/Drug_interaction
  • many herbs are dangerous on their own (liver toxicity)
• Prescription drugs are not, in general, safe either
  • E.g. "Acetaminophen (paracetamol, also known by the brand name Tylenol and Panadol) is usually well tolerated in prescribed dose, but overdose is the most common cause of drug-induced liver disease and acute liver failure worldwide.[10]" https://secure.wikimedia.org/wikipedia/en/wiki/Acetaminophen_toxicity

Safety of kava

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• the literature on the safety of kava is inconclusive about how risky it is
  • much medical research (including much published research) is rubbish. Studies are routinely rejected by survey papers for having poor methodology. See e.g. 2003 Cochrane review of kava as treatment for anxiety, which excluded 10 of 22 studies http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD003383/frame.html
  • it's common to find one paper which says "X is safe/effective" and another which says the opposite

• Regulatory agencies: it seems unlikely the US Food and Drug Administration would allow sale of kava if there was a reasonable risk (although it has issued several warnings [2] p.20)
  • especially since kava is consumed on a vast scale
    • $100 million in sales (in the US alone?) in 1998 http://tandfprod.literatumonline.com/doi/abs/10.1080/10590500801907407
  • it's widely available in health food shops in the US (and e.g. amazon.com). [2] p.18 "Kava kava is one of the most extensively used herbal products in the United States, with estimated sales of $106 million (Mirasol, 1998), and is readily available at health stores, pharmacies, and Walmart stores (ABC News, 1998). Kava kava sales generated almost EUR 100 million in 2001 and local annual sales of kava kava in Fiji have been reported in the range of $30 million, with exports amounting up to $17 million (NSM, 2010). Kava kava is used by approximately 2.2 million people in the United States as a natural alternative to anti-anxiety drugs such as Xanax® and Valium® (Gardiner et al., 2007)."
  • on the other hand, kava is banned in various countries including Canada and the UK (2011)
    • are they just overcautious? Germany (at least) has lifted its ban [2] p.21

• kava has been associated with a number of liver failures
  • but most herbs and drugs have risks associated with them
  • what matters is the prevalence of problems: is it 11/11 cases or 11/11 million?
• severe liver problems associated with kava are very rare
  • This statement by a kava industry representative (from 2002?) states 36 cases in Europe where 100 million doses had been consumed. http://www.spc.int/cis/documents/Awa%20and%20the%20Liver.pdf I would guess that's hundreds of thousands of individuals who have used it

[1] (2008) "In Europe, there have been more than 30 cases of liver damage possibly associated with kava intake, although this remains controversial."

• two people can react very differently to the same substance
  • many reactions are idiopathic: they occur rarely and unpredictably https://secure.wikimedia.org/wikipedia/en/wiki/Idiosyncratic_drug_reaction
  • this is partly due to your genes: - p. 16 "The genetic difference in CYP2D6 enzyme levels between Caucasian and the Pacific Islanders suggests that Caucasian individuals are more susceptible to kava-induced hepatotoxicity [liver toxicity]." http://tandfprod.literatumonline.com/doi/pdf/10.1080/10590500801907407
• liver problems seem to be associated with heavy use of kava
  • [1] states "It is not clear what doses were used and the period of use associated with the risk of liver damage."
  • But in 9 of the 10 case studies of liver failure mentioned on pages 11-12 in [1] kava was used daily for at least 2 months. (The 10th case is ambiguous but seems to have also been long-term use.)

Mechanisms by which kava might cause liver damage

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• Some blame the extraction of active ingredients by using acetone or alcohol rather than traditional methods. I haven't looked at the status of this debate.
• Blame for liver problems has been attributed to pipermethystine which is found in the leaves and stems and in European products based on them, whereas traditionally only the root is used. However, while this 2008 study showed the root had no pipermethystine, the levels in the leaves were unlikely to cause problems either http://www.atypon-link.com/GVR/doi/abs/10.1691/ph.2008.7638
  • See also p. 11 of this 2008 paper http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD003383/frame.html
• This 2009 study suggests liver damage may be due to contamination with aflatoxins or other mould hepatotoxins Teschke R., Qiu S.X., Lebot V. "Herbal hepatotoxicity by kava: Update on pipermethystine, flavokavain B, and mould hepatotoxins as primarily assumed culprits" [Article in Press] Digestive and Liver Disease 2011

Summary

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• kava isn't 100% safe, but what is?
• it's not clear how unsafe it is
• cases of liver damage in the past seem to have been heavy users (i.e. daily for months)
• as a rule of thumb it's safer not to take any other drugs or herbal supplements at the same time
  • "same time" is hard to define. The biological half-life https://secure.wikimedia.org/wikipedia/en/wiki/Biological_half-life of many subtances is considerable. So interactions can occur between substances you have taken days apart. (You may want a "washout period" before moving from one to another.)

This seems a good summary: "The direct toxicity of kava extracts is quite small under any analysis, yet the potential for drug interactions and/or the potentiation of the toxicity of other compounds is large. Presently, kava toxicity appears to be idiosyncratic." Clouatre, D L. 2004. Kava kava: examining new reports of toxicity. Toxicol Lett, 150(1): 85–96.

The most useful thing for consumers would be a figure for the incidence of side effects such as prescription drugs have e.g. 1 in 1000 people suffer liver damage. It might be possible to infer the figures from rat and mouse toxicology studies e.g. [2] by comparing with other drugs which have the same toxicology profile in rats and mice and looking at the incidence of problems they cause in humans.

[1] Toxicity of Kava Kava. Journal of Environmental Science and Health, Part C Volume 26, Issue 1, 2008. http://tandfprod.literatumonline.com/doi/full/10.1080/10590500801907407

[2] NTP TECHNICAL REPORT ON THE TOXICOLOGY AND CARCINOGENESIS STUDIES OF KAVA KAVA EXTRACT (CAS NO. 9000-38-8) IN F344/N RATS AND B6C3F1 MICE (DRAFT, January 2011). http://ntp.niehs.nih.gov/NTP/About_NTP/TRPanel/2011/January/DraftTR571.pdf Abstract made public here: http://ntp.niehs.nih.gov/?objectid=A8D5CF03-F1F6-975E-7FFA7423EB8CAAF0

[3] Medical toxicology of natural substances: foods, fungi, medicinal herbs, plants, and venomous animal Donald G. Barceloux. Wiley, 2008.

Further work on the wikipedia article

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Wikipedia science help desk might get answers to specific questions from a toxicologist http://en.wikipedia.org/wiki/Wikipedia:Reference_desk/Science

Alternatively it's probably possible to flag an article for consideration by some kind of expert

Extracts from recent papers (2010-2011)

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[2] NTP TECHNICAL REPORT ON THE TOXICOLOGY AND CARCINOGENESIS STUDIES OF KAVA KAVA EXTRACT (CAS NO. 9000-38-8) IN F344/N RATS AND B6C3F1 MICE (DRAFT, January 2011). http://ntp.niehs.nih.gov/NTP/About_NTP/TRPanel/2011/January/DraftTR571.pdf Abstract made public here: http://ntp.niehs.nih.gov/?objectid=A8D5CF03-F1F6-975E-7FFA7423EB8CAAF0

Summary of evidence in the literature of toxicity of kava in humans from [2] p. 25 "There is conflicting evidence in the literature on kava-induced hepatotoxicity in humans. Although some reports have associated kava administration with hepatotoxicity including hepatitis, cirrhosis, and liver failure (Escher et al., 2001; Campo et al., 2002; Hefner, 2002; Gruenwald and Skrabal, 2003; Humberston et al., 2003; Teschke et al., 2003), others have shown that it is safe in most individuals at recommended doses (Denham et al., 2002; Kopp, 2003). However, whether the dose or duration of use may be correlated with the risk of liver damage remains unknown. It is also unclear if the safety profile of kava is comparable to other agents used in the management of anxiety. The toxicity of kava in humans has been partially attributed to the CYP2D6 deficiency seen in 7% to 9% of Caucasian, 5.5% of Western European, almost 1% of Asian, and less than 1% of Polynesian populations (Wanwimolruk et al., 1998; Poolsup et al., 2000; Ingelman-Sundberg, 2005). Reports suggest that genetic differences may constitute significant contributory factors for increased hepatotoxicity in Caucasians (Singh, 2005). However, caution must be exerted while interpreting kava-related toxicity due to difficulties inherent in causality assessment when dealing with herbal hepatotoxicity. Risk factors for kava kava-related adverse reactions include daily overdose, prolonged therapy, and coingestion with up to five other herbals, dietary supplements, and synthetic drugs (Teschke et al., 2008). Chronic heavy use of kava has been associated with case reports of renal dysfunction, hematologic abnormalities, pulmonary hypertension, dermopathy, and choreoathetosis (abnormal body movements) (Mathews et al., 1988; Singh, 1992; Spillane et al., 1997). These effects have been observed primarily in the context of heavy traditional/ceremonial use, and the causal relationship with kava is unclear due to multiple confounders. In reviews of 26 previously reported cases of kava kava-associated hepatic injury, causality was undeterminable in 16 cases and a low score from the Council for International Organizations of Medical Sciences excluded two more cases (Mathews et al., 1988; Singh, 1992; Spillane et al., 1997). Only one of the remaining eight cases had adhered to recommended dosing. Therefore, according to these authors’ assessment, kava kava is rarely associated with hepatotoxicity, but comedication, overdose, and/or extended treatment duration may increase this risk. In addition, there have been a few reports of kava kava-induced neurotoxicity in humans and drug-herb interactions including oral and lingual dyskinesia (Schelosky et al., 1995) and choreoathetosis (Spillane et al., 1997)."

"Kava extracts and alkaloids have also been shown to inhibit cytochrome P-450s in vitro. ... Inhibition of these CYPs or a deficiency in CYP2D6 indicates that exposure to kava and other drugs and chemical agents at the same time has a high potential for causing drug interactions ...The clinical relevance of these in vitro effects has not been evaluated in vivo."

From Discussion and conclusions p. 91 [2] "Based on these studies, kava kava appears to induce liver toxicity in rats and mice via alteration of hepatic metabolizing enzymes. These findings raise the possibility that kava kava consumption as a dietary supplement may result in hepatic toxicity due to its enzyme modulating effects." [But not by causing mutations.] "Furthermore, kava kava may have profound effects on the pharmacokinetics of many coadministrated drugs or other food supplements, potentially exacerbating hepatotoxicity. However, it should be noted that these studies were not designed to assess herb-drug interactions in humans."

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Kava and Kava Hepatotoxicity: Requirements for Novel Experimental, Ethnobotanical and Clinical Studies Based on a Review of the Evidence Rolf Teschke, Samuel X. Qiu, Tran Dang Xuan and Vincent Lebot PHYTOTHERAPY RESEARCH (2011)

Abstract: "Kava hepatotoxicity is a well described disease entity, yet there is uncertainty as to the culprit(s). In particular, there is so far no clear evidence for a causative role of kavalactones and non‐kavalactone constituents, such as pipermethystine and flavokavain B, identified from kava. Therefore, novel enzymatic, analytical, toxicological, ethnobotanical and clinical studies are now required. Studies should focus on the identification of further potential hepatotoxic constituents, considering in particular possible adulterants and impurities with special reference to ochratoxin A and aflatoxins (AFs) producing Aspergillus varieties, which should be urgently assessed and published. At present, Aspergillus and other fungus species producing hepatotoxic mycotoxins have not yet been examined thoroughly as possible contaminants of some kava raw materials. Its occurence may be facilitated by high humidity, poor methods for drying procedures and insufficient storage facilities during the time after harvest. Various experimental studies are recommended using aqueous, acetonic and ethanolic kava extracts derived from different plant parts, such as peeled rhizomes and peeled roots including their peelings, and considering both noble and non‐noble kava cultivars. In addition, ethnobotanical studies associated with local expertise and surveillance are required to achieve a good quality of kava as the raw material. In clinical trials of patients with anxiety disorders seeking herbal anxiolytic treatment with kava extracts, long‐term safety and efficacy should be tested using traditional aqueous extracts obtained from peeled rhizomes and peeled roots of a noble kava cultivar, such as Borogu, to evaluate the risk: benefit ratio. Concomitantly, more research should be conducted on the bioavailability of kavalactones and non‐kavalactones derived from aqueous kava extracts. To be on the side of caution and to ensure lack of liver injury, kava consuming inhabitants of the kava producing or importing South Pacific islands should undergo assessment of their liver function values and serum aflatoxin levels. The primary aim is to achieve a good quality of kava raw material, without the risk of adulterants and impurities including ochratoxin A and AFs, which represent the sum of aflatoxin B1, B2, G1 and G2. Although it is known that kava may naturally be contaminated with AFs, there is at present no evidence that kava hepatotoxicity might be due to aflatoxicosis. However, appropriate studies have yet to be done and should be extended to other mould hepatotoxins, with the aim of publishing the obtained results. It is hoped that with the proposed qualifying measures, the safety of individuals consuming kava will substantially be improved."

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Role of Ethanol in Kava Hepatotoxicity X. Z. Li1 and I. Ramzan PHYTOTHERAPY RESEARCH 24: 475–480 (2010)

Summary "No single mechanism explains kava hepatotoxicity and its unpredictable nature. This review has evaluated the possible mechanisms and the strength of literature evidence available to support or refute a particular mechanism; in particular, how alcohol may play a role in kava-hepatotoxicity by generating reactive metabolites via CYP 2E1 during chronic alcohol intake or by hepatic enzyme inhibition during acute alcohol ingestion leading to enhanced kavalactone exposure. There are reasonable grounds to suggest that a metabolic interaction of kava with alcohol might be a possible mechanism of kava hepatotoxicity."

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Medical toxicology of natural substances: foods, fungi, medicinal herbs, plants, and venomous animal Donald G. Barceloux. Wiley, 2008. Paywall got in the way... — Preceding unsigned comment added by 87.194.94.230 (talk) 21:51, 21 September 2011 (UTC)

Effects

"Some report that caffeine, consumed moderately in conjunction with kava can significantly increase mental alertness." Its uncited, i'd propose deleting it largely because the increase in mental alertness is generally just caffine. While i wouldnt rule out its possibility as kava is inhibitiory to a number of CYP enzymes it does seem a little bit surplus without a citation. --MattMPh (talk) 18:24, 26 February 2012 (UTC)

It had been waiting for a citation since July 2011, i've removed it for the time being. --MattMPh (talk) 11:25, 28 February 2012 (UTC)

Additionally: "After wakening the drinker usually does not experience any mental or physical after effects." (awaiting citation) As far as i'm aware (though i've never tried kava) this isnt strictly true.

McDonald D, Jowitt A. Kava in the Pacific Islands: a contemporary drug of abuse?. DRUG ALCOHOL REV. 2000 19: pp 217-227 (http://www.hawaii.edu/hivandaids/Kava_in_the_Pacific_Islands__A_Contemporary_Drug_of_Abuse.pdf)
Admitedly it reads as more of an opinion poll format than strict science, but it does state that kava drinkers are percieved as having "lazy days" following an evening of kava drinking. --MattMPh (talk) 11:25, 28 February 2012 (UTC)

The half life of alot of the key kavalactones is around 9 hours.. Its unlikely that there are no after effects. — Preceding unsigned comment added by 128.243.253.116 (talk) 11:14, 6 May 2012 (UTC)

Citations needed

In the intro paragraph these statements need to be supported by a citation:

The roots of the plant are used to produce a drink with sedative and anesthetic properties. Kava is consumed throughout the Pacific Ocean cultures of Polynesia, including Hawaii, Vanuatu, Melanesia and some parts of Micronesia. Kava is sedating and is primarily consumed to relax without disrupting mental clarity. Its active ingredients are called kavalactones.

In particular, these medicinal claims must be supported by evidence that these are the accepted effects: "Kava is sedating and is primarily consumed to relax without disrupting mental clarity." Most of the section on Preparation is also in needed of citations. Ileanadu (talk) 23:09, 13 October 2012 (UTC)

Kava liver damage and side-effects are maybe exaggerated

After reading research papers and using kava personally I have came to following conclusion and tried to change the wikipedia page but some edits were refused.

Reckless use of Kava can cause liver problems but they are typically benign and do not lead to permanent liver damage. There are also other supplements out there that can cause liver problems or death if used improperly. The liver failures were caused by improperly prepared kava supplements in europe while such things are not reported in traditionally prepared kava.

Kava causes less side-effects to nervous system than alcohol. Actually, the most heavy kava users they could find did NOT have nervous system problems but some strange liver readings and other non-fatal side-effects. The real agenda behind Kava ban seems to be that it might kill and damage the abusers and heavy users less slowly than alcohol and those people could actually work because of minimal nervous system problems. So the reason behind the ban is to work against substance abuse (if properly used, heavy kava use kills more slowly than heavy alcohol use => more costs to society?). So they don't want kavaholics instead of alcoholists so they want to ban kava.

Regulatory

Let's be really careful about stating regulatory requirements for drugs in other countries. Germany never reinstated the Kava regulation of 2001 as this was stated in the ABC article. They actually put Kava preparations under very strict regulatory control. 2601:1C0:C001:76E2:E2F8:47FF:FE3C:9BDA (talk) 09:58, 28 February 2016 (UTC)

PROPOSED EDIT:

However, if improperly used (some kava supplements), kava can be worse than alcohol. But this is problem within supplement industry (they sell people lots of garbage). And doctors want to control things keep too powerful supplements away from the reach of people.A few people taking badly prepared kava-based dietary products in europe have suffered liver damage or liver failure as a result of hepatotoxicity. Consequently, kava is regulated in a number of countries although in traditional use it seems to cause only benign temporal changes in liver function and less nervous system side-effects than alcohol. (contribution by 85.76.175.91 on 9 Feb 2014 at approx. 22:10 UTC)

This is covered in some detail in the "Toxicity and safety" section: it seems clear there is concern over safety and doubt about quite how the toxicity arises. Are there some good sources we aren't using? Alexbrn ^{talk|contribs|COI} 22:15, 9 February 2014 (UTC)

References

Buttermilk?

The following sentence seems to make no sense.

The extract is an emulsion of kavalactone droplets in starch and buttermilk.

How can the kava extract contain buttermilk? Dratman (talk) 02:34, 3 March 2016 (UTC)

History

Do you think there should be more information added about the specifics of traditional kava ceremonies under the history section? Livia Manning 21:33, 1 August 2016 (UTC) — Preceding unsigned comment added by Lmann 416 (talk • contribs)

Something should be added, yes. Plantdrew (talk) 22:01, 1 August 2016 (UTC)

Other Names for Kava

I found an article listing some other common names of Piper methysticum.

Other names for kava include kawa, kavain, Rauschpfeffer, intoxicating long pepper, tonga, yagona, and yaqona (Yeung and Gubili, 2009, 170).

Yeung KS, Gubili J. 2009. Kava (Piper methysticum). Journal of the Society for Integrative Oncology 7(4): 170-172.

(Tori.sanders (talk) 00:55, 25 October 2016 (UTC)

Effects of Kavalactones

The active chemicals, referred to as kavapyrones or kavalactones, of P. methysticum are typically found in the root region of the plant (LaPorte et al., 2011, 103). These kavapyrones are responsible for producing skeletal muscle relaxation as well as non-narcotic and local anesthetic effects (Yeung and Gubili, 2009, 170). These effects make kava extracts useful in treating seizures and psychotic states, but are mostly used for treating anxiety (Ernst, 2002, 49).

Ernst E. 2002. The risk-benefit profile of commonly used herbal therapies: ginkgo, st. john’s wort, ginseng, echinacea, saw palmetto, and kava. Annals of Internal Medicine 136(1): 42-53.

Yeung KS, Gubili J. 2009. Kava (Piper methysticum). Journal of the Society for Integrative Oncology 7(4): 170-172.

(Tori.sanders (talk) 00:59, 25 October 2016 (UTC))

Kava may be safer to use than benzodiazepines!

In a study comparing benzodiazepine and aqueous kava extract for the treatment of generalized anxiety, researchers found that the overall safety and effectiveness of the two drugs were comparable (Sarris et al., 2009, 405). No conclusions were drawn regarding which of the two treatments were better were since they showed highly similar effects and because varying opinions exist on the topics regarding medicine. When given a placebo for a week following kava or benzodiazepine administration, the kava group showed no adverse reactions (Sarris et al., 2009, 405). Those who were taking benzodiazepines experienced the signs and symptoms of withdrawal, which included insomnia, agitation, and digestive disturbances (Sarris et al., 2009, 405). This study also confirmed that aqueous kava extract seems to be safe with regards to liver toxicity, as no signs of liver damage were observed in the participants (Sarris et al., 2009, 405). Kava extract also shows an antidepressant effect (Sarris et al., 2009, 406).

Sarris J, Kavanagh DJ, Byrne G, Bone JM, Adams J, Deed G. 2009. The kava anxiety depression study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum. Psychopharmacology 205: 399-407.

(Tori.sanders (talk) 01:00, 25 October 2016 (UTC))

Unsourced, redundant culture content

Removing this content below for discussion. It is unsourced, speculative, repetitive with content elsewhere in the article, and adds no unique information worthy of remaining. --Zefr (talk) 23:00, 21 March 2017 (UTC)

The use of kava is strongly linked with the cultures of numerous Pacific Islands. This practice remained unknown to the rest of the world until James Cook, an English naval captain and explorer, discovered the plant's use in 1777 during one of his voyages in the Pacific Islands. George Forster, a naturalist on Cook's voyage, wrote a description of the process in which the islanders prepared the kava:

[Kava] is made in the most disgustful manner that can be imagined, from the juice contained in the roots of a species of pepper-tree. This root is cut small, and the pieces chewed by several people, who spit the macerated mass into a bowl, where some water (milk) of coconuts is poured upon it. They then strain it through a quantity of fibers of coconuts, squeezing the chips, till all their juices mix with the coconut-milk; and the whole liquor is decanted into another bowl. They swallow this nauseous stuff as fast as possible; and some old topers value themselves on being able to empty a great number of bowls.

On some islands (most notably the Cook Islands and Niue) their efforts were successful. On other islands, the missionaries either failed to completely eradicate kava (e.g. Hawaii) or actually incorporated it into Christian practices (most notably in Samoa and Tonga). Kava continue to be used on most Pacific Islands for various ceremonies and gatherings. Hillary Clinton, Pope John Paul II, Queen Elizabeth II and numerous other leaders have participated in a Kava ceremony while visiting communities who continue this practice. Today, kava is a staple cash crop in the Pacific Islands and it is extracted by machinery which is later manufactured into various forms.