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used for Parkinson's disease and benzodiazepines used for anxiety. Alcohol or acetaminophen
(Tylenol), which may injure the liver, should never be used with kava. Kava may interfere with
the effects of dopamine and drugs that are similar to dopamine and may worsen the
neurological side effects of drugs that block dopamine, such as haloperidol (Haldol).
Psychotropics and anesthesia. Kava may have chemical properties similar to monoamine
oxidase inhibitors (MAOIs), and may be additive to the effects of MAOI antidepressants, such as
isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate). Thus, kava should
never be used with MAOIs. Adjunctive use with other psychotropic drugs, including tricyclic
antidepressants and SSRIs, has not been tested, but should not be attempted without careful
coordination with the prescribing physician. Kava may cause excessive drowsiness when taken
with SSRI antidepressant drugs such as fluoxitine or sertraline. Kava may also cause anesthesia
to last longer and use should be carefully coordinated with the prescribing physician or
anesthesiologist.
Anti-cancer and birth control drugs. Kava may also interact with anti-cancer and birth control
drugs.
SIDE EFFECTS
CAUTION: LIVER TOXICITY: Reports from health authorities in Germany, Switzerland, France,
Canada, and the United Kingdom have linked kava use to at least 30 cases of liver toxicity,
including hepatitis, cirrhosis, and liver failure. Kava is banned in Germany, Canada and
Switzerland. The U.S. FDA issued a consumer advisory in 2002, which is still in effect. The FDA
cautions: Persons who have liver disease or liver problems, or persons who are taking drug
products that can affect the liver, should consult a physician before using kava-containing
supplements.
Of the consulted sources, Consumer Reports is the most directive: Based on the 2002 FDA
warning, kava is one of 12 supplements that Consumer Reports advises that you should avoid.
Brown et al. also do not recommend kava, and Fugh-Berman no longer recommends it, because