Complementary & Alternative Medicine for Mental Health

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effects." Busperone and opipramol may also have additive effects when taken with

kava, or with opioid analgesics like oxycodone and propoxyphene or herbs like valerian.

Kava may also interact with anti-cancer and birth control drugs.

6. SIDE EFFECTS:
    Fugh-Berman and Cott cited mild gastrointestinal complaints or allergic skin reactions
   (incidence, 1.5%) as the most common effects. Chronic use of kava up to 100 times the
   therapeutic dose results in an ichthyosiform eruption (yellowed skin) known as kava
   dermopathy, which is often accompanied by eye irritation. Abstaining from kava results
   in complete resolution of symptoms.
    According to Brown et al., post marketing studies have revealed a 1.5% to 2.3%
   incidence of side effects from kava, primarily gastrointestinal upset, allergic reactions,
   headache, and light sensitivity. Less common side effects include restlessness,
   drowsiness, lack of energy, and tremor. In four cases, kava was associated with
   dyskinesias or worsening Parkinsonian symptoms.
    According to Mischoulon and Rosenbaum, the most common side effects of kava use
   are gastrointestinal upset, allergic skin reactions, headaches and dizziness. Liver toxicity
   has been noted with prolonged aboriginal use as well as in the cases cited by the FDA.
   There are reports of adverse interactions with benzodiazepines^6 and alcohol. According
   to Mischoulon and Rosenbaum, the more serious toxic reactions have been associated
   with high doses (over 300 g. per week, 43 g. per day – 43,000 mg per day) or prolonged
   use of kava, and use of kava without physician supervision.

 Lake and Spiegel (Lee, Yee and Naing) add antiplatelet activity and apathy with long-

term use.

 The Natural Standard relates the history, that kava had generally been thought to be

“safe in otherwise healthy people not taking any other drugs, herbs or supplements,

over short periods of time (1 to 2 months), and at recommended doses." However, the

facts recited in the FDA release have required a change in the Natural Standard’s stance,

concluding that, " kava should be used only under the supervision of a qualified