A member of the pepper family, kava (or kava-kava) is a natural tranquilizer that soothes jangled nerves and eases anxiety with few of the mind-dulling effects of prescription relaxants. Its Latin name, Piper methysticum, means "intoxicating pepper," and indeed, on the South Pacific islands where it is grown, kava is made into a traditional beverage that is drunk at ceremonies and on social occasions--as alcohol is in other societies--to relax people and induce a sense of well-being.
Doctors in Europe have long prescribed kava as a gentle alternative to prescription tranquilizers. But things are changing quickly. Recent news about kava has not been good. In Europe, approximately 40 reports of liver damage among kava users have surfaced over the past two years. Six of these people required liver transplants, and the three died. This was sufficient evidence for the governments of Germany and Switzerland to call for an immediate ban on kava products; Canada and Great Britain shortly followed suit.
In Europe, herbal therapies are carefully monitored by governmental agencies comparable to the Food and Drug Administration (FDA). This situation is quite different in the United States. Here, most herbs can be taken without physician supervision, and problems may never get reported at all. Because the FDA classifies kava as a nutritional supplement rather than a drug, the agency can't act on "adverse event" reports from physicians by recalling it. Rather the FDA simply issues a "warning," which it has done in the case of kava.
The lack of medical supervision regarding herbal therapies is currently reflected in the U.S. data on kava, with only a single case reported so far:a woman who developed liver failure while using the herb. Given the widespread use of kava, it is statistically quite likely that more people had or even still have kava-induced liver toxicity but remain unaware of it. When abnormalities in liver function do occur with kava, they usually clear up within weeks of discontinuing the herb.
Herbalists in the United States seem to be divided equally about the use of kava. One group recommends no official withdrawal of the herb, but carefully considered use instead. Cautions would include taking the herb for no more than one month, not exceeding dosage recommendations, and avoiding it altogether if there is pre-existing liver disease or if drinking alcohol or taking any medication associated with liver toxicity. They contend that combining kava, acetaminophen(Tylenol), and alcohol would be an extremely dangerous mix, for example. Other herbalists are willing to abandon kava altogether and recommend alternative relaxing herbs such as valerian, passionflower, chamomile, and the amino acid GABA (gamma aminobutyric acid).