Kava Interactions

Kava's kavalactones act on the GABA-A receptor, the same system diazepam enhances, so combining them produces additive central nervous system depression and excessive sedation. A published case report describes a man who became semicomatose within days of adding kava to a benzodiazepine. Kava also carries a separate, documented liver-safety signal.

Kava carries a well-documented risk of serious, unpredictable liver injury and acts as a central nervous system depressant, so combining it with fluoxetine raises concern about additive sedation and liver harm. Kava also inhibits the liver enzymes that clear fluoxetine, though this has only been shown in laboratory studies and any rise in fluoxetine levels in people remains theoretical.

Kava (Piper methysticum) is a central nervous system depressant with a documented risk of serious liver injury, and combining it with sertraline raises the chance of additive sedation and additive liver stress. Kava also inhibits drug-metabolizing enzymes, and a case report describes prolonged serotonin syndrome in a patient taking kava alongside a serotonergic antidepressant.

Kava's active compounds (kavalactones) act on the brain's GABA-A receptor, the same inhibitory system that alprazolam, a benzodiazepine, enhances. Taken together they cause additive central nervous system depression. A published case report describes a previously healthy 54-year-old man who became semi-comatose after three days of combining kava with his prescribed alprazolam, recovering once the kava was stopped. Kava also carries an independently documented risk of liver injury.

Kava and alcohol both depress the central nervous system, producing additive sedation and impaired coordination. More importantly, both are hepatotoxic: kava is a well-documented cause of severe and occasionally fatal liver injury, and alcohol adds a second liver stressor.