Kava

6Node page

what any key link opens

psx:substance/kava/value/contraindication/5af31abd-7705-4712-8d4b-bdde8eb956b5@2

valuereferenced by edges — no row of its own

derived from · upstream

derived_fromcontraindication · pregnancy_breastfeedingpsx:substance/kava/proposal/contraindication/677c482f-dc59-49f2-8ed1-8328efc55109

feeds · downstream

none recorded

psx:substance/kava/value/contraindication/5af31abd-7705-4712-8d4b-bdde8eb956b5@2
└─ derived_from  proposal/contraindication/677c482f-dc59-49f2-8ed1-8328efc55109  contraindication · pregnancy_breastfeeding

indented by distance from this node, not by parentage

1Provenance card

the boundary, as counts

Sources

4329 with DOI

14 strong · 22 moderate · 7 weak

Compilations

12026-05-13T09:26:52.449Z

pipeline-v5 · prompt hash not recorded — run predates 2026-09

Decisions

23last ruled 2026-06-04

1 awaiting a ruling

Issued documents

42026-10-19T20:32:24.941Z

notice · info card · emergency

Searches

264 with no results

queries and counts on the build

Claims checked

2003 supported

3 supported · 197 not

Correspondence

0received

consent field ships in Phase 4

Edges

502

derivations recorded for this entity

Complete over 43 sources, 1 compilation, and 23 decisions.Not here: the private journal (never); 1 proposal awaiting a ruling (listed as pending only).Working material — drafts, discards, unsupported claims — is listed below and readable on the working page.Cite: psychedex.org/substances/kava/archive

2Build

one panel per compilation run

generation run 2026-05-13

70 min completedmodel pipeline-v5plan not recordedrun/cdc57bcc…

Selection

results seen105

selected by the model43

consumed as sources43

Verification

claims checked200

supported3

partially supported0

not supported0

inconclusive197

record
seen / partial
working

The model's own caveats

sparse_evidence
safety_data_unverified
structural_inference

Reproduce

inputs: 43 source keys (listed under Sources)
plan: not recorded — template version, prompt hash and git SHA are written from 2026-09 onward
model: pipeline-v5
streams: none — agent transcripts are persisted from 2026-09 onward

26 searches — query, source, results, what was kept and why

26 searches for this run
#	source	query	seen	kept	rationale
1	PubMed	kava comprehensive review efficacy safety psychopharmacology Sarris 2011	1	1	—
2	PubMed	kava hepatotoxicity liver toxicity adverse effects case reports	7	6	—
3	WebSearch	Piper methysticum Georg Forster botanical first description 1786	10	—	—
4	PubMed	kava global perspectives health economic social 2025	1	1	—
5	ClinicalTrials.gov	kava Piper methysticum anxiety	8	—	—
6	PubMed	Clinical pharmacokinetics kavalactones oral dosing	1	1	—
7	PubMed	kava drug interaction CYP inhibition herb	8	7	—
8	PubMed	kavalactone GABA receptor binding anxiolytic mechanism	2	1	—
9	PubMed	kava dependence withdrawal dermopathy adverse effects	2	1	—
10	PubMed · absence	Piper methysticum kava taxonomy botanical identity	0	—	—
11	PubMed · absence	kava ethnobotany traditional use Pacific Island history	0	—	—
12	PubMed	flavokavain hepatotoxicity kava toxic constituents	4	4	—
13	WebSearch	kava Piper methysticum legal status Germany FDA USA Australia UK	10	—	—
14	PubMed · absence	kavalactone kavapyrone chemical constituents concentration HPLC	0	—	—
15	PubMed	kava driving impairment oxazepam KALM study	1	2	—
16	WebSearch	kava UN convention scheduling status DEA controlled substance	10	—	—
17	PubMed · absence	kava kavalactone pharmacokinetics bioavailability absorption metabolism	0	—	—
18	PubMed	kava Piper methysticum pharmacology mechanism action receptor	7	4	—
19	PubMed	kavain amphetamine immunoassay false positive drug test	1	1	—
20	PubChem	kavain, dihydrokavain, methysticin, dihydromethysticin, yangonin, desmethoxyyangonin	6	—	—
21	OpenAlex	kava Piper methysticum kavalactones pharmacology	10	5	—
22	PubMed	kavalactone chemotype noble tudei Piper methysticum	1	1	—
23	PubMed	Kava clinical nutrient comprehensive review 2020	1	1	—
24	Multiple sources	Kava botanical identity cross-reference GBIF POWO	3	—	—
25	PubMed	German kava ban lifted court ruling	1	1	—
26	PubMed	kava anxiety clinical trial randomized controlled	10	6	—

200 claims by section — every cited sentence, checked against its source

safety96 · 2 ok

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One severe withdrawal case has been documented: a 45-year-old man using both kava and kratom heavily presented to the emergency department with auditory and visual hallucinations, anxiety, insomnia, and diffuse muscle jerking after abrupt cessation. buprenorphine (administered for suspected kratom withdrawal component) was insufficient; phenobarbital produced significant improvement, and the patient was transitioned to diazepamsupported
45-year-old male with heavy kava and kratom use. Kava withdrawal managed with phenobarbital. Buprenorphine initiated for suspected kratom withdrawal. GABAergic withdrawal from kava also present requiring benzodiazepine/barbiturate management. j.ajem.2025.06.016
Medical supervision is recommended for long-term heavy users, and GABAergic withdrawal protocols (phenobarbital or benzodiazepine) may be indicated in severe cases.supported
Kava withdrawal managed with phenobarbital. GABAergic withdrawal from kava also present requiring benzodiazepine/barbiturate management. j.ajem.2025.06.016
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summary26 · 1 ok

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One case of severe GABAergic withdrawal requiring hospitalization has been documented, though concurrent kratom use confounds attributionsupported
45-year-old male with heavy kava and kratom use. Kava withdrawal managed with phenobarbital. Buprenorphine initiated for suspected kratom withdrawal. GABAergic withdrawal from kava also present requiring benzodiazepine/barbiturate management. j.ajem.2025.06.016
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neuroscience20 · 0 ok

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preparations18 · 0 ok

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history16 · 0 ok

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alkaloid-profile14 · 0 ok

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botanical-overview10 · 0 ok

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3Sources

43 consumed · sorted by year · feeds = sections resting on it

Sources 1 to 30
year	source	tier	status	feeds
2025	Global Perspectives on Kava: A Narrative Systematic Review of the Health Effects, Economic and Social Impacts and Policy ConsiderationsEconomidis G, Lynch M, Taylor S, Asare-Doku W, Macpherson G, Degenhardt L, Farrell M, Santo T · Drug and Alcohol Reviewdoi:10.1111/dar.14080	strong	consumed	cited only
2025	Severe kava withdrawal managed with phenobarbitalBleifuss W, Boley S, Bardwell J, Goebel C, Wilkinson J · American Journal of Emergency Medicinedoi:10.1016/j.ajem.2025.06.016	weak	consumed	2 sections
2024	Evaluation of the Effects of Extracts Containing Valeriana officinalis and Piper methysticum on the Activities of Cytochrome P450 3A and P-GlycoproteinNascimento ML et al. · Planta Medicadoi:10.1055/a-2360-4808	moderate	consumed	1 section
2023	Effect of kava (Piper methysticum) on peripheral gene expression among individuals with generalized anxiety disorderCribb L, Sarris J, Savage KM, et al. · Phytotherapy Researchdoi:10.1002/ptr.7999	strong	consumed	1 section
2023	Neuroimaging Insights: Kava's (Piper methysticum) Effect on Dorsal Anterior Cingulate Cortex GABA in Generalized Anxiety DisorderSavage K, Sarris J, Hughes M, et al. · Nutrientsdoi:10.3390/nu15214586	strong	consumed	1 section
2022	Clinical pharmacokinetics of kavalactones after oral dosing of standardized kava extract in healthy volunteersKanumuri SRR, Mamallapalli J, Nelson R, McCurdy CR, Mathews CA, Xing C, Sharma A · Journal of Ethnopharmacologydoi:10.1016/j.jep.2022.115514	moderate	consumed	2 sections
2021	Biological Activity, Hepatotoxicity, and Structure-Activity Relationship of Kavalactones and Flavokavins, the Two Main Bioactive Components in KavaWang Y, Su C, Zhang B, et al. · Evidence-Based Complementary and Alternative Medicinedoi:10.1155/2021/6851798	moderate	consumed	1 section
2020	Kava as a Clinical Nutrient: Promises and ChallengesBian T, Corral P, Wang Y, Botello J, Kingston R, Daniels T, Salloum RG, Johnston E, Huo Z, Lu J, Liu AC, Xing C · Nutrientsdoi:10.3390/nu12103044	moderate	consumed	6 sections
2020	Kava for generalised anxiety disorder: A 16-week double-blind, randomised, placebo-controlled studySarris J, Byrne GJ, Bousman CA, et al. · Australian and New Zealand Journal of Psychiatrydoi:10.1177/0004867419891246	strong	consumed	4 sections
2020	Kavain Interference with Amphetamine ImmunoassayMadhavaram H, Patel T, Kyle C · Journal of Analytical Toxicologydoi:10.1093/jat/bkaa178	weak	consumed	1 section
2019	Liver transplantation and the use of KAVA: Case reportBecker MW, Lourençone EMS, et al. · Phytomedicinedoi:10.1016/j.phymed.2018.08.011	weak	consumed	1 section
2016	Flavokawain A inhibits Cytochrome P450 in in vitro metabolic and inhibitory investigationsNiu L, Ding L, Lu C, et al. · Journal of Ethnopharmacologydoi:10.1016/j.jep.2016.06.039	moderate	consumed	cited only
2016	Hepatotoxicity Induced by the 3Ks: Kava, Kratom and KhatPantano F, Tittarelli R, Mannocchi G, et al. · International Journal of Molecular Sciencesdoi:10.3390/ijms17040580	strong	consumed	2 sections
2016	Kavain, the Major Constituent of the Anxiolytic Kava Extract, Potentiates GABAA Receptors: Functional Characteristics and Molecular MechanismChua HC, Christensen ET, Hoestgaard-Jensen K, et al. · PloS Onedoi:10.1371/journal.pone.0157700	moderate	consumed	2 sections
2015	German Kava Ban Lifted by Court: The Alleged Hepatotoxicity of Kava (Piper methysticum) as a Case of Ill-Defined Herbal Drug Identity, Lacking Quality Control, and Misguided Regulatory PoliticsKuchta K, Schmidt M, Nahrstedt A · Planta Medicadoi:10.1055/s-0035-1558295	moderate	consumed	1 section
2013	Does a medicinal dose of kava impair driving? A randomized, placebo-controlled, double-blind studySarris J, Laporte E, Scholey A, King R, Pipingas A, Schweitzer I, Stough C · Traffic Injury Preventiondoi:10.1080/15389588.2012.682233	strong	consumed	2 sections
2012	Are mould hepatotoxins responsible for kava hepatotoxicity?Rowe A, Ramzan I · Phytotherapy Researchdoi:10.1002/ptr.4620	moderate	consumed	1 section
2012	Kava hepatotoxicity in traditional and modern use: the presumed Pacific kava paradox hypothesis revisitedTeschke R, Sarris J, Schweitzer I · British Journal of Clinical Pharmacologydoi:10.1111/j.1365-2125.2011.04070.x	moderate	consumed	1 section
2012	The acute effects of kava and oxazepam on anxiety, mood, neurocognition; and genetic correlates: a randomized, placebo-controlled, double-blind studySarris J, Scholey A, Schweitzer I, Bousman C, Laporte E, Ng C, Murray G, Stough C · Human Psychopharmacologydoi:10.1002/hup.2216	strong	consumed	1 section
2011	Constituents in kava extracts potentially involved in hepatotoxicity: a reviewOlsen LR, Grillo MP, Skonberg C · Chemical Research in Toxicologydoi:10.1021/tx100412m	moderate	consumed	3 sections
2011	Kava and kava hepatotoxicity: requirements for novel experimental, ethnobotanical and clinical studies based on a review of the evidenceTeschke R, Qiu SX, Xuan TD, Lebot V · Phytotherapy Researchdoi:10.1002/ptr.3464	moderate	consumed	2 sections
2011	Kava hepatotoxicity solution: A six-point plan for new kava standardizationTeschke R, Sarris J, Lebot V · Phytomedicinedoi:10.1016/j.phymed.2010.10.002	moderate	consumed	3 sections
2011	Kava: a comprehensive review of efficacy, safety, and psychopharmacologySarris J, LaPorte E, Schweitzer I · Australian and New Zealand Journal of Psychiatrydoi:10.3109/00048674.2010.522554	moderate	consumed	3 sections
2011	Re-introduction of kava (Piper methysticum) to the EU: is there a way forward?Sarris J, Teschke R, Stough C, Scholey A, Schweitzer I · Planta Medicadoi:10.1055/s-0030-1250290	moderate	consumed	2 sections
2009	Kava hepatotoxicity: comparison of aqueous, ethanolic, acetonic kava extracts and kava-herbs mixturesTeschke R, Genthner A, Wolff A · Journal of Ethnopharmacologydoi:10.1016/j.jep.2009.03.038	moderate	consumed	cited only
2009	Toxic hepatitis after consumption of traditional kava preparationChristl SU, Seifert A, Seeler D · Journal of Travel Medicinedoi:10.1111/j.1708-8305.2008.00259.x	weak	consumed	1 section
2008	Clinical assessment of CYP2D6-mediated herb-drug interactions in humans: effects of milk thistle, black cohosh, goldenseal, kava kava, St. John's wort, and EchinaceaGurley BJ, Swain A, Hubbard MA, et al. · Molecular Nutrition & Food Researchdoi:10.1002/mnfr.200600300	strong	consumed	cited only
2008	Kava hepatotoxicity: a clinical survey and critical analysis of 26 suspected casesTeschke R, Schwarzenboeck A, Hennermann KH · European Journal of Gastroenterology & Hepatologydoi:10.1097/meg.0b013e3283036768	moderate	consumed	cited only
2008	Supplementation with goldenseal, but not kava kava, inhibits human CYP3A activity in vivoGurley BJ, Swain A, Hubbard MA, et al. · Clinical Pharmacology and Therapeuticspmid:17495878	strong	consumed	2 sections
2007	Effect of goldenseal and kava kava supplementation on digoxin pharmacokinetics in humansGurley BJ, Swain A, Barone GW, et al. · Drug Metabolism and Dispositionpmid:17079360	strong	consumed	1 section

Show all 47 sources — 17 more

Sources 31 to 47
year	source	tier	status	feeds
2006	In vitro cytotoxicity of nonpolar constituents from different parts of kava plantJhoo JW, Freeman JP, Heinze TM, et al. · Journal of Agricultural and Food Chemistrypmid:16608246	moderate	consumed	2 sections
2005	In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypesGurley BJ, Gardner SF, Hubbard MA, et al. · Clinical Pharmacology and Therapeuticspmid:15900287	strong	consumed	cited only
2005	Meta-analysis of the efficacy of the acetonic kava-kava extract WS1490 in patients with non-psychotic anxiety disordersWitte S, Loew D, Gaus W · Phytotherapy Researchpmid:15934028	strong	consumed	1 section
2005	Pharmacokinetics and disposition of the kavalactone kawain: interaction with kava extract and kavalactones in vivo and in vitroMathews JM, Etheridge AS, Valentine JL, et al. · Drug Metabolism and Dispositionpmid:16033948	moderate	consumed	2 sections
2005	Potential for interaction of kava and St. John's wort with drugsSingh YN · Journal of Ethnopharmacologypmid:16005588	moderate	consumed	1 section
2004	In vitro toxicity of kava alkaloid, pipermethystine, in HepG2 cells compared to kavalactonesNerurkar PV, Dragull K, Tang CS · Toxicological Sciencespmid:14737001	moderate	consumed	3 sections
2003	Acute hepatitis induced by kava kavaHumberston CL, Akhtar J, Krenzelok EP · Journal of Toxicology: Clinical Toxicologypmid:12733846	weak	consumed	cited only
2002	Kava extract for treating anxiety (Cochrane review)Pittler MH, Ernst E · Cochrane Database of Systematic Reviewspmid:12076477	strong	consumed	2 sections
2002	Therapeutic potential of kava in the treatment of anxiety disordersSingh YN, Singh NN · CNS Drugspmid:12383029	moderate	consumed	4 sections
2001	Kava Hepatotoxicity (letter)Russmann S, Lauterburg BH, Helbling A · Annals of Internal Medicinedoi:10.7326/0003-4819-135-1-200107030-00036	weak	consumed	2 sections
2000	Efficacy of kava extract for treating anxiety: systematic review and meta-analysisPittler MH, Ernst E · Journal of Clinical Psychopharmacologypmid:10653213	strong	consumed	2 sections
1997	Effects of kawain and dihydromethysticin on field potential changes in the hippocampusWalden J, von Wegerer J, Winter U, Berger M, Grunze H · Progress in Neuro-Psychopharmacology & Biological Psychiatrypmid:9194150	moderate	consumed	1 section
1996	Coma from the health food store: interaction between kava and alprazolamAlmeida JC, Grimsley EW · Annals of Internal Medicinepmid:8967683	weak	consumed	2 sections
—	Searched PubMed for "kava ethnobotany traditional use Pacific Island history" — no resultsabsence		no results	—
—	Searched PubMed for "kava kavalactone pharmacokinetics bioavailability absorption metabolism" — no resultsabsence		no results	—
—	Searched PubMed for "kavalactone kavapyrone chemical constituents concentration HPLC" — no resultsabsence		no results	—
—	Searched PubMed for "Piper methysticum kava taxonomy botanical identity" — no resultsabsence		no results	—

4Docket

one filing per activity — decisions, correspondence, reports

awaiting ruling — 1

dependence · taper2026-07-03

0012026-03-17importImported from Curiosity v1
imported 2026-03; original sourcing not recoverable
psx:substance/kava/import/curiosity-v1
0022026-03-17publicationPublication — backfill
psx:substance/kava/pub/34839bb8-1d19-4413-b8c5-754534b5becb
0032026-03-17revisionRevision 1
no edit summary recorded
psx:substance/kava/version/1
0042026-05-13revisionRevision 2
Initial LLM generation (plant pipeline v1, wiki, prose phase)
psx:substance/kava/version/2
0052026-06-04proposal17 value proposals approved together
one review action inferred from a shared reviewer and instant — the graph records one activity per proposal
17 items in this filing
- contraindication · hepatic
- contraindication · other
- contraindication · pregnancy_breastfeeding
- contraindication · age
- contraindication · metabolic
- contraindication · other
- contraindication · other
- dose_tier · threshold
- dose_tier · light
- dose_tier · common
- dose_tier · strong
- dose_tier · heavy
- toxicity
- dependence · full
- withdrawal
- tolerance
psx:substance/kava/proposal/contraindication/ba204661-37cd-4c09-b3a9-d1314b6d4e6e
0062026-06-04publicationPublication — backfill
psx:substance/kava/pub/e9efb35c-74ef-46cc-94d8-2f1c0bee216e

5Issued documents

what the notice, info card and emergency page said, by hash

Issued documents
document	content hash	issued	from version	superseded
info_card	300c35280892a317a7aabbc8…	2026-10-19 20:32	Revision 2	current
emergency	777b5863d801327b008f5610…	2026-09-04 04:30	Revision 2	current
info_card	7a366c971d01070613447893…	2026-09-04 04:30	Revision 2	superseded2026-10-19
notice	ed1c6ba5a7707ef46116693b…	2026-09-04 04:30	Revision 2	current

Kava

6Node page

derived from · upstream

feeds · downstream

1Provenance card

2Build

generation run 2026-05-13

research→

draft→

audit→

verify→

simplify→

publish

Selection

Verification

The model's own caveats

Reproduce

3Sources

4Docket

awaiting ruling — 1

5Issued documents

research

draft

audit

verify

simplify