Hepatitis associated with Kava, a herbal remedy for anxiety

Kava, the rhizome of the pepper plant Piper methysticum , has been widely used in the South Pacific as a narcotic drink. Lactones, the major constituents of kava, are considered to be pharmacologically active and are sold in Europe and the United States as standardised extracts for anxiety and tension. A 50 year old man presented to his doctor because of jaundice. He had noticed fatigue for a month, a “tanned” skin, and dark urine. The medical history was unremarkable …