Coma from the Health Food Store: Interaction between Kava and Alprazolam

Letters1 December 1996Coma from the Health Food Store: Interaction between Kava and AlprazolamJoenie C. Almeida, MD and Edwin W. Grimsley, MDJoenie C. Almeida, MDMemorial Medical Center, Savannab, GA 31403. and Edwin W. Grimsley, MDMemorial Medical Center, Savannab, GA 31403.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-11-199612010-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Millions of Americans use drugs sold in health food stores, yet most of these agents are unregulated. The potential for drug interactions is great. We report an interaction between kava and alprazolam that caused a semicomatose state.A 54-year-old man was hospitalized at our center in a lethargic and disoriented state. His medications included alprazolam, cimetidine, and terazosin. His vital signs and results of laboratory studies were normal. His alcohol level was negative, and a drug screen was positive for benzodiazepines. He became more alert after several hours and stated that he had been taking a “natural ...References1. Singh YN. Kava: an overview. J Ethnopharmacol. 1992; 37:13-45. Google Scholar2. Schelosky L, Raffauf C, Jendroska K, Poewe W. Kava and dopamine antagonism [Letter]. J Neurol Neurosurg Psychiatry. 1995; 58:639-40. Google Scholar3. Davies LP, Drew CA, Duffield P, Johnston GA, Jamieson DD. Kava pyrones and resin: studies on GABAA, GABAB and benzodiazepine binding sites in rodent brain. Pharmacol Toxicol. 1992; 71:120-6. Google Scholar4. Jussofie A, Schmiz A, Hiemke C. Kavapyrone enriched extract from Piper methysticum as modulator of GABA binding site in different regions of rat brain. Psychopharmacology (Berlin). 1994; 116:469-74. Google Scholar Author, Article, and Disclosure InformationAuthors: Joenie C. Almeida, MD; Edwin W. Grimsley, MDAffiliations: Memorial Medical Center, Savannab, GA 31403. 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