Related Terms

• Abyssinian tea, African salad, Arabian-tea, bushman's tea, cat, cathine, cathinone, Catha edulis, Celastraceae (family), Celastrus edulis, chat, chaat (Arabic), gat (Arabic), herbal ecstasy, kat (Arabic), kus es Salahin (Arabic), miraa, oat, phenylpropanolamine, qat (Yemen), qut, somali tea, tchaad (Arabic), tohai (Arabic), tohat (Arabic), tshcut (Arabic).

Background

• Khat is believed to have originated in Ethiopia. It is a flowering evergreen plant native to tropical East Africa. Khat has been grown for use as a stimulant for centuries and predates the use of coffee.

• Khat is an agent that has been used in social settings to induce feelings of euphoria and pleasure. Medicinally, it has been used to treat depression and to enhance work capacity. Khat has also been used as an aphrodisiac, to treat premature ejaculation, and to enhance sexual desire.

• Currently, there are no well-designed clinical trials evaluating khat for any indication. Two poorly documented trials evaluated khat in cognitive function. One study revealed no difference in cognitive function in the elderly with khat use. In the other study, cognitive functioning was negatively affected by khat use.

• Fresh khat leaves contain cathinone - a Schedule I drug under the Controlled Substances Act; however, the leaves typically begin to deteriorate after 48 hours, causing the chemical composition of the plant to break down. Once this occurs, the leaves contain cathine, a Schedule IV drug. Khat is currently illegal in the United States.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Appetite suppressant, depression, gastric ulcers, fatigue, male infertility, obesity, physical work capacity, premature ejaculation, sexual activity enhancement, stimulant.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old)

• There is no proven safe or effective dose for khat. However, approximately 100-200 grams of fresh leaves have been chewed, one at a time for their stimulant effects. The juice can be swallowed while the residue is retained in the cheek and later expelled. A juice has also been made by blending khat with water and lemon and then filtering the mixture. A tincture can be made by alcohol extraction of the active ingredients.

Children (under 18 years old)

• There is no proven safe or effective dose for khat in children, and use in not recommended.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Avoid in individuals with a known allergy or hypersensitivity to Cathus edulis or members of the Celastraceae family.

Side Effects and Warnings

• Fresh khat leaves contain cathinone - a Schedule I drug under the Controlled Substances Act; however, the leaves typically begin to deteriorate after 48 hours, causing the chemical composition of the plant to break down. Once this occurs, the leaves contain cathine, a Schedule IV drug, which is similar in structure to amphetamine.

• The stimulatory effect associated with khat has been documented with delusions, paranoia, hypomania, mood swings, depression, irritability, insomnia, and increased alertness. There have also been reports of persistent hypnagogic hallucinations caused by khat use.

• Khat may cause nervousness, nightmares, aggressiveness, excitement, talkativeness, manic behavior, and hyperactivity. Khat chewing has dependency potential and may lead to dependence and addiction. Avoid using in patients with psychotic personalities. Use cautiously in patients with motor tics and Tourette's syndrome. Theoretically, khat may exacerbate motor tics and Tourette's syndrome. Khat is currently illegal in the United States.

• Although not well studied in humans, khat may increase respiratory rates, increase systolic and diastolic blood pressure and heart rate, or cause acute myocardial infarction (heart attack). Other reported side effects include gastritis (stomach inflammation), malnutrition, hemorrhoidal disease, constipation, and oral carcinoma. Avoid holding khat in the cheek for extended periods of time to avoid oral infection.

• Use cautiously in patients with hypertension (high blood pressure), tachycardia (fast heart rates), or cardiovascular disease because khat may increase blood pressure and heart rate. Khat should also be used cautiously in patients taking antihypertensives (blood pressuring lowering agents). Theoretically, khat may antagonize the effects of these drugs.

• Fasciola hepatica infection, a parasite infection, has been reported after the chewing of khat leaves. Loss of appetite and anorexia has also been noted.

• Methcathinone, a methyl derivative of cathinone, has been reported to cause mydriasis (dilation of the pupil).

• Use cautiously in patients taking stimulant drugs or herbs. Increased stimulant effects may occur. Avoid driving after khat use; there are reports of impaired driving and psychophysical function. Avoid using in patients with glaucoma.

Pregnancy and Breastfeeding

• Khat is not recommended for use in pregnant or breastfeeding women due to possible reductions in birth weight, birth defects and breastfeeding inhibition.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• Use khat cautiously in patients taking amoxicillin or ampicillin. Khat may reduce the effectiveness of these drugs. These two antibiotics, particularly ampicillin, should be taken two hours after khat chewing.

• Sympathomimetic effects of khat such as mydriasis (dilation of the pupil) and hypertension (high blood pressure) may be antagonized by antiadrenergic drugs including clonidine, reserpine, or terazosin.

• Theoretically, khat may antagonize the effects of heart medications or blood pressure lowering agents. Khat has been reported to cause an increase in systolic and diastolic blood pressure and heart rate.

• Use cautiously in patients taking beta-blockers or tricyclic antidepressants. Theoretically, khat may increase the risk of cardiovascular side effects with these drugs.

• Khat may cause central nervous system (CNS) stimulation and use with other CNS stimulants may lead to additive effects. Stimulant and amphetamine-like effects are likely due to the phenylalkylamine alkaloid cathinone.

• Theoretically, concurrent use of khat with monoamine oxidase inhibitors may cause hypertensive (high blood pressure) crisis.

Interactions with Herbs and Dietary Supplements

• Khat may antagonize the effects of antihypertensive (blood pressure lowering) herbs and supplements. Khat has been reported to cause an increase in systolic and diastolic blood pressure and heart rate. Caution is advised.

• Theoretically, concurrent use of khat with herbs with monoamine oxidase inhibitor-like activity may cause hypertensive (high blood pressure) crisis.

• Theoretically, khat may increase the stimulant effects if taken with stimulant herbs and supplements, such as guarana or ephedra.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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