Which herb is psychoactive and linked to liver toxicity?

• A. Milk thistle
• B. Kava-kava
• C. Ginseng
• D. Goldenseal

Answer: (B)

Psychoactive effects combined with a notable risk of liver injury point to kava-kava. Its active compounds, kavalactones, produce sedation and anxiolysis, altering mental state. At times, use of kava-kava has been linked to serious liver injury, including hepatitis and liver failure, especially with long-term use, high-dose extracts, or concurrent alcohol use or existing liver disease. In older adults, this risk is especially worrisome due to age-related changes in liver function and potential interactions with other medications. Milk thistle supports liver health but is not psychoactive and isn’t primarily associated with liver toxicity. Ginseng isn’t psychoactive and isn’t a classic hepatotoxic concern, and goldenseal isn’t psychoactive either. Therefore, the herb that is both psychoactive and linked to liver toxicity is kava-kava.