Khat, a Cultural Chewing Drug: A Toxicokinetic and Toxicodynamic Summary

Abstract

Khat (Catha edulis) is a recreational, chewed herbal drug that has been used as a psychostimulant for centuries in East Africa and the Arabian Peninsula, namely in Somalia, Ethiopia, and Yemen. However, the growing worldwide availability of khat has produced widespread concern. The plant comprises a large number of active substances, among which cathinone, cathine, and norephedrine are the main constituents, which can be included in the group of sympathomimetics of natural origin. In fact, these compounds are amphetamine analogues, and, as such, they have amphetamine-like nervous system stimulant effects. Chewing the leaves gives people a sensation of well-being and increases energy, alertness, and self-confidence. The chronic use of khat is, however, associated with severe cardiac, neurological, psychological, and gastrointestinal complications. The psychological dependence and withdrawal symptoms of khat are the reasons for its prolonged use. The aim of this paper is to review current knowledge on the khat plant with toxicokinetic and toxicodynamic perspectives. Namely, this review paper addresses in vitro, in vivo, and human studies. The models used, as well as the concentrations and doses with the respective biological effects, are discussed. Additionally, the main drug interactions involved with khat are described.

Prevalence and Correlates of Anemia among Adolescents Living in Hodeida, Yemen

“…Khat chewing was also found to be an independent predictor of anemia in our study population. Because of its amphetamine-like stimulant effects [ 48 ], khat chewing has become an epidemic in Yemen, and a common practice among high school, college, and university students [ 40 , 49 ]. Previous studies have reported on the association between khat chewing and anemia, which could be explained by its potential impact on appetite [ 50 ].…”

“…In addition, khat contains a substantial amount of tannins, which can reduce the bioavailability of non-heme iron from plant-based foods, which represent the basis of the population’s diet in Yemen [ 55 , 56 ]. The WHO reported that khat chewing may cause dependency [ 57 , 58 , 59 , 60 , 61 ], while predisposing chewers to an array of serious medical conditions [ 48 ]. Raising awareness about the adverse health impacts of khat chewing, and the provision of medical and nutritional management that targets khat chewers, are important points for the prevention of undernutrition and anemia among adolescents in Yemen.…”

Identification of predictive factors for surgical site infections in gastrointestinal surgeries: A retrospective cross-sectional study in a resource-limited setting

“…24 Furthermore, long-term Khat consumption poses a risk of developing severe complications including hepatitis, hepatic fibrosis, and cirrhosis in advanced stages. 25 Future prospective and more inclusive studies are recommended to investigate this issue, particularly in our country where the traditional use of these plants is widespread.…”

Natural Sympathomimetic Drugs: From Pharmacology to Toxicology

“…Other recent works even in our group reviewed both Khat and synthetic cathinones [ 157 , 187 ] are worth looking for further and more detailed information.…”