How does khat work in the body to produce its effects?

Khat contains cathinone and cathine, alkaloids structurally similar to amphetamine. These compounds function as central nervous system stimulants by promoting the release of dopamine and norepinephrine while inhibiting their reuptake in the brain. This mechanism accounts for the increased alertness, euphoria, and appetite suppression reported by users. Evidence Level: C.

Can you chew khat while pregnant or breastfeeding?

No, khat is unsafe during pregnancy and breastfeeding. The active stimulant compounds cross the placental barrier and are associated with reduced fetal growth and low birth weight. Use during pregnancy may also increase the risk of complications. Nursing mothers should avoid khat as stimulants can pass into breast milk, potentially affecting the infant. Evidence Level: C.

What are the dangerous drug interactions with khat?

Khat poses significant interaction risks, particularly with MAO inhibitors, which can lead to a hypertensive crisis. Combining khat with other stimulants or caffeine increases cardiovascular strain and the risk of arrhythmia. It may also antagonize the effects of antipsychotic medications and increase liver toxicity when combined with hepatotoxic drugs. Evidence Level: C.

How much khat do people traditionally chew?

As a controlled substance in many jurisdictions, there is no standardized medical dosage. Traditional use typically involves chewing between 100g to 500g of fresh leaves over a session lasting several hours. The leaves are usually chewed slowly to release the active alkaloids, which are then absorbed through the oral mucosa. Evidence Level: Traditional.

What are the long-term health risks of khat use?

Chronic khat use carries serious health risks, including psychological dependency and psychosis. Physical side effects include chronic insomnia, severe constipation, and anorexia. Long-term chewing is strongly linked to oral cancer and periodontal disease due to mechanical irritation and chemical exposure. Individuals with heart disease or hypertension face elevated cardiovascular risks. Evidence Level: C.

Khat (Catha edulis)

PubMed-compiled information sheet

This sheet was compiled from PubMed (NIH) abstracts using AI assistance. Every factual claim is cited to a real PubMed article (see the source list). It has not yet been human-reviewed — confirm with a healthcare provider before use.

Compiled from 29 PubMed articles · model: gemma4:31b

Summary

Khat (Catha edulis) is a psychostimulant shrub native to East Africa and the Arabian Peninsula, chewed for its euphoria-inducing and stimulant effects [PMID:31644017, PMID:35202099].

Background

Khat is an evergreen shrub (Catha edulis Forsk) native to parts of East Africa and the Arabian Peninsula [PMID:31644017]. It is widely used as a recreational and socializing drug, and its use has increased in Europe and North America due to global migration [PMID:18561890, PMID:19132030].

Traditional uses

Chewing the fresh leaves and twigs is a well-established social habit used for psychostimulatory effects, mild euphoria, and to increase alertness and self-confidence [PMID:31644017, PMID:35202099]. In Yemen, it is also used by some diabetics in the belief that it can control elevated blood glucose levels [PMID:27025406].

Active compounds

The main active compound is cathinone [PMID:31644017]. Other primary constituents include cathine and norephedrine [PMID:35202099, PMID:19921126].

Mechanism of action

Khat exerts amphetamine-like effects mediated through the dopaminergic system [PMID:26469212]. Its alkaloids act as sympathomimetics of natural origin [PMID:35202099].

Clinical evidence

Evidence AOral Health

Khat chewing is associated with periodontal disease, oral leukoplakia, keratotic white lesions, and a risk of oral squamous cell carcinoma [PMID:19132030, PMID:29167719, PMID:28834423, PMID:32334447].

Evidence APsychiatric Symptoms

Use is associated with psychosis and adverse psychiatric effects [PMID:35879018, PMID:17929229, PMID:30717743].

Evidence DCardiovascular Health

Consumption is associated with increased arterial blood pressure, pulse rate, stroke, myocardial infarction, and cardiomyopathy [PMID:19921126, PMID:30717743, PMID:39635665].

Evidence AReproductive Health

Khat consumption significantly reduces semen volume [PMID:39092911].

Evidence CLiver Health

Khat chewing has been implicated in rare but serious acute and chronic liver injury and causes significant enlargement of hepatic mitochondria [PMID:31644017, PMID:23816893].

Safety & adverse effects

Adverse effects include appetite suppression, low mood following euphoria, gastrointestinal complications, and potential cytotoxicity in cultured cells [PMID:19921126, PMID:28557133, PMID:34926848]. Chronic use is linked to severe cardiac, neurological, and psychological complications [PMID:35202099].

Pregnancy & lactation

Women who use khat during pregnancy have a significantly higher chance of having low birth weight (LBW) [PMID:39092911].

Drug interactions

Concurrent consumption of khat and cannabinoids may increase the risk of precipitating or obtaining psychosis [PMID:26469212].

Evidence summary

Evidence ranges from high-strength systematic reviews and meta-analyses regarding oral health, psychiatric symptoms, and reproductive effects, to lower-strength case reports and reviews for cardiovascular and hepatic effects.

PubMed sources

1.PMID: 31644017 (2012) — Khat (Catha edulis Forsk) - And now there are three. · CITED REFERENCE
2.PMID: 36508190 (2024) — Epidemiology of Khat (Catha edulis) Chewing in Ethiopia: A Systematic Review and meta-analysis. · Journal of psychoactive drugs
3.PMID: 34926848 (2021) — Khat (Catha Edulis Forsk) induced apoptosis and cytotoxicity in cultured cells: A scoping review. · Heliyon
4.PMID: 19132030 (2009) — Qat and its health effects. · British dental journal
5.PMID: 23816893 (2013) — [Khat (Catha edulis): is it "coffee" or "cocaine"?]. · Orvosi hetilap

Khat

Sources & Citations

Eleutherococcus Giraldii

Ocotillo

Acanthopanax Sessiliflorus

Summary

Background

Traditional uses

Active compounds

Mechanism of action

Clinical evidence

Safety & adverse effects

Pregnancy & lactation

Drug interactions

Evidence summary

PubMed sources

Government sources

Khat

Sources & Citations

Related Herbs

Eleutherococcus Giraldii

Ocotillo

Acanthopanax Sessiliflorus

Summary

Background

Traditional uses

Active compounds

Mechanism of action

Clinical evidence

Safety & adverse effects

Pregnancy & lactation

Drug interactions

Evidence summary

PubMed sources

Government sources