Archive for category Kava kava'

Kava Kava (Piper methysticum)

Kava Kava: Medical Uses Kava kava is used to improve mental function and for anxiety disorders, hot flashes, and anxiety and mild depression associated with menopause. Historical Uses Kava comes from a Greek word meaning “intoxicating.” The herb has been used in Polynesian countries to make a ceremonial drink. Growth This tropical, perennial shrub is a member of the pepper family and is native to Oceania. Part Used • Root Major Chemical Compound • Kavalactones Kava Kava: Clinical Uses Kava kava is used to improve mental function and for nonpsychotic anxiety disorders, hot flashes, and anxiety and mild depression associated with menopause. It is approved by the German Commission E for “anxiety, stress, and restlessness”. Mechanism of Action Kava kava has sedative, analgesic, anticonvulsant, and muscle relaxant effects and acts on the limbic system. Its action is different from that of aspirin, morphine, and benzo-diazepines. Little information is currently available on kavalactones. For anxiety: Standardized extract: 70 mg kavalactones two to three times daily. Capsules or tablets: 400 to 500 mg up to six times daily. Tincture (1:2): 15 to 30 drops up to three times daily. Tincture drops Read more […]

Kava Kava: Contraindications and Precautions. FAQ

Endogenous depression — according to Commission E. Although clinical studies indicate no adverse effects on vigilance, the herb’s CNS effects may slow some individuals’ reaction times, thereby affecting ability to drive a car or operate heavy machinery. Additionally, it should not be used by people with pre-existing liver disease and long-term continuous use should be avoided unless under medical supervision. It should be used with caution in the elderly and in those with Parkinson’s disease. Pregnancy Use Not recommended for use in pregnancy. Practice Points / Patient Counselling Kava kava is a scientifically proven treatment for the symptoms of anxiety and stress states. Its anxiety-reducing effects are similar to those of 15 mg oxazepam or 9 mg bromazepam, yet physical tolerance and reduced vigilance have not been observed. It also reduces symptoms of anxiety related to menopause when used together with HRT, and reduces withdrawal symptoms associated with benzodiazepine discontinuation. It has anxiolytic, sedative, antispasmodic, analgesic and local anaesthetic activity. Although the herb is considered to have a low incidence of adverse effects, long-term use should be carefully supervised because Read more […]

Kava Kava: Significant Interactions

ALCOHOL Potentiation of CNS sedative effects has been reported in an animal study; however, one double-blind placebo-controlled study found no additive effects on CNS depression or safety related performance. Alternatively, a study of 10 subjects found that when alcohol and kava were combined, kava potentiated both the perceived and measured impairment compared to alcohol alone. Caution. BARBITURATES Additive effects are theoretically possible. Use with caution and monitor drug dosage. However, interaction may be beneficial under professional supervision. BENZODIAZEPINES Additive effects are theoretically possible. Use with caution and monitor drug dosage. However, interaction may be beneficial under professional supervision. The combination has been used successfully to ease symptoms of benzodiazepine withdrawal. L-DOPA MEDICATION Antagonistic effects are theoretically possible, thereby reducing the effectiveness of L-dopa. Avoid concurrent use unless under professional supervision. METHADONE AND MORPHINE Additive effects with increased CNS depression are theoretically possible, so use with caution, although interactions may be beneficial under professional supervision. SUBSTRATES FOR CYP3A4 Although Read more […]

Kava Kava: Adverse Reactions

In RCT, the incidence of adverse effects to kava kava has been found to be similar to placebo. Two post-marketing surveillance studies involving more than 6000 patients found adverse effects in 2.3% and 1.5% of patients taking 120-240 mg standardised extract. The most common side-effects appear to be gastrointestinal upset and headaches. HEPATOTOXICITY A systematic review assessing the safety of kava which included a total of 7078 patients taking kava extract equivalent to 10 mg to 240 mg kavalactones per day for 5-7 weeks identified no cases of hepatotoxicity. Considering that case reports of hepatotoxicity exist, they should be considered a very rare event based on the evidence. LONG-TERM USE Most adverse effects, such as yellow discolouration of the skin, hair and nails, have been associated with excessive long-term use. This temporary condition is known as ‘kava dermopathy’ and reverses once kava use is discontinued. A 2003 report found no evidence of brain dysfunction in heavy and long-term kava users. Clinical note Commercial kava products and links to hepatotoxicity Conflicting reports abound. On 15 August 2002, the TGA initiated a voluntary recall of all products containing kava kava. The response was Read more […]

Kava Kava: Clinical Use. Dosage

Kava extracts are popular in Europe and have been investigated in numerous clinical trials, primarily in European countries. As a result, many research papers have been published in languages other than English. In order to provide a more complete description of the evidence available, secondary sources have been used where necessary. NERVOUS ANXIETY A 2000 Cochrane review of the scientific literature assessed the results from seven, double-blind, randomised placebo-controlled trials and concluded that kava extract has significant anxiolytic activity and is superior to placebo for the symptomatic treatment of anxiety. An update of this review was published in 2003 and analysed results from 12 clinical studies involving 700 subjects. The results of 7 studies that used the Hamilton Anxiety Scale (HAM-A) score were pooled and a significant reduction in anxiety was observed for kava treatment compared with placebo. The results of the five studies that were not submitted to meta-analysis largely support these findings. The extract most commonly tested was WS 1490 at a dose of up to 300 mg daily. Preliminary evidence suggests it may be equivalent to benzodiazepines for non-psychotic anxiety. Safety According to the authors Read more […]

Kava Kava: Background. Actions

Common Name Kava kava Other Names Kawa, awa, intoxicating pepper, rauschpfeffer, sakau, tonga, yagona Botanical Name / Family Piper methysticum (family Piperaceae) Plant Parts Used Root and rhizome Chemical Components The most important constituents responsible for the pharmacological activity of kava rhizome are the fat-soluble kava lactones (kavapyrones), mainly methysticin, dihydromethisticin, kavain, dihydrokavain and desmethoxyangonin and flavonoids (flavokavains). Historical Note For many centuries, Pacific Islanders have used the kava kava root to prepare a beverage used in welcoming ceremonies for important visitors. Drinking kava is not only done to induce pleasant mental states but also to reduce anxiety and promote socialising. It is believed that the first report about kava came to the West from Captain James Cook during his voyages through the Pacific region. Kava Kava: Main Actions CNS EFFECTS The kava lactones reach a large number of targets that influence CNS activity. They interact with dopaminergic, serotonergic, GABA-ergic and glutamatergic neurotransmission, seem to inhibit monoamine oxidase B and exert multiple effects on ion channels, according to in vitro and in vivo research. Read more […]