Kava Kava for relaxation and reduction of anxiety

What is Kava?
Kava is the term used for both the plant and the beverage made from it. The beverage is prepared from the root of a shrub called the pepper plant, Piper methysticum, found in Polynesia, Melanesia, and Micronesia. The kava root is ground to a powder, and it has a brownish color. The brownish powder is then mixed with water and drank as a beverage, without being fermented. Extracts from the kava root are now placed in capsules and sold as kava or kava kava. For more kava information by herbal expert Ray Sahelian, M.D.

Alternatives to Kava - Supplements that may be useful for anxiety
5-HTP  works by increasing levels of serotonin. You can buy 5-HTP here.
Valerian is able to reduce anxiety in some people.
Theanine may be helpful in some people at a dosage of 100 or 200 mg when used at night.

Click here to buy Kava Kava product

Side Effects of Kava
Tiredness and decreased sex drive or sensation have been reported with frequent use. If you have a lowered libido from kava use, or for other reasons, consider a new product called Passion Rx. Rare cases of liver damage has occurred with the intake of kava. Those who take Tylenol or statin drugs, or who drink more than one glass of alcohol a few times a week should not take kava.

Kava and liver
Most studies show regular kava use can harm the liver. This study does not show kava kava damages liver tissue.

Kava feeding in rats does not cause liver injury nor enhance galactosamine-induced hepatitis.
Food Chem Toxicol. 2007 July. DiSilvestro RA, Zhang W, DiSilvestro DJ. Human Nutrition, The Ohio State University, 345 Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210-1295, United States.
Kava, like a number of herbals, has been associated with causing liver damage based on limited evidence. In contrast, the present study found that in rats, 3 months feedings of two types of kava extracts (an acetone extract and an ethanol extract of the Samoan kava cultivar Ava Laau) at three different doses (31.25, 62.5 and 133 mg/kg diet) produced no liver injury based on serum markers of liver damage (sorbitol dehydrogenase activities, bile acid concentrations, and beta-glucuronidase activities) and serum lipid peroxide readings. In fact, for some measurements and some kava doses, the injury marker readings were below control values. Moreover, for these same parameters, kava feeding did not enhance the effects of the hepatotoxin galacatosamine; some kava doses even showed modest protection against liver injury. Liver histology analysis showed no signs of kava causing or enhancing liver injury. Thus, this study does not support the concept that kava produces or aggravates liver injury.

What's in Kava?
As with any herbal medicine, a number of compounds contribute to its medical effects. The active compounds are concentrated in the root of the plant. Kava kava contains a variety of chemicals known as pyrones or kavalactones. Specific names of these kavalactones include kawain, methysticin, and yangonin.
   The water-soluble extract of kava contains different compounds than the fat-soluble extract. The central nervous activity of the water-soluble extract was determined in mice to have mild pain-killing ability, but did not induce sleep (Jamieson, 1989). The fat-soluble extract had sleep inducing and marked pain-killing properties. The researchers state, "The pharmacological effects of kava ingestion appear to be due to the activity of the compounds present in the fat-soluble fraction."
   Many of the studies done with kava used a standardized extract, called WS 1490, from a German manufacturer. The kava products you find over the counter will contain the active ingredients.

Kava in generalized anxiety disorder
Kava in generalized anxiety disorder: three placebo-controlled trials.
Int Clin Psychopharmacol. 2006 Sep;21(5):249-53. Connor KM, Payne V, Davidson JR.
Duke University Medical Center, Durham, North Carolina Private Practice, Pelican Rapids, Minnesota, USA.
In this study, we evaluated the efficacy and safety of kava kava (Piper methysticum) in generalized anxiety disorder. Data were analyzed from three randomized, double-blind, placebo-controlled trials of kava, including one study with an active comparator (venlafaxine), in adult outpatients with DSM-IV generalized anxiety disorder. The pooled sample (n=64) included the following number of participants: kava, n=28; placebo, n=30; and venlafaxine, n=6. Given the comparability of the study designs, the data comparing kava and placebo were then pooled for further efficacy and safety analyses. No significant differences were observed between the treatment groups in any of the trials. In the pooled analyses, no effects were found for kava, while a significant effect in favor of placebo was observed in participants with higher anxiety at baseline. No evidence of hepatotoxicity was found with kava, and all of the treatments were well tolerated. Findings from these three controlled trials do not support the use of kava in DSM-IV generalized anxiety disorder.

Kava Research Update
Treatment of anxiety, tension and restlessness states with Kava special extract WS 1490 in general practice: a randomized placebo-controlled double-blind multicenter trial.
Gastpar M, Klimm HD. Rheinische Kliniken, Essen, Germany.
Phytomedicine. 2003 Nov;10(8):631-9.
The efficacy and tolerability of 150 mg/d Kava special extract WS 1490 were investigated in a randomized, placebo-controlled, double-blind multicenter study in patients suffering from neurotic anxiety (DSM-III-R diagnoses 300.02, 300.22, 300.23, 300.29, or 309.24). 141 adult, male and female out-patients received 3 x 1 capsule of 50 mg/d WS 1490 or placebo for four weeks, followed by two weeks of observation without study-specific treatment. During randomized treatment the total score of the Anxiety Status Inventory (ASI) observer rating scale showed more pronounced decreases in the WS 1490 group than in the placebo group. Although a treatment group comparison of the post-treatment ASI scores was not significant (p > 0.05), an exploratory analysis of variance across the differences between treatment end and baseline, with center as a second factor, showed superiority of the herbal extract over placebo (p < 0.01, two-sided). 73% of the patients treated with WS 1490 exhibited ASI score decreases > 5 points versus baseline, compared to 56% for placebo. Significant advantages for WS 1490 were also evident in a structured well-being self-rating scale (Bf-S) and the Clinical Global Impressions (CGI), while the Erlangen Anxiety, Tension and Aggression Scale (EAAS) and the Brief Test of Personality Structure (KEPS) showed only minor treatment group differences. Although the results show consistent advantages for WS 1490 over placebo in several psychiatric scales and indicate significant improvements in the patients' general well-being, the differences versus placebo were not as large as in previous trials which employed 300 mg/d of the same extract. WS 1490 was well tolerated, with no influence on liver function tests and only one trivial adverse event (tiredness) attributable to the study drug.

Kava kava extract LI 150 is as effective as Opipramol and Buspirone in Generalised Anxiety Disorder--an 8-week randomized, double-blind multi-centre clinical trial in 129 out-patients.
Boerner RJ,. Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany.
Phytomedicine. 2003;10 Suppl 4:38-49.
An 8-week randomized, reference-controlled, double-blind, multi-centre clinical trial investigated Kava-Kava LI 150 in Generalized Anxiety Disorder (GAD; ICD-10: F41.1). METHOD: 129 out-patients received either 400 mg Kava LI 150, 10 mg Buspirone or 100 mg Opipramol daily for 8 weeks. At week 9, subjects were seen to check for symptoms of withdrawal or relapse. Primary outcome measures comprised the HAMA scale and the proportion of responders at week 8. Secondary measures were the Boerner Anxiety Scale (BOEAS), SAS, CGI, a self-rating scale for well-being (Bf-S), a sleep questionnaire (SF-B), a quality-of-life questionnaire (AL) and global judgements by investigator and patients. RESULTS: In 127 patients (ITT) no significant differences could be observed regarding all efficacy and safety measures. About 75% of patients were classified as responders (50% reduction of HAMA score) in each treatment group, about 60% achieved full remission. CONCLUSION: Kava-Kava LI150 is well tolerated and as effective as Buspirone and Opipramol in the acute treatment of out-patients suffering from GAD.

Kava questions

Q. I am presently taking oxycontin prescribed by my doctor for leg and back pain from failed back surgery and nerve damage. Can I take the Kava while taking the Oxy or can I take the Kava to help with withdrawals while I try to cut back on the Oxy?
     A. Kava should not be taken the same day as oxycontin or other pain meds, liver harm is a concern, especially with the use of kava and acetaminophen. Kave may help relax muscles.

Q. I was wondering if there is any correlations of Kava effecting (raising) the level of blood alcohol count. I have heard it may and could give a false reading, is this possible?
   A. We are not aware of kava raising blood alcohol lever, however, kava can make a person have less control over neuromuscular function when used the same time as alcohol.

Q. I’ve struggled with anxiety (GAD) most of my life, in bouts. I’ll have long periods of time when I feel fine but then will experience a modulator; some uncontrollable event that my mind convinces me is much, much worse than it is and I become extremely fearful and worrisome. I’ve used Kava in the past because it allowed me to tackle these periods (usually lasting a few days) without having to be on some pharmaceutical SSRI or anxiolytic drug full time. I’ve been a bit worried (ironic) about Kava the last couple years due to the negative reports coming out of Europe (so I quit using it). I also noticed that GNC took it off the shelves and the Arizona Tea company took it out of their RX Stress tea. Can you give me any up to date info on Kava?
   A. Kava is an herb that appears to be fine when used once or twice a week. Other options for anxiety include 5-HTP, small amounts of ashwagandha, tryptophan, passionflower. Perhaps alternating different herbs and nutrients could be an option to prevent relying too much on one anti anxiety herb and thus reducing the potential side effects.

Q. What is your position on all these noise about the liver toxicity of kava kava?
   A. There is a possibility that high doses of kava could be harmful to the liver if used daily in some individuals. Hence, we suggest using kava no more than 3 days a week and take a full week off each month. We have not seen any problems or toxicity with kava use when done so 3 days a week.

Q. I am a woman in my 40s who bought a kava product from a vitamin company on the internet. I took the kava daily for about three weeks. In the meantime I took a few other herbal products for more energy and for allergies. I also drink a glass or two of wine in the evenings and sometimes a shot or two of vodka with soda. I occasionally take Aleve or Tylenol, but not regularly. I am not on statin drugs or other medications. Never had liver problems. About 3 weeks after starting the kava, I went to my doctor who did blood studies and found my liver enzymes were very high. I stopped all the herbs and alcohol but my liver went into failure a couple of weeks thereafter and I ended with a liver transplant. I email you this so that other people become aware of liver problems that can occur with kava use.

Q. I recently purchased a bottle of Kava Kava by GAIA Herbs. This kava product was recommended to me by a friend to deal with my anxiety. I have asthma and I have found when I am really anxious that I have a hard time breathing.
My question to you is: My child's school had an epidemic of hepatitis about 33 years ago. The school recommended that all the children and parents take an injection to prevent the spread of hepatitis. We had the injection and my niece and I were the only two in our family to get the jaundice. I was sick, no food or drink for 15 days, lost weight of course and had yellow skin and dark stools. Is this considered to be Liver Damage and is it safe for me to take the Kava Kava?
   A. It is impossible for us to say whether the liver condition you had was completely resolved or there is still residual liver damage or malfunction. One way to tell is for your doctor to do liver enzyme tests. Even if your liver is perfectly normal, we suggest not using kava more than 3 days a week and to take a full week off each month.


Supplements and Herbal Index tongkat ali home page