KAVA KAVA : NATURE'S ANSWER TO ANXIETY,STRESS & INSOMNIA

INTRODUCTION

Kava Kava -Piper Methysticum- is a member of the pepper family and is native to many Pacific Ocean islands. Natives to the islands used Kava as part of important rituals and rites,and it was the focus of many social gatherings.Kava was valued both for its mellowing effects and to encourage socializing. It was also noted for initiating a state of contentment,enhance mental acuity, memory or sensory perception and a greater sense of well-being.

Today,Kava Kava extracts are gaining in popularity in Europe in the treatment of anxiety and depression. Kava root can reduce stress-related anxiety and the effects of anxiety disorders. At lower dosages, Kava helps you be more aware and active, but not tense. At higher dosages, the chemicals in kava root can make you sleepy. Kava Kava root preparations are quickly becoming one of the best-selling botanical agents on the market.Overall sales of Kava extracts have risen 116 percent in the past few years. Americans spend about $30-$50 million annually on Kava-containing products.Several European countries like Germany,United Kingdom, Austria , and Switzerland have approved Kava Kava preparations in the treatment of nervous anxiety,stress,restlessness and insomnia on the basis of detailed pharmacological data, recent research studies and favorable clinical trials.

The active ingredients in Kava are called kavalactones and are found in the root of the plant. These approved Kava Kava preparations are extracts standardized for kavalactone content (usually 30 to 70 percent). Kavalactones cause reactions in the brain similar to synthetic drugs commonly prescribed for anxiety,insomnia,and mood disorders.Kava's chemical constituents are thought to contain anesthetic, analgesic, anticonvulsive, antifungal and sleep inducing properties. Research has shown that kavalactones have an overall calming and sedative effect that relaxes muscles, relieves spasms, and prevents convulsions without the typical side effects associated with many psychoactive drugs. Kavalactones,according to some experts,also have analgesic properties that may bring relief to pain and physical suffering.

Recent research studies have shown that Kava is a safe and nonaddictive anti-anxiety medicine,as effective as commonly prescribed psychiatric drugs used to treat anxiety (e.g. containing benzodiazepines or hypnotic substances) such as Valium.While benzodiazepines tend to promote mental impairment,substance abuse or addiction issues, and lethargy, Kava extract,on the other hand,has been shown to improve memory, concentration and reaction time for people suffering from Anxiety or Stress Disorders. Kava extract has been clinically demonstrated as a means of achieving a state of relaxation without adverse side effects. Kava is the most relaxing botanical herb with exception of the opium poppy.Clinical studies show Kava's active ingredients produce an overall feeling of well being and physical/mental relaxation.

DOSAGE RECOMMENDATIONS

Kava is usually sold in a standardized form where the total amount of kavalactones per pill is listed. For use as an antianxiety agent, the dose of Kava should supply about 40 to 70 mg of kavalactones 3 times daily. The total daily dosage should not exceed 300 mg.

The proper dosage for insomnia is 210 mg of kavalactones 1 hour before bedtime (Bratman et al.,2000).Some herbalists suggest using Kava extracts supplying 120–240 mg of kava-lactones per day in two or three divided doses.Length of treatment varies. It may take four weeks before significant improvements are noticed.Recommendations are not to take Kava extract for longer than three months (Brown,1996).

INTERACTIONS & SIDE EFFECTS

The American Herbal Products Association (AHPA) advises pregnant and breast-feeding women not to take Kava extract. It also advises against taking more than the recommended dosage, using Kava for longer than three months at a time, and driving while using this medicinal herb.

Possible interactions (Bratman et al.,2000):

1.-Antipsychotic drugs : Kava might increase the risk of side effects (dystonic reaction).

2.-Medications for insomnia or anxiety (benzodiazepines) :Do not take kava in addition.

3.-Levodopa for Parkinson's disease : Kava might reduce its effectiveness.

Natural sedatives (e.g.valerian), synthetic anti-depressants and other mood-altering drugs may enhance the effects of Kava and should not be taken at the same time.Because Kava extract tends to depress the nervous system, it should not be taken with alcohol or in conjunction with anti-anxiety psychoactive drugs like Valium.Persons who are taking any type of medication should consult a physician before taking Kava extracts. Self-medication with Kava Kava is probably not appropriate for individuals with major anxiety disorders.

In recommended amounts, the most common side effect from Kava use is mild gastrointestinal disturbances in some people.In comparing the side-effects of Kava with benzodiazepines, research shows that Kava does not cause drowsiness or impair cognitive and motor functions. In fact, Kava has been shown to improve mood, well-being, and drive.

There have also been reports that high doses of Kava extract (for prolonged periods of time) may cause serious liver damage.Products containing herbal extracts of Kava have been implicated in Europe in at least 25 cases of serious liver toxicity including hepatitis, cirrhosis and liver failure."Although liver damage appears to be rare, FDA believes consumers should be informed of this potential risk" the agency said in a recent statement.Medical supervision is highly recommended when using Kava Kava-based products.

CLINICAL APPLICATIONS OF KAVA KAVA : SCIENTIFIC EVIDENCES

1.-Kava extracts have been found to be effective anxiolytic agents. In one double-blind, placebo controlled study, 29 subjects were treated for four weeks with 100 mg three times daily Kava extract (standardized to contain 70% kava lactones).Compared to the placebo group, the Kava group experienced significant decreases in symptoms of anxiety measured on the Hamilton Anxiety Scale (Kinzler et al.,1991).

2.-Kava extract has been extensively studied as a treatment for anxiety disorders.The amount often used in studies is a 100 mg capsule standardized to 70% kava-lactones three times per day. Double-blind studies, including one that lasted six months, have validated the effectiveness of Kava for people with anxiety,including menopausal women.One study found Kava to be just as effective as benzodiazepines in treating mild anxiety over the course of six weeks (Woelk et al.,1993).

3.-In a number of clinical studies Kava extracts have compared favorably to prescription medications such as benzodiazepines and tricyclic antidepressants (often used to treat anxiety disorders), and without the side-effects commonly seen with these psychiatric drugs.Not only does Kava appear not to impair reaction time,this herb appears to improve concentration.In two separate studies, a common anxiolytic medication (oxazepam) was found to slow reaction time, while Kava extract actually enhanced and optimized performance (Heinze et al.,1994).

4.-Another recent study, published in the January 1997 issue of Pharmacopsychiatry, also showed favorable results.The study took place in the department of psychiatry at Jena University in Germany. In a double-blind clinical trial, 101 people who had been diagnosed with anxiety disorders were given either an extract of Kava or a placebo for 25 weeks. Those who had been given Kava Kava showed signs of reduced anxiety during the eighth week and displayed none of the side effects associated with prescription relaxants and antidepressants (such as drowsiness and light-headedness). The researchers concluded that Kava Kava was a feasible therapy in the treatment of anxiety disorders.

5.-There have been six meaningful studies of Kava, involving a total of more than 400 participants. The best of these was a 6-month double-blind study that tested Kava's effectiveness in 100 people with various forms of anxiety.Over the course of the trial, they were evaluated with a list of questions called the Hamilton Anxiety Scale (HAM-A).The HAM-A assigns a total score based on such symptoms as restlessness, nervousness,stomach discomfort,heart palpitations,dizziness, and chest pain. Lower scores indicate reduced anxiety. Participants who were given Kava extract showed significantly improved scores beginning at 8 weeks and continuing throughout the duration of the treatment (Volz & Kieser,1997).

CONCLUSION

As Kierkegaard pointed out long ago, we live in the age of anxiety.Anxiety Disorders are the most prevalent of the psychiatric disorders.According to U.S statistics, around 17 percent of the population experiences Anxiety Disorders in any one year, and the lifetime prevalence is almost 25 percent. Conventional psychiatric treatment involves benzodiazepine drugs,which can have serious side effects, including (among others) daytime drowsiness,dependence and memory impairment.Kava,on the other hand, has demonstrated a remarkable safety profile, with side effects of only 1.5 to 2.3 percent reported in studies of more than 3,000 patients.Kava is an excellent agent in anxiety, tension,restlessness and nervousness in most all situations.Kava may also help in transient insomnia.According to some experts Kava extracts may also relieve urinary infections, asthma,rheumatism, fatigue and pain relief.

Perhaps Kava may one day replace benzodiazepines in the pharmacological treatment of Anxiety Disorders.Kava extracts are able to produce anxiety-relieving effects comparable to benzodiazepines,but is free from the common and expected side effects of these highly addictive psychiatric drugs.

REFERENCES

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Brown,D.(1996).Herbal Prescriptions for Better Health. Rocklin.California : Prima Publishing.

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Kinzler,E.; Kromer,J. & Lehmann,M.(1991).Effect of a special kava extract in patients with anxiety-, tension-, and excitation states of non-psychotic genesis. Double blind study with placebos over 4 weeks. Arzneimittelforschung , 41 , 584-588.

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Woelk,H.;Kapoula,S.; Lehrl,S. et al.(1993).Treatment of patients suffering from anxiety double-blind study: Kava special extract versus benzodiazepines.Z Allegemeinmed , 69, 271–277.