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Kava:  The Alternate Treatment

Monica Trujillo

Why herbal treatments?          

In this day and age of technological advancements, amazing cures, and unprecedented achievements in the medical field, why would anyone even consider home remedies?  With the myriad variances of effects through medicinal treatments, a person’s conscience would lead them to choose a so called “natural method” with the assumptions that natural means free from harm. As more and more people incur new illnesses the use of medication is outstanding, and more times than not, induce unwanted side effects that often cause severe discomfort. Natural remedies are rumored to have far less side effects than the average medication, and since the remedies are natural they are assumed to be free from harm. Although our naïve side tells us that all natural is good, there can always be adverse effects to any substance that you deposit into your body.  There are thousands of herbal treatments on the verge of approval by health codes, and those that are anxiously awaiting trials, yet on the other hand many are already available for public utilization. Kava is one such herbal treatment. This herb can be used for many disorders; however, I will focus on its effectiveness to treat anxiety.


What is Kava?

Kava, which means the “intoxicating pepper”, is a leafy herb whose existence and usage originated in the South Pacific Islands (http://www.mhsource.com/pt/p000363.html). This pepper was often turned into a nonalcoholic drink, which was consumed at welcoming ceremonies, social gatherings, and meetings in an attempt to in essence clear the atmosphere, of unnecessary emotions (http://www.gnc.com/wellness/natpharm/Herb/Kava.htm). Kava can be administered as a raw root, a powder, an alcohol-based tincture, or in capsules or gel pills (http://www.mhsource.com/pt/p000363.html). Presently kava is used to reduce many types of anxiety, creating a tranquil atmosphere for the consumer. This particular herb is said to be effective because it blocks norepinephrine uptake, (http://www.prairienet.org/~Kagan/medline.htm) which is one of the three substances in your brain that creates excitement in high levels, but depression in low ones (http://my.webmd.com/content/article/1680.50550). By blocking this intake, a person’s generally normal excitement level would undoubtedly drop a few notches creating a calmer person.  Kava, also, at times is said to relax a persons muscles by directly acting on the central spinal nerves. (http://www.mhsource.com/pt/p000363.html).  Kava relaxes the muscles of the body because its components called kavapyrones (used interchangeably with kavalactones) have the ability to go straight to the muscles and reduce contractions (http://www.kavakure.com/WHATISKA.HTM) This herb is composed of kava lactones also known as kavapyrones, which are believed to be composed of anti-anxiety and anticonvulsant effects because of the body’s response through emotions, and actions (http://www.gnc.com/wellness/natpharm/Herb/Kava.htm). Kavapyrones affect a person’s GABA (gamma-aminobutyric acid) receptors in the brain, increasing their activity. GABA is an inhibitory neurotransmitter, and when its presence is decreased anxiety is more likely to surface (http://food4livecells.com/kavamist.htm).


 

Is Kava an effective treatment?

            Through various experiments, Kava has proven to be effective in that “it does not seem to impair reaction time or alertness, as do many of the more prevalent medicines being used currently in our world.” (http://www.gnc.com/wellness/natpharm/Herb/Kava.htm).  In one such experiment at Jena University in Germany, 101 people were randomly assigned to either be given a placebo or a kava extract throughout a period of six months, under the guidelines of a double-blind experiment. All of the subjects had been previously diagnosed with anxiety disorders so that the herb and placebo each acted as treatments. The subjects’ anxiety was measured using the Hamilton Anxiety Scale, before and throughout the experiment. It was concluded that the subjects who received the doses of kava scored lower on the scale than those who had been given the placebo (http://navigation.helper.realnames.com/framer/1/262/default.asp?realname=WebMD&url=http%3A%2F%2Fwww%2Ewebmd%2Ecom%2F&frameid=1&providerid=262&uid=200967734). Thousands of other experiments have been analyzed with the use of kava, and the herb continues to prove effective. Patients, doctors, and scientists are continually expressing their opinion in an attempt to create hope for people with anxiety that have no alternate means of medicine.

            Published in The Nurse Practitioner, is a twenty-five week, double-blind, randomized trial. Kava extract (WS 1490) was compared to a  placebo, and proved effective, with minimal side effects. One hundred and one patients who had been previously diagnosed with different types of anxiety, as categorized in the DSM-III-R, were continually tested using the Hamilton Anxiety Scale. Randomly selected patients were administered kava three times a day. During the eighth week of the trial all patients were tested once again using the HAMA scale, and the patients who had consumed the kava extract scored lower than the control group who had taken the placebo. In an experiment conducted by the same scientists and also published in The Nurse Practitioner, kava was compared to Oxazepam, an anti-anxiety drug. This was also a double-blind experiment, but was a trial testing twelve males; ages twenty-four to thirty-six. The subjects were given fifteen mg of Oxazepam the night before the actual experiment took place, and then seventy-five the morning of the experiment. An electrode cap recorded the electric potentials of the subjects during a word recognition task. The results concluded that kava does not affect cognitive function to the extreme that Oxazeopam does.

            Dr. Max H. Pittler and Dr. Edzard Ernst of the University of Exeter, England (2000, page 64) said, “Oral kava extract is comparatively safe and more effective than placebo for the symptomatic treatment of anxiety disorder.”

            A lab rat trial published in the Journal of Progress in Neuro-Psychopharmacology and Biological Psychiatry showed the use of kava extract has variable effects. In this study kava was broken down by its kavapyrone components and administered to several rats as one substance, and then as individual kavapyrone substances. Kava extract is composed of D,L-Kawain, dihydrokawain, methystian, dihydromethystian, yangonin, and desmethoxyyangonin. Lab rats were selected on weight basis, ranging from 220-300 grams. Before the experiment could begin the rats were sustained in a 12-hour light/dark cycle in temperature and humidity in a controlled environment prior surgery for the implementation of a guide cannula into their brain so that a microinjection pump could be connected to the microdialysis probe, and kavapyrones could be injected directly to their brains. Cremophor was used as the solvent in this experiment. The kavapyrones were mixed into the solvent and administered in three different doses: 30/mg/kg, 120 mg/kg, and 220 mg/kg. The control group received the solvent containing no active substances.   Basal levels were tested after administration and kava proved to change the extra cellular dopamine levels whose change lasted for eight hours. The lowest dosage of kava induced sedation, and as the dosages increased so did dopamine levels. Each of the individual kavapyrones initiated an increase in dopamine levels with the exception of yangonin, a dopamine antagonist. Kava is believed to be effective because of this ingredient. The effects of yangonin supersede the effects of the other kavapyrones at times and do not allow dopamine neurons to become active, preventing elation. However, yangonin is present in small amounts in kava and therefore does not always prove effective. 

            David Schardt believes that kava can help bring relief from the stresses and annoyances of daily life as were published in his discussion of five previously published studies in the Nutrition Action Healthletter. Over several hundreds of people composed these five studies, each utilizing a kava and a placebo. In the studies 300-400 mg of kava were used daily for eight weeks in four of the studies, and twenty-four weeks in the fifth one. Patients were tested on anxiety levels by using the Hamilton Anxiety Scale. All participants showed lower test scores as compared to their scores prior to the administration of kava. In the twenty-four week study, participants showed no withdrawal signs nor signs of dependency as most people experience with the use of anti-anxiety medications. In this final study both categories of people showed significant improvement in their HAMA test scores regardless if they were consuming kava or the placebo, therefore, the results were somewhat distorted in this final experiment.

            MH Pittler, M.D. discusses a systematic review and meta-analysis of seven kava trials to conclude his opinion that kava is, “worthy of consideration as an herbal treatment option for anxiety.” Double- blind, placebo-controlled, randomized trials of kava were collected and then blinded so that two independent reviewers could review them. The quality of each experiment was assessed as well as all of the data, and in each experiment kava proved superior over the placebo. In the end, the mean difference of scores, that prove kava effective, on the HAMA scale was 9.69.

What dosage is right for me, and will I experience any discomfort?

 Like any other drug or remedy, kava must be administered by certain guidelines as a preventative for any adverse effects. It is suggested that no person exceed 120-240 milligrams per day. This dosage amount should be divided into 2-3 dose regiments for no more than three months (http://www.gnc.com/wellness/natpharm/Herb/Kava.htm). Although kava is a natural herb, its use can cause “gastrointestinal disturbances, yellowing of the skin with excess use, and at times cause pupil enlargement” (http://www.gnc.com/wellness/natpharm/Herb/Kava.htm). Regardless of the few possible side effects related to the use of kava, studies have shown that its use tends to be effective without the side effects caused by benzodiazepines, an anti-anxiety drug (http://www.mhsource.com/pt/p000363.html). An “A” list was composed detailing the most effective herbal treatments today and their probable uses. Kava was on this list as a treatment for anxiety (http://navigation.helper.realnames.com/framer/1/262/default.asp?realname=WebMD&url=http%3A%2F%2Fwww%2Ewebmd%2Ecom%2F&frameid=1&providerid=262&uid=200967734).  In addition to causing a few side effects, kava is suspected to interfere with dopamine levels in the brain, and therefore should not be used by people with Parkinson’s disease (http://www.iherb.com/kavkavin.html#depression).

The decision is yours…

On a personal level, I am a friend of parents whose child used to consume kava on a weekly basis to prevent her anxiety, of which is caused by cerebral palsy. They expressed that their daughter had always been hyperactive, and nothing would calm her down. Upon discovering this, they immediately turned to a doctor of alternate medicine who specializes in osteopathy. These family friends are one of the many who share the common satisfaction with the use of kava.

Conclusion

            As new remedies and treatments continue to surface, let us all remember that no matter what we decide to use, we must first question the validity of the treatment and the sources of this proposed validity. While many herbal treatments have proved ineffective, kava is contrary, and thus far a proposed efficient treatment. In many studies and reviews it has showed positive signs of stress relief, and far less side effects than ideal anti-anxiety drugs. Although kava has been suspected to be a remedy for menopause and depression, it primarily treats anxiety (http://www.gnc.com/wellness/natpharm/Herb/Kava.htm). Consider the experiments tested on kava, and shape for yourself your own conclusion as to the outcome of a patient who treats anxiety with kava. 

References:

Baum, Siedy Sallstrom; Hill, Regina; Rommelspacher, Hans. Progress in Neuro-Psychopharmacology and Biological Psychiatry; Effect of kava extract and individual kavapyrones on neurotransmitter levels in nucleus accumbeus of rats. Vol. 22, Issue7, Oct 1998; pgs 1105-1120

Cupp, Melanie Johns; Kinder, Carl. The Nurse Practitioner; Kava: An Herbal Sedative. Vol. 23, Issue 6 June 1998; page 14

Franklin, Deeanna. Family Practice News; Oral Kava Extracts Can Calm Anxiety Disorders. Vol. 30, Issue 6, March 15; page 64

Pittler, Ernest MH. Journal of Clinical Psychopharmacology 2000; Kava extract evaluated for treating anxiety. Vol 11, Issue 4, April 2000; page 4

Schardt, David. Nutrition Action Healthletter; Herbs for nerves. Vol. 25, Issue 8, Oct 1998; page 8

 

 

 

 

 

 

 

 

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