Medicinal Plants : Piper methysticum

Name

Kava

Biological Name

Piper methysticum

Other Names

Kava Kava, Kava, ava, awa, ava pepper, intoxicating pepper, kawa, kew, tonga

Parts Used

The medicinal parts are the peeled, dried, cut rhizome, which has normally been freed from the roots and the fresh rhizome with the roots.

Active Compounds

Kava lactones (kava pyrones, 5-12%): chief components ( + )- kavain, 7,8-dihydro-( + )-kavain (marindinine ), ( +)-methysticin, 7,8-dihydro-(+)-methysticin, yangonine, desmethoxyyangonin

The kava-lactones, sometimes referred to as kava-pyrones, are important active constituents in kava herbal extracts. High quality kava rhizomes contain 5.5-8.3% kava-lactones. Medicinal extracts used in Europe contain 30-70% kava-lactones.

History

Kava is native Pacific Islands. In early times, it was distributed eastward through tropical islands by migrating people, who valued the root both as a drink and a medicine. In Hawaii, more than 15 varieties were known. In many islands of the Pacific, Kava has long played an important part in the life of the people, being used in ceremonies, festivals, and as a sign of good will. The root is used to prepare the ceremonial drink. The drink is reputed to be sedative, aphrodisiac, tonic, stimulant, diuretic, and diaphoretic. The root has a faint but characteristic odor, an aromatic, bitter, pungent taste, with a slight local anesthesia resulting.

Remedies For

Anxiety and Insomnia

Also for nervousness, stress, and restlessness. Kava-lactones may have anti-anxiety, analgesic (pain relieving), muscle relaxing, and anticonvulsant effects. Studies suggest that kava directly influences the limbic system, the ancient part of the brain associated with emotions and other brain activities.

Whereas benzodiazepine tranquilizers can be addictive, impair memory, and worsen a depression, kava improves mental functioning and mood and is not addictive.

In a 1996 randomized, placebo-controlled, double-blind study, two groups of 29 patients with anxiety syndromes were treated with 100 mg of kava extract standardized to 70- percent kavalactones three times a day for four weeks. The symptoms of anxiety were significantly reduced in patients taking kava as compared to placebo. No adverse reactions were observed in the kava group.

In a 1997 multi-center, randomized, placebo-controlled study, a total of 101 outpatients were given one capsule of a kava extract containing 70 mg of kavalactones or placebo three times daily. In this twenty-five-week study, all the patients suffered from moderate to severe anxiety, including agoraphobia, generalized anxiety disorder, specific phobia, and social phobia. The results showed that the short- and long-term effectiveness of kava was superior to that of placebo. After twenty-four weeks, over half of the kava group were rated as "very improved": anxiety, fear, tension, and insomnia decreased steadily with treatment. Kava was well tolerated, and adverse reactions were mild and rare. The researchers concluded that kava was a treatment alternative to both benzodiazepines and synthetic antidepressants for anxiety disorders.

Description

Kava is a member of the pepper family and is native to many Pacific Ocean islands. The rhizome (root stock) is used.

Dosage

Take extract supplying 140-210 mg of kava-lactones per day. Alternatively, 1-3 ml of fresh liquid kava tincture can be taken.

Kava pills come in different strengths, usually from 100 to 250 mg, and the percentage of kavalactones (the active chemicals in kava) in the extract can vary from 50 to 70 percent. The dosage used in most clinical studies for anxiety is three daily 100-mg doses of kava extract standardized to 70- percent kavalactone content, which research has shown can be as effective as the benzodiazepine drug Serax (oxazepam), 15 mg daily. A 70-percent kava extract is not yet commercially available in the United States.

Enzymatic Therapy has a 150-mg capsule of a 55-percent kava extract, which would contain 82.5 mg of kavalactones. It is best to begin with a total daily dosage of 70 to 85 mg of kavalactones, taken in the evening. Stay on one capsule if it effectively reduces anxiety. If it is not enough, you can add a second pill in the morning. Remain on this twice daily dosage for at least a week. If you still feel tense or fearful after that, add a third capsule in the middle of the day. When you consistently feel more relaxed, gradually decrease your dosage by one pill every few days.

Do not take kava on a daily basis for longer than twenty-five weeks (four to six months). When used in small amounts on an occasional basis, it can be used longer, if necessary. If 70 to 85 mg of kavalactones three times a day is not effective for your anxiety, see your doctor for a reevaluation to see if taking more kava is indicated or if you may require a prescription drug.

Safety

March 25, 2002: The US Food and Drug Administration has warned consumers that kava may be linked to serious liver injury.

FDA recommends that kava users should consult a doctor if they experience any possible symptoms of liver disease. These include jaundice, or yellowing of the skin or eyes; brown urine; nausea or vomiting; light-colored stool; unusual tiredness or weakness; stomach or abdominal pain; or loss of appetite. People who already have liver problems should ask a doctor before taking kava. Due these complications of Kava, it has been banned in some countries such as Canada.

Serious toxic reactions can develop when kava is not used with care. High doses can cause:

Visual and skin problems
Muscle weakness
Disorders of complex movement, accompanied by undisturbed consciousness
Tiredness
Sleepiness
Central nervous system depression
Breathing problems

If kava is used over extended periods of time, a syndrome referred to as "kawaism" or "kawa dermopathy" may develop, with such symptoms as:

Reddened eyes
Scaly skin eruptions
Yellowish discoloration of skin, hair, and nails

Heavy users of kava are likely to experience health problems such as:

Rashes
Puffiness in the face
Weight loss
Blood in the urine
Blood abnormalities

These may be aggravated by the heavy use of alcohol and cigarettes.

At ten times the recommended dosage, consumed for many months, some heavy drinkers of kava root in the Polynesian islands have developed a scaly eruption or yellowing of the skin associated with muscle spasms, biochemical abnormalities, vision disturbances, and even shortness of breath. These disturbances go away quickly when kava is discontinued. Large intake of kava is unnecessary and strongly discouraged. At the recommended therapeutic levels, no such side effects have been reported.

In recommended doses, some people may experience mild gastrointestinal disturbances. Do not take kava if you are taking other medication or substances that also act on the central nervous system, such as alcohol, barbiturates, antidepressants, and antipsychotic drugs.

Unless you are under medical supervision, do not combine kava with benzodiazepine tranquilizers. It has been reported that a patient became disoriented and lethargic after combining Xanax ( alprazolam ) and kava, requiring brief hospitalization. If you are taking a synthetic tranquilizer, you should be gradually withdrawn from it under medical supervision before beginning kava.

Don't take Kava if you are suffering from Parkinson's disease, because it might worsen muscular weakness and twitching. Some people suffer an allergic reaction to kava. Care should be taken when driving or operating machinery. People who are elderly or medically ill should take smaller doses of kava and only under a doctor's supervision. Kava is not recommended during pregnancy or breast-feeding or for severe anxiety disorders and depression.

Do not take kava if you are diagnosed with clinical depression; it increases the danger of suicide.