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  Kava Kava

Kava Kava

People in the Pacific Islands, where kava comes from, have probably used kava for thousands of years. First knowledge of it in the West came with one of the expeditions led by Captain James Cook in the 1700s. Natives to the islands used kava as part of important rituals and rites, and it was the focus of many social gatherings. The drink prepared from the roots numbs the mouth. In the 20th century, kava has been given to many important visitors to the Pacific Islands. Hillary Rodham Clinton and Pope John Paul II were given kava during welcoming ceremonies, as were President and Mrs. Lyndon B. Johnson in 1966.

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. But usually, kava is simply calming, as opposed to the heavier sedation of alcohol or antianxiety prescription drugs. Health care providers prescribe kava for pain and stiffness, anxiety, insomnia, menopausal anxiety, uncontrolled epilepsy, pain, and jet lag.

Plant Description

The root comes from a tall shrub that grows in the islands of the Pacific Ocean, including Hawaii. This shrub produces large, green, heart-shaped leaves that grow thickly on the branches, off thick stalks. Long, slender flowers that look like Chinese baby corn grow where the branches meet the stems. The roots look like bundles of woody, hairy branches.

What's It Made Of?

Kava root contains chemicals called kavapyrones, which reduce convulsions and cause muscles to relax in laboratory tests using animals. The kavalactones also cause reactions in the brain that are believed to be like those caused by pharmaceutical drugs used for depression and anxiety. Kavalactones are what numbs your tongue if you put liquid kava in your mouth or on your gums.

Available Forms

In some cultures, kava is prepared by chewing the root and spitting it into a bowl. The saliva mixes with the root and activates the plant medicine. Today, manufacturers use alcohol or acetate instead. You can find kava in liquid form, as tinctures or extracts, and in capsules or tablets. It's also available powdered or crushed.

How to Take It

If your health care provider has recommended kava, make sure you read the label to look for kava products that are standardized to contain a 70 percent kavalactone content. A standardized product is one with a listing of specific amounts of active plant material per dosage.

For the relief of anxiety and insomnia, and to reduce stress, the recommended kava dose is 2.0 to 4.0 g as decoction (a preparation made by boiling down the herb in water) up to three times daily. Take 60 to 600 mg kavalactones daily of standardized formulas or follow your provider's instructions.

Length of treatment varies. It may take four weeks before you notice improvement. Recommendations are not to take kava for longer than three months.

Precautions

Kava's side effects are mild. It can numb the mouth and may have an unpleasant taste. A very small percentage of people report nausea, headache, dizziness, or skin rash when they take kava. If any of these happen to you, make sure you tell your health care provider. Don't drive if you are taking Kava.

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

Missionaries to the Pacific islands during the 19th century noticed that people who took kava all the time had yellowish, scaly skin. In a more recent study, people who took 100 times the recommended dose experienced this same yellowing, developed a rash, lost hair, and had trouble with vision, appetite, and breathing. These changes go away when you stop taking kava.

Possible Interactions

Do not take kava with alcoholic beverages and medications that have sedative effects like antihistamines and therapies for anxiety and insomnia. Kava may increase the effects of these medications.

Kava may reduce the effectiveness of levodopa that is used for the treatment of Parkinson's disease. Therefore, you should not take this herb if you are taking any medications containing levodopa.

Supporting Research

Almeida JC, Grimsley EW. Coma from the health food store: interaction between kava and alprazolam. Ann Intern Med. 1996;125:940–941.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, Mass: Integrative Medicine Communications; 1998.

Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, Ore: Eclectic Medical; 1998:88-89.

Davies LP, Drew CA, Duffield P. Kava pyrones and resin: studies on GABA A, GABA B, and benzodiazepine binding sites in the rodent brain. Pharmacol Toxicol. 1992;71:120–126.

De Smet PAGM, et al, eds. Adverse Effects of Herb Drugs 2. Berlin, Germany: Springer Verlag; 1993.

Foster S. 101 Medicinal Herbs. Loveland, Colo: Interweave Press; 1998.

Furguiele AR, Kinnard WJ, Aceto MD, et al. Central activity of aqueous extracts of Piper methyticum (kava). J Pharm Sci. 1965;54(2):247–252.

Heiligenstein E, Guenther RN. Over-the-counter psychotropics: a review of melatonin, St. John’s wort, valerian, and kava kava. JACH. 1998;46:271–276.

Jamieson DD, Duffield PH, Cheng D, et al. Comparison of the central nervous system activity of the aqueous and lipid extract of kava (Piper methysticum). Arch Intern Pharmacodynam Ther. 1989;301:66–80.

Jamieson DD, Duffield PH. Positive interactions of ethanol and kava resin inmice. Clin Exp Pharmacol Physiol. 1990;17:509–514.

Jussofie A, Schmiz A, Hiemke C. Kava–pyrone enriched extract from Piper methysticum as a modulator of GABA binding sites in different regions of rat brain. Psychopharmacol (Berl). 1994;116:469–474.

Kinzler E, Kromer J, Lehmann E. Effect of a special kava extract in patients with anxiety-, tension, and excitation states of non-psychotic genesis. Double blind study with placebos over four weeks [in German]. Arzneimforsch. 1991;41:584–588.

Lehmann E, et al. Efficacy of special kava extract (Piper methysticum) in patients with states of anxiety, tension and excitedness of non-mental origin—A double blind placebo controlled study of four weeks treatment. Phytomedicine. 1996;3:113–119.

Lindenberg Von D, Pitule-Schodel H. D, L-Kavain in comparison with oxazepam in anxiety states. Double-blind clinical trial. Forschr Med. 1990;108:50–54.

McGuffin M, Hobbs C, Upton R, Goldberg A. American Herbal Products Associations's Botanical Safety Handbook. Boca Raton, Fla: CRC Press; 1996.

Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158(20):2200–2211.

Munte TE, Heinze HJ, Matzke M, et al. Effects of oxazepam and an extract of kava roots (Piper methysticum) on event-related potentials in a word recognition task. Neuropsychobiology. 1993;27:46–53.

O’Hara MJ, Kinnard WJ, Buckley JP. Preliminary characterization of aqueous extracts of Piper methysticum (kava, kawa kawa). J Pharm Sci. 1965;54(7):1021–1025.

Schelosky L, Raffauf C, Jendroska K, et al. Kava and dopamine antagonism. J Neurol Neurosurg Psychiatry 1995;58(5):639–640.

Schulz V, Hänsel R, Tyler V. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. New York, NY: Springer-Verlag; 1998.

Seitz U, Schule A, Gleitz J. [3H]-monoamine uptake inhibition properties of kava pyrones. Planta Med. 1997;63(6):548–549.

Singh YD, Blumenthal M. Kava: An overview. HerbalGram. 39:34–55.

Singh YN. Kava: an overview. J Ethnopharm. 1965;37:13–45.

Volz HP, Kieser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders—a randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry. 1997;30:1–5.

Walden J, von Wegerer J, Winter U, et al. Effects of kawain and dihydro- methysticin on field potential changes in the hippocampus. Prog Neuropsycho-pharmacol Biol Psychiatry. 1997;121(4):697–706.

Warnecke G. Psychosomatic dysfunction in the female climacteric. Clinical effectiveness and tolerance of kava extract WS 1490 [in German]. Fortschr Med. 1991;109:119–122.


Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

           
                                                    

                         

                                

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