Kava Kava

You are meeting new people, and you are anxious. You have a job interview, and you are anxious. You are balancing children, a job, and a spouse, and you are anxious. Your business is not doing as well as you think it should, and you are anxious.

Today, anxiety seems to be something that many of us have in common. Our fast-moving lives just seem to breed it. Always being anxious, however, is reason to be anxious.

Anxiety is a feeling of worry, nervousness, or apprehension about what is happening to you or what you believe will happen to your future. It is very often a normal response to a specific situation, but if you are always anxious, it is a serious stress that can affect your health. This is a viscous circle: anxiety is a form of stress, and the stresses in your life result in anxiety.

How can you combat anxiety? You might try using the root of an herb known as kava kava.

Kava kava

Kava kava (Piper methysticum) is a member of the pepper family and is native to islands of the South Pacific. Although kava kava appears to be a “new” herb, it is no Johnny-come-lately: its use spans several centuries of medicinal and ceremonial use.

Traditionally, kava kava was used in the South Pacific in special ceremonies such as welcoming visiting royalty or highly honored guests. This tradition continues. Former U.S. President Lyndon Johnson, Pope John Paul III, Queen Elizabeth, and the wife of U.S. President Bill Clinton, Hillary Rodham Clinton, have all been honored by kava kava ceremonies while visiting the South Pacific.

How it works

Because kava kava does promote a sense of relaxation and a heightened sense of awareness, researchers have been studying the plant for some 130 years. The relaxing properties of the plant were traced to its root and rhizomes and a group of fat-soluble compounds, called kavalactones.

For anxiety, kava kava extracts are generally standardized to contain 30 percent kavalactones. A recommended serving is generally 200 mg taken one to three times per day, which yields 60 to 180 mg of kavalactones per day.

Although its exact mechanism is unknown, researchers believe that kava kava promotes relaxation by affecting either GABA receptors or the limbic system.

Kava kava may slightly increase the activity of gamma-aminobutyric acid (GABA). Decreased GABA activity promotes anxiety. Kavalactones may influence GABA receptors, promoting increased relaxation.

Kavalactones also appear to act in the limbic system to promote relaxation. The limbic system is the “ancient” part of the brain, and its interlinked modules and pathways are associated with emotions, feelings, and moods. Kava kava appears to work with the amygdala, two small lobes that are part of this system.

Does kava kava really work?

This may sound good, but does kava kava really work? A growing number of controlled clinical trials, many with published results in peer-reviewed literature, say ‘yes.’ The trials report that kava kava does indeed decrease anxiety and nervous tension. This is illustrated through both the subjects own accounts and the measurement of brain activity: kava kava appears to create changes in the brain, as measured by EEG (electroencephalogram). What is more impressive, perhaps, is that those using kava kava report an increased attentiveness and concentration while feeling relaxed.

Kinzler et al. (Arzneim-Forsch Drug Res 41 (1991): 584-588) demonstrated the anti-anxiety properties of kava kava extract in a double-blind, placebo-controlled study. Fifty-eight patients with anxiety syndrome not caused by psychotic disorders were randomly assigned into two groups: 29 subjects received a placebo and 29 subjects received 300 mg per day of a standardized kava kava extract that provided 210 mg per day of kavalactones. Efficacy was assessed by the Hamilton-Anxiety-Scale (HAMA), a standard anxiety questionnaire, at one, two, and four weeks of treatment. A significant reduction in anxiety in the group receiving the kava kava was found after only one week. Anxiety relief continued to improve over the four-week period in the kava kava group. No side effects were noted.

A study (Fortsch Med 109 (1991): 119-122) on women suffering from anxiety associated with menopause compared the effectiveness of 300 mg per day of standardized kava extract to a placebo. After eight weeks, the kava kava-treated group showed a significant reduction in anxiety compared to the placebo-treated group. Improvements were seen as early as after one week of treatment. In addition, the kava kava-treated group reported improvement in depression and sense of well-being, and lessened severity of menopausal symptoms over the eight-week treatment period.

In the longest clinical trial to date (Pharmacopsychiatry 30 (1997): 1-5), a 25-week multicenter, double-blind, placebo-controlled trial, researchers randomized 101 outpatients suffering from anxiety of nonpsychotic origin to receive either kava extract (300 mg per day providing 210 mg per day of kavalactones) or a placebo. The kava extract was found to be significantly superior to placebo for the treatment of anxiety as measured by the HAMA anxiety test and other self-rating anxiety tests. Overall tolerability of the kava extract was excellent.

An unpublished clinical trial (N. N. Singh, unpublished data, 1997) reported the beneficial effects of kava kava extract on daily stress. This trial consisted of a four-week, double-blind, placebo-controlled protocol involving 60 subjects, age 16 to 60 years, in good health with self-assessed minimal anxiety. Subjects were randomized into two groups and received either 800 mg per day of kava kava, providing 240 mg per day of kavalactones, or a placebo. Daily stress due to interpersonal problems, personal competency, cognitive stressors, and environmental hassles was significantly less in the group consuming the kava kava extract compared to the placebo group, with no side effects. Further, a greater reduction in stress was seen the longer the extract was taken.

In a meta-analysis of kava kava extract for anxiety (J Clin Psychopharmacol 20, no. 1 (February 2000): 84-9), Pittler looked at seven double-blind, randomized, placebo-controlled trials of oral kava kava extract for the treatment of anxiety. In all seven trials, the kava extract was found to be superior to a placebo. The analysis of three trials suggests a significant difference in the reduction of the total score on the HAMA anxiety test in favor of kava kava extract. The author concludes in the abstract that “These data imply that kava extract is superior to placebo as a symptomatic treatment for anxiety. Therefore, kava extract is an herbal treatment option for anxiety that is worthy of consideration.”

Taken together, these results support the use of standardized kava kava extract as a natural way to support neuro health and deal with stress.

Kava is not recommended for use by pregnant or lactating women, and should not be combined with other drugs that act on the central nervous system, such as alcohol, barbiturates, and antidepressants.

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