(This is a reproduction of an article from www.herbalgram.org.
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Anxiety
Kava (Piper methysiticum)
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| Date: February 15, 2004 |
HC#
042115-OLO |
Re:Kava
- A Brief Review
Pepping J. Kava: Piper methysticum American Journal of Health-Systems
Pharmacy. 1996;56:957-960.
Use
of kava kava (Piper methysticum) predates written history in the islands of the
South Pacific. Offered as a beverage during social occasions or ceremonies, the
pulverized underground portions of the kava plant are often mixed with coconut
milk. The beverage has played a role in greeting visitors, securing marriages,
and settling disputes. For at least the past twelve years, scientific
investigation into the warm and sociable effects this plant induces has led to
medicinal use for modern day anxiety.
Today, extracts standardized to
30-70% kavalactones are used for reducing daily stress and anxiety in general
populations, as well as for treating patients with anxiety of psychosomatic,
neurotic, or nonpsychotic origins. Research also shows that kava's anxiolytic
effects may extend to women entering into their menopausal years.
In
this article, Pepping states that only a few small studies have assessed kava
for anxiety; however, there have been at least six double-blind
placebo-controlled randomized (DBPCR) studies on 335 participants which have
found significant anxiolytic activity, with a meta-analysis confirming those
results. In addition to these, at least half a dozen clinical trials have
examined kava.
Many pharmaceutical sedative-hypnotics act by binding to
gamma-aminobutyric acid (GABA) and benzodiazepine receptors in the brain. The
author writes that kavalactones may have a unique mechanism, as binding studies
to these receptors in vivo are conflicting. Kava appears to act on the amygdala
complex within the limbic system, the emotional center, of the
brain.
Studies have shown that kava decreases levels of the excitatory
neurotransmitter, glutamate, increases daydreaming waves, and decreases
concentrating brain wave activity. Kavalactones relax skeletal muscle, and have
mild anticonvulsant properties. Sleep quality is enhanced, with an increase in
deep sleep without affect on rapid-eye-movement.
Kava should not be used
by pregnant or nursing women, however, or consumed with alcohol, barbiturates,
benzodiazepines, other anxiolytics, or psychopharmacological drugs. Case reports
suggest that kava may reduce the effectiveness of levodopa therapy in patients
with Parkinson's disease.
Kava offers an alternative to pharmaceutical
anxiolytics. The author advises people to proceed with caution. 'Higher doses
can affect motor function, and long-term use could lead to psychological
dependence,' he states. However, Pepping fails to cite any reference for this
last statement; and there is no strong evidence linking continual kava use with
dependence according to ethnobotanical data citing traditional use or modern
case reports where kava is frequently used in modern European clinical medicine.
In fact, one 25-week long study showed no signs of withdrawal.
It is not
recommended to use kava for more than three months without medical supervision,
a caution based on the relatively conservative safety assessments of the German
Commission E. Reports of liver toxicity associated with prolonged use of kava at
very high doses have been cited (Pizzorno JE, Murray MT. Textbook of Natural
Medicine. 2nd Ed.) as well as the exacerbation of hepatitis in patients with a
history of recurrent hepatitis, even with short-term use.
-Carolyn
Williams Orlando,
MA |
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