Drugs A - Z

Kava (Piper methysticum G. Forst)

an herbal product - treats Insomnia, Anxiety, Parkinson's disease, and Stress

Generic Name: kava

Category

Herbs & Supplements

Synonyms

(+) -dihydrokawain-5-ol, 11-methoxy-5, 5-hydroxydihydrokawain, 6-dihydroyangonin, antares, ava, ava pepper, ava pepper shrub, ava root, awa, bornyl cinnamate, cavain, flavokavines A and B, Fijian kava, gea, gi, grog, intoxicating long pepper, intoxicating pepper, kao, kava kava extract LI 140, kava kava rhizome, kavakava, kavalactones, kavapiper, kavapyrones, kavarod, kava root, kavasporal forte, kavain, kave-kave, kawa, kawa kawa, kawa pepper, Kawa Pfeffer, kew, LI150, long pepper, Macropiper latifolium, malohu, maluk, maori kava, meruk, milik, pepe kava, olanzapine, Piper methysticum, pipermethystine, piperis methystici rhizoma, Rauschpfeffer, rhizoma piperis methystici, rhizome di kava-kava sakaua, risperidone, sakau, sakua, tonga, wurzelstock, WS 1490, yagona, yangona, yaqona, yongona.

Background

Kava beverages, made from dried roots of the shrub Piper methysticum, have been used ceremonially and socially in the South Pacific for hundreds of years and in Europe since the 1700s.

Several well-conducted human studies have demonstrated kava's efficacy in the treatment of anxiety with effects observed after as few as one to two doses and progressive improvements over one to four weeks. Preliminary evidence suggests possible equivalence to benzodiazepines.

Many experts believe that kava is neither sedating nor tolerance-forming in recommended doses. Some trials report occasional mild sedation, although preliminary data from small studies suggest lack of neurological-psychological impairment.

There is growing concern regarding the potential for liver toxicity from kava. Multiple cases of liver damage have been reported in Europe, including hepatitis, cirrhosis, and liver failure. Kava has been removed from shelves in several countries due to these safety concerns. The U.S. Food and Drug Administration (FDA) has issued warnings to consumers and physicians. It is not clear what dose or duration of use is correlated with the risk of liver damage. The quality of these case reports has been variable; several are vague, describe use of products that do not actually list kava as an ingredient, or include patients who also ingest large quantities of alcohol. Nonetheless, caution is warranted.

Chronic or heavy use of kava has also been associated with cases of neurotoxicity, pulmonary hypertension, and dermatologic changes. Most human trials have been shorter than two months, with the longest study being six months in duration.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Anxiety: Human studies have found at least moderate benefit of kava in the treatment of anxiety, and early evidence suggests that kava may be as effective as benzodiazepine drugs such as diazepam (Valium®). Kava's effects were reported to be similar to the prescription drug buspirone (Buspar®) used for Generalized Anxiety Disorder (GAD) in one study. However, there is concern regarding the potential danger from taking kava based on multiple reports from Europe and the United States that included hepatitis, cirrhosis, and liver failure. The U.S. Food and Drug Administration (FDA) has issued warnings to consumers and physicians. Many products have been pulled from the market. Natural Standard has collaborated with the World Health Organization (WHO) to prepare a detailed report of kava and associated adverse effects, which is now available.
Grade: A

Insomnia: Kava may cause sedation or lethargy. However, early research suggests that kava may not be effective for insomnia.
Grade: C

Parkinson's disease: There is unclear evidence for the use of kava for Parkinson's disease. Kava has been shown to increase 'off' periods in Parkinson's patients taking levodopa and can cause a semicomatose state when given with alprazolam. Consult with a qualified healthcare professional before taking kava due to the risk of harmful side effects.
Grade: C

Stress: Early study results suggest that kava and valerian may be beneficial to health by reducing the body's reactions during stressful situations and stress induced insomnia. Further research is needed to confirm these results.
Grade: C

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