Kava For Anxiety and Insomnia

Kava (Piper methysticum) is a South Pacific plant, enjoyed by native people for almost 3000 years, that can be made into a relaxing beverage. Today, kava is increasingly recognized as a valuable medicinal plant for the mitigation of two common health disorders--anxiety and sleeplessness. Studies show that it can offer an herbal alternative to major pharmaceutical drugs when used for mild cases of these conditions.

The Need For An Herbal Alternative According to the National Foundation for Brain Research in Washington, D.C., approximately 50 million U.S. adults battle anxiety. The effects can include weakened immunity, nervousness, indigestion, difficulty concentrating, sleeplessness, chronic fatigue and an overall haggard feeling.

If anxiety progresses into full-blown panic, symptoms can include physiological responses such as rapid or irregular heartbeat, dizziness, trembling, choking or smothering sensations, and fear of dying or losing control of the mind. According to the National Institutes of Health Office of Medical Applications of Research in Bethesda, Md., panic disorder may affect as many as 3 million Americans in the course of their lifetimes.

To combat symptoms of both anxiety and panic disorder, many allopathic doctors prescribe tranquilizers, particularly the benzodiazepine class of drugs that includes Valium®, Halcion®, Serax®, and Xanax®. Unfortunately, these drugs can have serious side effects and complications including seizures, vision problems, headaches, appetite loss, neuromuscular difficulties and psychosis. Is the cost worth the cure?

If people try other methods before a case becomes full-blown, they may be able to avoid a drug treatment regimen. Kava, along with other anti-stress agents such as good diet, exercise and meditation, can be used to reduce the effects of stress. It is important to note, however, that no studies support the use of kava for more than mild cases of anxiety. In addition, people should not consume kava with any other psychopharmaceuticals.

Sleeplessness is yet another problem that frays the mind and exhausts the body. It is estimated that 60 percent of American adults experience some degree of occasional insomnia. They have trouble falling asleep, wake up in the middle of the night and can't get back to sleep, sleep fitfully, or lie in an uncomfortable half-sleep and wake up feeling tired. Whatever the nature of insomnia, it robs people of badly needed rest. Not all insomnia is due to anxiety, but the connection is there in many cases. Here again, kava can be used with great effectiveness for mild cases.

Anxiety And The Brain One task of researchers is to determine what happens where in the brain. One area of the brain known as the limbic system is a collection of structures including the fornix, hippocampus, hypothalamus and pituitary gland. The limbic system is the root of feelings of fear, anger, sadness and myriad complex psychophysical responses we call emotions. In addition, homeostatic mechanisms in the limbic system regulate blood pressure, heart rate, body temperature, blood sugar, sexual impulses, and hunger and sleep cycles. While various parts of the limbic system play unique roles (the pituitary, for example, helps regulate hormones) the components of the limbic system seem to work in concert through a labyrinthine network of interconnecting fibers and pathways. Given these interconnections, the relationship between fear and sleeplessness, or loss of appetite and heart palpitations, may not be so unusual. They, and many other functions, are all regulated by the limbic system.

Psychotropic drugs work on the brain. Benzodiazepines, for example, augment the activity of gamma-aminobutyric acid (GABA) in the limbic system. Decreased GABA activity promotes anxiety. Benzodiazepines bind to receptor sites in the brain (specific cellular areas that recognize and bind with other specific molecules, often hormones or neurotransmitters), enhancing the activity of GABA and producing a tranquil feeling. The limbic system also contains a small organ the size of a chick pea, the amygdala, that regulates feelings of fear and anxiety. The amygdala is a significant activity site for benzodiazepines. A 1989 National Advisory Mental Health Council report noted that "benzodiazepine receptors are located in many different regions of the limbic system as well as in other parts of the brain. However, researchers found recently that benzodiazepine receptors are highly concentrated in the amygdala, suggesting that this structure may be an important site of their action." Kava's effects also appear to center here-in studies reported in 1991, the preferential site of action for the kavalactones (the pharmacologically active constituents in kava) was the amygdala. However, unlike the benzodiazepines, the kavalactones did not appear to interact with GABA or its receptor sites, but operated by other, as yet unknown means.

Scientific Support Many people experience benefits from anti-anxiety drugs, however, some individuals who are treated for situational episodes may wish to stop taking medication after they have completed therapy. Getting off of these drugs can be uncomfortable and in some cases risky. The documented symptoms of benzodiazepine withdrawal syndrome include anxiety, agitation, tremulousness, insomnia, dizziness, headaches, appetite loss, ringing in the ears, blurred vision, diarrhea, neuromuscular irritability, psychosis and seizures.

Kava, on the other hand, offers an effective alternative. Various studies show it demonstrates no toxicity or withdrawal symptoms when used at recommended doses. There is documentation on two side effects: The Journal of Neurology, Neurosurgery and Psychiatry reported four cases where patients developed involuntary movements after exposure to various kava preparations (extrapyramidal side effects), raising the question of whether kava is a dopamine antagonist (dopamine is a form of the amino acid dopa found in the adrenal glands and other areas of the body).¹ In addition, chronic high doses of kava have created a temporary yellow discoloration of the skin or a reversible scaly skin condition in some patients.² People also relate personal testimonies of interactions between kava and alcohol leading to nausea and stomach upset.

Following is an overview of some of the more significant studies on the use of kava:

* In a 1991 four-week study of 58 patients suffering from anxiety, 29 were given 100 mg of a 70 percent kavalactone extract three times daily, whereas the control group was given a placebo. Those who took the kava extract experienced significant reduction in anxiety after just one week and were significantly improved at the end of the study. As with other studies, no adverse effects were reported as a result of the kava use.³

* In a 1991 eight-week study of 40 women with menopausal symptoms, 20 women were given a daily dose of 100 mg of kava extract standardized to a 70 percent kavalactone value, and 20 were given a placebo. The group given the kava experienced a significant reduction in menopausal symptoms, anxiety and depression compared to the control group.⁴

* In a 1977 double-blind, placebo-controlled study of 84 patients suffering from anxiety, a daily dose of 400 mg of purified d,l-kavain (a synthetic version of naturally occurring kava that contains 50 percent ingredients not occurring naturally) improved vigilance, memory and reaction time.⁵

* In a 1990 study of 38 patients suffering from anxiety, d,l-kavain and oxazepam (a benzodiazepine marketed under the trade name Serax®) were compared over a period of four weeks. Each reduced symptoms of anxiety equally as measured by both the Self-Rating Anxiety Scale and the Anxiety Status Inventory. However, unlike kavain, oxazepam is addictive and produces side effects such as drowsiness, dizziness, headaches and vertigo. This study made it clear that d,l-kavain possesses anti-anxiety activity comparable to the benzodiazepines but without the hazards.⁶

* A 1979 study confirmed that administration of kavalactones induces sedation (a relaxed easy state) and sleepiness.⁷
* In a 1993 study of 12 volunteers, the effects of a standardized kava extract and oxazepam on mental function were compared. Using several parameters, oxazepam was shown to decrease both the quality and speed of responses to a word recognition test whereas the kava extract did not adversely affect mental function. In the test, the group receiving oxazepam had slowed reaction time and a reduced number of correct answers whereas the group receiving kava extract showed a insignificant increase in reaction time and recognition.⁸ While further research is needed to confirm kava's effects, this study supports the claims of many current users who say that, if kava is used properly, there is no impairment of mental function, including memory or clarity of thought. High amounts of kava, however, can create these impairments.

* In a battery of other tests given to 40 subjects in 1993, kava extract administered to volunteers did not impair their performance while driving an automobile or operating heavy machinery. Kava taken in appropriate doses did not appear to impair coordination, visual perception or judgment.⁹

Proper Dosage Kava can offer a safe, effective alternative to prescription drugs for mild cases of anxiety and insomnia. But in what amounts? The majority of anti-anxiety studies show that an effective daily dose of kava is between 70 mg and 200 mg of kavalactones. In the 1991 anxiety study of 58 patients described above, the effective dose of kava was 70 mg of kavalactones taken three times daily. In the 1991 study of menopausal women cited above, the dose was 100 mg of kavalactones daily. To promote sleep, a dose of approximately 150 mg to 200 mg of kavalactones taken 30 to 60 minutes prior to bedtime is recommended.

Kava can be a useful anti-anxiety and sleep-promoting agent when used appropriately. It is not, however, a viable alternative for people who are on prescribed anti-anxiety or insomnia drugs without the sanction and supervision of a qualified physician. There is not enough evidence to make the switch unguided.

Chris Kilham is a medicinal plant researcher, founder of Cowboy Medicine Expeditions, and author of Kava, Medicine Hunting in Paradise (Park Street Press, 1996).

REFERENCES
1. Schelosky, et al. Journal of Neurology, Neurosurgery and Psychiatry, 58: 639-40, 1995.

2. German herbal monograph, "Piperis methystici rhizoma," Bundesanzeiger, no. 101, June 1, 1990.

3. Kinzler, E., Kromer, J., & Lehmann, E. "Clinical efficacy of a kava extract in patients with anxiety syndrome: Double-blind placebo-controlled study over four weeks," Arzneimittel-Forsch 41: 584-88, 1991.

4. Warnecke, G. "Neurovegetative dystonia in the female climacteric. Studies on the clinical efficacy and tolerance of kava extract WS 1490," Forschr Med 109: 120-22, 1991.

5. Scholing, W.E., & Clausen, H.D. "On the effect of d,l-kavain: Experience with neuronika," Med Klin 72: 1301-06, 1977.

6. Lindenberg, D., & Pitule-Schodel, H. "D,l-kavain in comparison with oxazepam in anxiety disorders. A double-blind study of clinical effectiveness," Forschr Med 108: 49-50, 53-54, 1990.

7. Holm, E., et al. "Studies on the profile of the neurophysiological effects of D,l-kavain: Cerebral sites of action and sleep-wakefulness-rhythm in animals," Arzneimittel-Forsch 41: 673-83, 1991.

8. Munte, T.F., et al. "Effects of oxazepam and an extract of kava roots (Piper methysticum) on event-related potentials in a word recognition task," Neuropsychobiology 27: 46-53, 1993.

9. Herberg, K.W. "The influence of kava-special extract WS 1490 on safety-relevant performance alone and in conjunction with ethyl alcohol," Blutalkohol 30: 96-105, 1993.

Next >

[ Back ]

Registration/Login

Categories
Health Concerns
Brands

Vitamin Trader - Healthy Discounts on Quality Vitamins