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December 14, 2018

Therapeutic potential of Kava as a treatment for generalised anxiety disorder

anxiety, mental health

Anxiety disorders are becoming ever more common in modern society, and the consequences while often difficult to manage for individual sufferers, also represent a significant burden on healthcare systems.1 Medical treatments for anxiety have remained stagnant over the last decade, with no significant changes to the types of drugs used, and many of these treatments are now being recognised for the adverse effects they present to long term users.2 For this reason, further research into safe and effective anxiety treatments are needed. This is an area in which Kava is demonstrating an ever-increasing body of evidence, with multiple research trials confirming its benefits as a treatment for generalised anxiety disorders.3

Kava (Piper methysticum) is a shrub native to the Pacific.4 Kava has an extensive history of use throughout the Pacific Region, where it is regularly consumed as a recreational, ceremonial and medicinal drink. Kava is made through grinding and soaking the plant’s root in water or coconut milk, both common traditional methods of extraction.5,6 The active components within Kava are known as Kavalactones, and preparations of Kava containing between 60-280mg of kavalactones have been demonstrated to significantly reduce the symptom of generalised anxiety across multiple research trials. This response is driven by the influence kavalactones have on dopamine in the brain, increasing its availability, while also increasing brain sensitivity to chemicals such as the neurotransmitter GABA, while also reducing levels of noradrenaline. These neurochemical effects within the brain increase feeling of wellbeing and calm.7,8,9

Participants in research trials of Kava have reported reduced symptoms of stress and anxiety, increased coping ability, elevated mood, improved sleep and improved physical symptoms of stress, including reduced muscle tightness, heart palpitations and jitteriness.10

While liver damage has been a well-publicized side effect associated with Kava use, these reports have been exclusively associated with the simultaneous use of Kava with alcohol or other medications that damage the liver and with manufactured alcohol extractions of Kava. Traditional and water-based extractions of Kava (as described above) are associated with very low levels of adverse reaction.11 With the most significant side effect noted in multiple research trials being gastro-intestinal based, including mild cramping and nausea, with no adverse reactions or withdrawal symptoms identified.12 Research trials on water-based extractions of Kava routinely test liver function before and after Kava use and results have shown no significant changes in liver function as a result of Kava use.13

The mounting evidence for the therapeutic potential of Kava pose an exciting new horizon for the safe and effective treatment of generalised anxiety disorder and stress within the population.

References
  1. Sarris, J, Kavanagh, DJ, Byrne, G, Bone, KM, Adams, J, Deed, G, ‘2009, ‘The Kava Anxiety Depression Spectrum Study (KADSS): A randomised, placebo-controlled crossover trial using an aqueous extract of piper methysticum’ Psychopharmacology, Vol 205, Pp399-407, 2009
  2. Ibid
  3. Ibid
  4. Ooi, SL, Hendersen, P & Pak, SC, 2018, ‘Kava for Generalised Anxiety Disorder: A review of Current Evidence’ The Journal of Alternative and Complementary Therapies, Vol 24 (8), Pp770-80
  5. Ibid
  6. Sarris, J, Stough, C, Teschke, R, Wahid, ZT, Bousman, CA, Muray, G, Savage, KM, Mouatt, P, Ng, C & Schweitzer, I, 2013, ‘Kava for the Treatment of Generalised Anxiety Disorders RCT: Analysis of Adverse Reactions, Liver function, Addiction and Sexual Function’ Phytotherapy Research, Vol 27, Pp1723-28, 2013
  7. IBID
  8. Sarris, J, Adams, J, Kavanagh, DJ, 2010, ‘An Explorative Qualitative Analysis of Participants’’ experience of using kava versus placebo in an RCT’ Australian Journal of Medical Herbalism, Vol 22 (1), 2010
  9. Ob cit Ooi, SL et al 2018
  10. Ob Cit Sarris, J Et al 2010
  11. Sarris, J, Adams, J & Wardle, JL, 2009, ‘Time for a reassessment of the use of Kava for anxiety?’ Complementary Therapies in Medicine, Vol 17 (3), 2009
  12. Ob sit Sarris, J et al 2010
  13. Sarris, J, Stough, C, Teschke, R, Wahid, ZT, Bousman, CA, Muray, G, Savage, KM, Mouatt, P, Ng, C & Schweitzer, I, 2013, ‘Kava for the Treatment of Generalised Anxiety Disorders RCT: Analysis of Adverse Reactions, Liver function, Addiction and Sexual Function’ Phytotherapy Research, Vol 27, Pp1723-28, 2013