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Protocols: Kava Kava (Piper methysticum)

WARNING: Kava Kava has been linked to severe liver damage. It is the recommendation of this office that Kava Kava be avoided.

Psychoactive

Antianxiety Agent

Description: Piper methysticum, or "Intoxicating pepper" (shrub in the black pepper family) is native to the pacific islands. It has been used in ceremonies and celebrations because it's calming effect and ability to promote sociability.

Method of Action: Lipid-soluble fraction alpha-pyrones (dihydromethysticin [DHM] and dihydrokawain [DHK] appear to be the primary psychoactive components. Conflicting evidence exists regarding the affinity of kava pyrones for various GABA or benzodiazepine-binding sites in the amygdala complex. Primary pharmacoligic effect is muscular relaxation. Kavain, one kavalactone, has been shown to block the voltage-dependent sodium ion channel resulting in local analgesia. Electroencephalogram changes similar to diazepam (Valium). Some antifungal properties.

Indications and Usage: Mild-Moderate Situational Anxiety; Agoraphobia; Simple Phobias; Social Phobias; Sympathetic Nervous System Hyperarousal; Muscular Tension; Insomnia; Menopausal Symptoms; Mild Pain; Thought Disorder; Neuroprotective effects against ischemia. Anticonvulsive and antispasmodic effects. Local analgesic effect (via non-opiate pathways) when applied topically. For acute and emergent versus chronic use. Treatment alternative to tricyclics and benzodiazepines.

Contraindications: Do not use this product if you are pregnant or lactating without first seeking advice from your physician. May be contraindicated in individuals with tendency to substance addiction. Synergism with other sedatives with y-arninobutyric acid has been established. When used concomitantly with alprazolam (Xanex) has resulted in coma and concomitant use is ill advised.

Dosage and Administration: Dosage range 70 to 255 mg of kavalactones daily. Starting dose 70 to 85 mg of kavalactones taken in evening. Double dose (take second pill in morning) if not effective in two days. Remain at this dosage for at least a week before adding a third pill at noon. When you consistently feel more relaxed for at least two weeks gradually decrease dosage by one pill every few days. (Dosage used in research studies most frequently is three 100 mg doses standardized to 70% kavalactone content daily.) Do not take for more than 3 months without medical advice.

Clinical Effect In: Within 30 minutes. Therapeutic effect in one to four weeks.

Adverse Reactions: Tolerance may develop. Allergic skin reaction at very high doses. Discontinue if yellow discoloration (acquired ichthyosis) appears in skin. (Not a niacin deficiency as formerly proposed.) Will not impair cognition, mental acuity or reaction time and, in fact, may cause a slight increase in word recognition rate. No hypnotic effect. May cause ataxia (unsteadiness) and gross motor movements. Do not use when operating heavy machinery or performing potentially dangerous activities. Do not use if pre-existing parkinsonian condition is present as kava may decrease dopamine. Long-term use of high doses max' result in metabolic abnormalities such as decreased liver enzymes and liver toxicity, decreased albumin and plasma protein and increased cholesterol levels. If you suspect that an herb or other supplement is making you sick, call the FDA's MedWatch hotline at 800-332-1088 or contact the agency via its website at http://www.fda.gov/medwatch.

Known Interactive Effects: Do not use if also another psychoactive medications without medical supervision, or take with a depressant such as alcohol except under medical advice as drug may potentiate CNS effects of these substances. Do not use if pregnant. Do not take with valarian root, which has conflicting effects on benzodiazapine receptors.

Additional Considerations: Different varieties of Kava are available with the most desirable being the "white" (kasa leka, kasa balavu or yalu, and qolobi) versus the "black" Ask if product is "comparable to WSI1490" used in research trials. Does not appear to lose efficacy in humans over time but tolerance has been shown to develop rapidly in animal studies. Discontinue in 25 weeks or less. Use preparations that contain whole complex of kavalactones and other compounds found naturally in kava plant. More rapidly absorbed when given orally as crude extract of kava root rather than as refined, isolated kavalactones.

Warnings: The information above is provided for educational purposes and may not be construed as a medical prescription or as a substitute for the advice of your physician. Do not use this product without first consulting your physician especially if you are pregnant or lactating. Be advised that some herbs and dietary supplements can cause severe allergic reactions in some individuals and may also have an adverse result in conjunction with other medications or treatments. You should regularly consult your physician in matters regarding your health and particularly in respect to symptoms and conditions, which may require diagnosis or medical attention. Reevaluate use of this product after 6 months.

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