Kava Kava and Clinical Depression


What is Kava Kava?

Kava Kava (Piper Methysticum), also known as Kava, Cava Cava, Cava, Cawa Cawa, Awa, Ava, Sakua, and Yaqona is an herbal plant that can be found growing in the Polynesian Islands. As a relative of the black pepper plant, it has similar heart shaped leaves and flowers as the black pepper plant as well as a similar peppery taste. Many believe that it is extremely beneficial in countering the symptoms of depression, anxiety, and stress when it is in ingested.

History

Kava kava is native to some islands of the South Pacific, including Vanuatu and Fiji. Vanuatu is one of the world's foremost suppliers of kava kava. It has been used for centuries in Fiji and Hawaii to reduce fatigue, combat anxiety and enhance sleep.

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Preparation

Kava kava must undergo preparation before it can be used to treat depression or anxiety. The plant must grow for four years before it can be harvested. The roots are then cut from the plant, peeled, washed and ground. They are then steeped in water, and the root pieces are removed by straining the liquid through cheesecloth. The resulting liquid is ready to drink.

The ground root pieces can also be dried and used in supplement capsules.

Consumption

Kava Root (the only part of the plant that is used) is largely employed in many cultures as a celebratory drink much in the same way that alcohol is used in the West. It helps mark momentous occasions such as weddings, public festivals, political powwows and holidays, and it is even used in ceremonies honoring the dead. Unlike alcohol, kava does not produce or stimulate aggression. It does not condemn the user to a dreaded hangover, unlike alcohol.

Kava Kava can be purchased in liquid form, powdered form, as an extract or tincture, or in tablet or capsule form. In some places, the root itself is actually chewed which provides a much more concentrated dosage than any other preparation of the herb. The most popular way to consume Kava Kava is in the form of a tea.

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Therapeutic Effects

Many people find other uses for kava, including many medicinal ones. It’s interesting to note that kava has been shown to help ease anxiety, depression as well as producing a restful sleep. It is used by athletes, businessmen and diplomats to help “take the edge off” and focus concentration.  Widely prescribed throughout Oceania and Europe to treat hyperactivity in children, it has also been used to aid children who have difficulty sleeping on occasion.

People report the following positive effects on health and well-being:
• Relaxes muscles.
• Calms nerves.
• Creates a general feeling of well-being.
• Induces a feeling of peace, relaxation and contentment.
• Enhances mental alertness and concentration.
• Can be successfully used as an herbal aphrodisiac.
• Reduces inhibitions and makes people more sociable.

It is not exactly known how kava functions in the body yet, but it seems to influence a neurotransmitter called gamma-aminobutyric acid, or GABA in the brain, making it similar to benzodiazepines such as Valium and Xanax, according to an article in the international journal "Planta Medica," which reported that kava facilitated the transmission of GABA. In a 1990 "European Journal of Pharmacology" article, researchers reported that kava was able to inhibit uptake of another neurotransmitter called norepinephrine. In an article in the October 1998 issue of the journal "Progress in Neuro-Psychopharmacology Biology and Psychiatry," researchers found that one of the kavalactones, D,L-kawain, has been shown to affect dopamine, resulting in an increase in this neurotransmitter. According to Drugs.com, there are conflicting reports about kava's effects on serotonin. Based on the current research, it is difficult to say exactly how kava affects neurotransmitters --- of which the human body has many --- but at a minimum, it affects GABA, norepinephrine and dopamine.

The kavalactones in kava are able to pass through the blood-brain barrier and act as sedatives and analgesics, as well, meaning that if you are experiencing the irregular sleep cycles often found in individuals suffering from depression, kava can help with that, as well!

Consumers’ Experience

When first ingested, users will experience a numbing of their lips, tongue, and sometimes even their stomach that is caused by the blood vessels constricting. Kava Kava has an intoxicating effect which, which depending on the dosage taken, some might compare to that of drinking alcohol or using marijuana. When taken in moderation, most users experience a great sense of relaxation and well being combined with the ability to think clearly. It can also induce a restful, dreamless sleep. This can be extremely therapeutic to those that suffer from depression. In some cases, if the dosage is too high, individuals will enter a euphoric or dream like state that may be undesirable and can be avoided simply by lowering the dosage.

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Side Effects

For the most part, other than the initial numbness of the lips, tongue, and stomach, there are no reported side effects from Kava Kava as long as it is used in moderation. In fact, some have replaced alcoholic beverages with it because they get the same effect without waking up with a hangover the next morning. However, when used excessively, there are some reported side effects and/or health problems such as a hypertension, yellow, scaly rash, shortness of breath, eye irritation, and changes in red and white blood cells and platelets.

Kava Kava and Liver Damage

In the early 2000's, demand for Kava rose dramatically as it began to make its way into the mainstream. For many years, it was also being prescribed in parts of Europe to treat anxiety as well; something that the pharmaceutical companies were surely taking notice of. Shortly thereafter, reports of liver damage by a handful of people in Europe began to emerge. Unfortunately, doctors were quick to blame Kava, and soon, entire countries were banning this historically safe and effective herbal supplement. Three of those countries included the United States, Canada, and Germany. Others quickly followed suit and the legal status of kava was suddenly in serious jeopardy.

But, the health industry fought back with a vengeance. Leading that fight was the International Kava Executive Council. Even though they were outgunned by governments, pharmaceutical companies and the media, the herbal industry was able to provide more than enough evidence that the ban was unquestionably unjustified. Furthermore, the IKEC showed that the conclusions that were reached should never have been reached in the first place, as it became clear that Kava was nothing more than a convenient scapegoat for the reported liver damage. As the evidence was being submitted, ongoing research was also being conducted by a number of independent laboratories and universities behind the scenes, partly because a worldwide ban on kava kava could be devastating for several economies throughout Oceania.

Fortunately, within a small span of time, several key pieces of evidence emerged. Perhaps the most notable one came from from the University of Hawaii, as reported by the Honolulu Advertiser in early 2003. It turns out that there's a poison in the leaves and peelings (bark) of Kava called pipermethystine. And, not surprisingly, this poison could potentially lead to liver damage.

It turns out that once the demand for Kava skyrocketed, there wasn't enough Kava root to fill the demand. Suppliers then knowingly or unknowingly bought the leaves and peelings of Kava plants (the parts that are always thrown away as waste material) from unscrupulous growers. Up until that event, the only parts of the Kava plant that were traditionally used throughout its 3,000 year history were the roots; never the peelings or the leaves. On a related note: further research revealed that the handful of people who suffered liver damage also consumed alcohol on a regular basis, restoring Kava's place in the herbal medicine chest as a safe, effective, and pleasant herbal supplement.

Unfortunately, the damage had already been done. Countries started to lift their bans on Kava in 2003-onward, but kava was now synonymous with "but it causes liver damage." Nothing could be further from the truth, but the media had accomplished its task, and restoring Kava's reputation has been an uphill battle ever since.

So, where do we stand with the "kava legal status" question? Happily for many, the United States lifted its ban completely, Canada lifted its ban on Kava if it's imported by individuals for personal consumption, and even Germany, where much of the original controversy arose, lifted its ban on Kava in 2007. Except for a handful of countries such as Norway, Australia, and Sweden, Kava is indeed legal throughout the world once again! The Canadian Health Ministry even gave permission to export Kava to Canada, provided it was only to private individuals.

Dosage

The most significant anti-anxiety studies show that an effective daily dose of kava is 70-210 milligrams of kavalactones. The amount of kava to take depends on your purpose for using it and your individual sensitivity to the effects of kavalactones.

Death or severe illness from exclusive use of kava has not been reported in any medical literature.

No standard dose exists for kava. According to the University of Maryland Medical Center, a typical dose may be between 150-300 mg, taken between one to three times daily. However, the dosage recommendations on the labels of kava supplements will vary according to the brand. Do not take kava kava for more than three months without the close supervision of your physician.

Recent Research

In the recent, 2009, study, researchers at the University of Queensland in Australia have found a traditional extract of Kava, a medicinal plant from the South Pacific, to be safe and effective in reducing anxiety. Lead researcher Jerome Sarris, a PhD candidate from UQ’s School of Medicine, said the placebo-controlled study found Kava to be an effective and safe treatment option for people with chronic anxiety and varying levels of depression.

“We’ve been able to show that Kava offers a natural alternative for the treatment of anxiety, and unlike some pharmaceutical options, has less risk of dependency and less potential of side effects,” Mr. Sarris said.

Each week participants were given a clinical assessment as well as a self-rating questionnaire to measure their anxiety and depression levels. The researchers found anxiety levels decreased dramatically for participants taking five tablets of Kava per day as opposed to the placebo group which took dummy pills.

“We also found that Kava had a positive impact on reducing depression levels, something which had not been tested before,” Mr. Sarris said. In 2002 Kava was banned in Europe, UK and Canada due to concerns over liver toxicity.

While the three-week trial raised no major health concerns regarding the Kava extract used, the researchers said larger studies were required to confirm the drug’s safety.

“When extracted in the appropriate way, Kava may pose less or no potential liver problems. I hope the results will encourage governments to reconsider the ban,” Mr. Sarris said.

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Summary

While Kava Kava has been shown to help alleviate some of the debilitating symptoms of depression, it should never replace any prescription medication or traditional therapy without first consulting with a physician. It is important to remember that what works for one person might not necessarily work for another and what might be safe for one person might be dangerous to another. Kava Kava is an extremely potent herb for depression that can have some undesirable effects if it is misused. Work with your physician to determine if it is right for you…



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