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Depression, Anxiety, Stress, and Spirituality in Cardiovascular Disease
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Erminia Guarneri, Shyamia Stone
Piper methysticum is commonly known as kava and has been used for centuries as a drink to decrease anxiety, restlessness, and insomnia.119 Kava has been found to inhibit norepinephrine and dopamine reuptake as well as MAOB, and enhance GABA binding.119 This combination of actions allows kava to have unique properties in that it is anxiolytic, but not sedative like benzodiazepines. There have been controversies about the safety of kava in the past due to reports of hepatotoxicity; however, the rarity of these claims suggests potential poor supplement quality or overuse as a recreational beverage.119
Herbal Supplements and Health
Published in Anil K. Sharma, Raj K. Keservani, Surya Prakash Gautam, Herbal Product Development, 2020
Himangini Bansal, Sakshi Bajaj
Kava, a herbal sedative with antianxiety or calming effects, is prepared by extracting the rhizomes of Piper methysticum, a south pacific plant. There are at least 72 different cultivars of this species, which differ both in appearance and in chemical composition. The active chemicals of the plants, known as kavalactones, are concentrated in the rhizomes. Inhabitants of the south pacific islands prepare a kava-based drink by mixing fresh or dried rhizomes with cold water or coconut milk. Among more than 18 kavalactones characterized, 6 are considered the primary constituents of kava extracts: kawain, dihydrokawain, methysticine, dehydromethysticine, yangonin, and desmethoxyyangonin. Quite a considerable lot of these compounds, particularly those with a methylenedioxyphenyl derivatives (methysticine and dihydromethysticine), have been found to restrain various cytochrome P450s: CYP2C19, CYP1A2, CYP2C9, CYP3A4, CYP2D6, and CYPA4. It is therefore astonishing to discover that pharmacokinetic interactions among kava and Western medications are generally rare and are not very much reported in the literature. There is a case report that kava decreases the viability of levodopa (Dasgupta and Hammett-Stabler, 2010).
Nutraceutical Intervention for Treatment of Alcoholism and Drinking Problems
Published in Raj K. Keservani, Anil K. Sharma, Rajesh K. Kesharwani, Nutraceuticals and Dietary Supplements, 2020
An extract of the P. methysticum plant is commonly known as Kava and is usually used by the people of Pacific Islanders and Indigenous Australians. Herbal preparations containing kava have been used for the psychiatric dealing of nervousness and sleeplessness (Cairney et al., 2002). Kava has also been used as a traditional medicinal support for smoking and liquor termination. To cite a working example, a village in Fiji developed and applied an effective community-based smoking termination program that comprised the usage of kava (Groth-Marnat et al., 1996). Clinical research has also provided subsidiary proof that the administration of kava reduces patients’ desire for their drug of choice and substantially promotes self-discipline in drug-dependent patients (Steiner, 2001). The mode of action of kava is primarily due to the activation of a lipid-soluble group of compounds, called kava lactones (Bressler, 2005). Kava lactones bind to multiple sites in the brain and interact with numerous neurotransmitters. They significantly inhibit the update of noradrenaline but not serotonin (Seitz et al., 1997). Kava is natural and safe to consume with no side effects. Though, hepatotoxicity has been related to kava use due to mitochondrial toxicity in the liver (Lude et al., 2008).
Pharmacotherapy of adjustment disorder: A review
Published in The World Journal of Biological Psychiatry, 2018
Volz and Kieser (1997) compared kava-kava with placebo in the first multi-centre placebo-controlled study of the pharmacotherapy of adjustment disorder. One hundred and one patients who met DSM-III-R criteria for adjustment disorder with anxiety, generalised anxiety disorder, agoraphobia and specific phobia were recruited from general practices and randomised to kava-kava or placebo over 25 weeks. Kava-kava was superior to placebo on the main outcome measure, the Hamilton Anxiety Rating Scale, starting from 8 weeks on. Unfortunately the report of the trial does not detail the exact number of patients with adjustment disorder, nor the treatment response and AEs for this particular group of patients, markedly limiting the lessons that can validly be drawn from the data for research and practice related to this condition. The severe adverse hepatic events associated with kava-kava also bear consideration.
What are the pharmacotherapeutic options for adjustment disorder?
Published in Expert Opinion on Pharmacotherapy, 2022
The first multi-center, placebo-controlled trial for adjustment disorder compared kava-kava (a plant extract with GABAergic properties) to placebo over 25 weeks (n = 101). The study included patients with generalized anxiety disorder (GAD), agoraphobia, and specific phobia [9]. Although the study showed that kava-kava was superior to placebo on the Hamilton Anxiety Rating Scale from 8 weeks onwards, it is not clear how many participants had adjustment disorder, and the report does not delineate treatment responses for each condition. The authors also do not report on adverse effects, despite the potentially severe hepatic effects of kava-kava.
The sub-acute toxicity of kavalactone in rats: a study of the effect of oral doses and the mechanism of toxicity in combination with ethanol
Published in Drug and Chemical Toxicology, 2023
Mohammed Abdulabbas Hasan, Syam Mohan, Heshu Sulaiman Rahman, Hemn Hasan Othman, Shirwan Hamasalih Omer, Abdullah Farasani
Kava refers to the plant as well as the beverage obtained from the rootstock of Piper methysticum (Forst. f.) (family: Piperaceae). The generic term kava, or occasionally referred to as kava kava, refers to the substance in contemporary scientific literature and commerce internationally (da Silva et al. 2021). During the last part of the 19th century, research was carried out to determine the modes of action of the psychoactive components of kava, with the first primary scientific investigation of kava published in 1886 by L. Lewin (Rowe et al. 2011).