Kava is not a Magic Bullet

© Eliaviel | Dreamstime.com - Kava Drinking Photo

© Eliaviel | Dreamstime.com – Kava Drinking Photo

In “Nature’s Legal Relaxant,” KeptItLegal said he decided to try Kava after learning about it in an Anthropology class. He ordered some online and mixed up a batch with the blender/strainer method in the directions on the bag. Within a few sips, his mouth was slightly numb. There were no dramatic effects on his vision or his sense of balance. Mentally, he felt clear minded and rather normal. Emotionally, he felt calm and collected, rather than ecstatic.

The fact that my girlfriend had asked for a split earlier that day no longer irked me. I felt it was something I could handle. . . . All in all, I found Kava’s effects enjoyable without being inhibiting.

Before you go rushing out to buy some listen to the rest of the story on Kava. There are potentially serious health consequences from Kava. Cases of liver damage and even some deaths have been reported with kava use. In 2002 the FDA issued a warning that kava can cause liver damage. As a result of the health risks, it has been banned or restricted in many countries, including: Germany, Switzerland, France, Canada, and Great Britain. While some groups dispute the reports of liver damage, there seems to be “convincing evidence in some cases of severe hepatitis ending in full hepatic failure, requiring liver transplantation, and even leading to death.” Three medical case histories of either acute liver failure and death or acute hepatitis are described here.

A 22 year-old woman presented with a 3-week history of nausea, fatigue and then jaundice 4 months after starting kava (240 mg daily) for depression. She received a liver transplant, but died six months after transplant from multi-organ failure. A 56 year-old woman taking an herbal medication containing kava for three months developed the same acute hepatitis-like syndrome. She had no risk factors for viral hepatitis, no history of liver disease and drank minimal amounts of alcohol. She died of circulatory failure during transplant surgery.

Kava is derived from the roots of the Piper methysticum plant (meaning intoxicating pepper), a member of the pepper family found in the Western and South Pacific. It is used throughout the Polynesian cultures in Hawaii, Vanuati, Melanesia and some parts of Micronesia. In Fiji, a formal yaqona (kava) ceremony will often accompany important social, political, religious functions, usually involving a ritual presentation of the bundled roots as a gift and drinking of the yaqona itself.

The active ingredients are kavapyrones (kavelactones), which have alcohol-like effects. It is believed to help with anxiety, stress, and insomnia. Kava has analgesic, muscle relaxing and anticonvulsant effects. These effects vary widely according to the kind of kava plants and the amount used. Kava experiences on the pro-drug website Erowid ranged from mildly euphoric, to zombified and a hallucinogenic dream where a humanoid figure in black robes said: “Welcome to the Black church. Prepare for Death.”

Of course, that individual had taken 2400 mg of Ginko Biloba, 10.6 g of Valerian Root and 1 tablet of kava to help him sleep. “The night before was filled with rails of Modafinil, Flexeril, and Vicodin, ounces and ounces of liquid vicodin, and hydroponically grown Cannabis. Simply put, my brain was fried.”

Potential drug interactions occur, as would be expected, with alcohol and CNS depressants such as benzodiazepines and barbiturates. Also avoid taking them with sleep-aides such as Lunesta and Ambien. You should avoid combining kava with all psychotropic medications. A common side effect when using kava is nausea. Severe side effects that you should seek immediate medical attention can include:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood in the urine; changes in vision; enlarged pupils; lack of coordination; muscle weakness; puffy face; red eyes; shortness of breath; weight loss.

There have been some studies on the potential  usefulness of kava. The Australian & New Zealand Journal of Psychiatry reported that four out of six studies supported the use of kava to treat anxiety. However, they cautioned it should not be used with alcohol and other psychotropic medications. “Avoidance of high doses if driving or operating heavy machinery should be mandatory.” Regular users should get routine liver function tests.

In “Kava and Relapse,” Terence Gorski cautioned that kava could be a factor in the progression of a relapse into active substance use for a recovering addict or alcoholic. “Kava impairs judgment and impulse control and generally does not produce the desired high or the desired mood altering effect of the drug of choice.” The impaired judgment and poor impulse control that occurs before a lapse into active use could rationalize going back to using a drug of choice.

In the U.S., kava is legal and fairly easy to obtain. Although it does appear to have some potential as an anti-anxiety agent, it seems counterintuitive to use it to treat anxiety when the jury is still out on whether or not it contributes to liver problems. The mind-altering effect of kava is a danger for the recovering addict, because the part of the brain it relaxes is the same part of the brain used in recovery to exercise self-control over thoughts and desires to get high.  Kava does not seem to be a magic bullet for anxiety and depression.