Kava kava (Mikiyala Wells , University of Mississippi School of Pharmacy

KAVA KAVA

Mikiyala Wells, Student pharmacist Spring 2022 (Piper Methysticum)

Name is so nice, you say it twice.

Common Names: Kava, Kawa, ‘Ava (Somoa), ‘Awa (Hawaiian), Waka, Lawena, Sakau, Yaqona

https://erowid.org/plants/kava/kava.shtml

https://www.nccih.nih.gov/health/kava#hed2

Background/History

For many centuries, kava has been an important part of Pacific Island cultures. The rituals consisted of consuming kava as a beverage composed of the plant’s roots. It is prepared by pulverizing or chewing the roots then steeping them into water or coconut milk. The kava beverage was used in the ceremony to induce relaxation and symbolized respect and hospitality. In the early 1900’s, the use of kava was researched. Kava was used for anxiety, sleep disorders, and nervous disorders. It was one of the top herbals used in the US and Europe until the Food and Drug Administration issued a warning for the potential for liver injury.

Common Uses

● Anticonvulsant ● Anti-inflammatory ● Local anesthetic ● Anxiolytic ● Cognition ● Sleeping aid / Sedative ● Antithrombotic ● Spasmolytic

Pharmacology/MOA

The proposed mechanisms of action for kava are increased levels of dopamine and serotonin by inhibiting monoamine uptake, decreased levels of glutamate, increased excitatory neurotransmitters, and GABA receptor interactions.

Dosage Forms

Kavalactone tablets/capsules 125 mg with the maximum daily dose of 250 mg

Typical Dosing

Kavalactones 50 to 70 mg three times daily or dried kava root 2 to 4 grams boiled as a decoction three times daily.

Adverse Effects

- Dry scaly skin - Heart problems - Eye irritation

https://www.verywellmind.com/kava-kava-what-you-need-to-know-89703

Toxicity FDA published a notice for hepatotoxicity

https://erowid.org/plants/kava/kava.shtml

Effectiveness

Meta-analysis and systematic reviews suggest that kava is an effective anxiolytic compared with a placebo. Studies also suggest that kava has effective anti-inflammatory and anti-cancer effects.

Safety

Although there are well-documented benefits to kava use, there is reported hepatotoxicity in several reports in Europe and the United States. Kava should be used with caution in patients with renal or liver disease, Parkinson's disease, blood disorders, or depression.

Interactions

● Benzodiazepines ● CNS depressants ● Paroxetine ● Dopamine agonists ● No known food interactions

Professional Opinion

In my professional opinion, I would not recommend kava due to the warning issued by the Food and Drug Administration associated with liver damage and other safety concerns. ~ M. Wells

References:

1. Bian T, Corral P, Wang Y, Botello J, Kingston R, Daniels T, Salloum RG, Johnston E, Huo Z, Lu J, Liu AC, Xing C. Kava as a Clinical Nutrient: Promises and Challenges. Nutrients. 2020 Oct 5;12(10):3044. doi: 10.3390/nu12103044. PMID: 33027883; PMCID: PMC7600512.

2. U.S. Department of Health and Human Services. (n.d.). Kava. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/kava#hed2

3. Kava: An Overview. Kava: An overview. - american botanical council. (n.d.). https://www.herbalgram.org/resources/herbalgram/issues/39/ta ble-of-contents/article126/

4. Clouatre, Dallas L. “Kava kava: examining new reports of toxicity.” Toxicology letters vol. 150,1 (2004): 85-96. doi:10.1016/j.toxlet.2003.07.005.