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Kava kava (Piper methysticum)

DESCRIPTION

Kava kava is a member of the pepper family. Kava has been used in native medicine for its relaxing qualities, for urinary tract Infections, Asthma, as a topical anaesthetic, and other applications. The primary interest in the West has been its well-documented anxiolytic effects (1). Kava is a herb that has enjoyed respect in the islands of the South Pacific and has been used as a ritual beverage for ceremonial purposes, including the welcoming of important guests (1). The rhizome is the part used: it is chewed or ground with a pestle to produce a cloudy, milky mash. Saliva is added on chewing, causing enzymatic degradation, the productions of which give the full intoxicating effect. Having taken their kava drink, people feel calm and relaxed, with mental activity enhanced. Kava does not appear to have narcotic properties (2).

HERBAL USES

Kava has been specifically used in the treatment of nervous Anxiety, Insomnia, Depression and restlessness, through its sedative and anxiolytic properties.

SUGGESTED INTAKES

Part of the plant used: ROOTSTOCK (RHIZOME).
Herb powder 235-700mg three times daily.
The appropriate amount of kava preparation taken depends on the level of kavalactones. On the basis of clinical studies using pure kavalactones or kava extracts standardised for kavalactones, the dosage recommendation for anxiolytic effects is 45 to 70mg of kavalactones three times daily. For sedative effects, a dose providing 180 to 210mg of kavalactones can be taken one hour before retiring (3).

SUPPLEMENTAL USES

Kava root is primarily used as a natural sedative and sleep enhancement. Herbalists have traditionally used it as a remedy for Nervousness and Insomnia. Kava is an effective relaxant able to induce a feeling of relaxation, peace and contentment, along with a sharpening of the senses. As a sleep aid it promotes deep and restful sleep. It is also a muscle relaxant that may help relieve cramping due to spasms.

Kava has been used for cystitis, urethritis, rheumatism, joint pains, and Infection of the genitourinary tract, Headache and nervous exhaustion.
Kava affects motor and muscular function, while mental function appears to remain clear (1).

Kava may be helpful in the management of menopausal problems (1).

SAFETY AND PRECAUTIONS

High intakes of kava over a prolonged period is associated with "kava dermopathy" a scaly eruption of the Skin. The skin becomes dry, yellowy and covered with scales, especially the palms of the hands, soles of the feet, forearms, the back and shins (4).

It was thought that kava dermopathy may be due to interference with Niacin. However, in one study no therapeutic effect with niacinamide could be demonstrated (5).

Kava extract should not be used in Parkinson?s Disease, as it may interfere with dopamine production or binding to receptor sites and worsen the disease. Kava exerts an additive effect when combined with bensodiazepines (6).
Kava in high doses increases central nervous Depression and relaxation of skeletal muscle (2).
Following high doses of kava (more than 310g per week) for prolonged periods, adverse effects include biochemical abnormalities - low levels of serum albumin, protein, urea and bilirubin. The presence of blood in the urine, increased red blood cell volume, decreased platelet and lymphocyte counts and shortness of breath (7).
With long term use of kava, there may also be accommodative disturbances, such as enlargement of the pupils and disturbances of the oculomotor equilibrium (1).

Kava may adversely affect motor reflexes and judgement for driving and/or operating heavy machinery, especially when taken above the recommended dosage (1).

Kava should not be taken for more than three months without medical advice (1).

Kava is not recommended for use by persons under the age of 18 (1).

Kava is not recommended for use during Pregnancy or lactation (1).

RESEARCH STUDIES

Standardised preparations of kava are now gaining great popularity in Europe and the United States as a mild sedative and anxiolytics (3).

Many of the first comprehensive studies on the activities of kavalactones were conducted by a team of scientists from the Freiburg University Institute of Pharmacology in Germany, led by Hans J. Meyer, during the 1950s and 1960s. This research has determined that kavalactones exhibit sedative, analgesic, anticonvulsant, and muscle relaxant effects (1). More recent studies, have confirmed and/or elaborated on these effects (3).

REFERENCES

1. Herbal Medicine, 2000, Expert Committee of the German Federal Institute for Drugs and Medical Devices.
2. Herbal Medicine, 1998, Rudolf Fritz Weiss MD. Beaconsfield Arcanum. 1988.
3. The Healing Power of herbs, Michael T Murray N.D. Prima 1995.
4. Journal of American Academy of Dermatology, 1994, 31; 89-87.
5. Lancet, 1990, 335; 1442-1445.
6. Encylopedia of Natural Medicine, Michael T Maurray N. D. and Joseph Pizzorno N.D. Little, Brown and Company. 1998.
7. Medical Journal of Australia, 1988, 148: 548-555.
8. Arzneim Forsch, 1991, 41; 584-588.