Kava as a Pharmacotherapy of Anxiety Disorders: Promises and Concerns

@article{Rivers2016KavaAA,
  title={Kava as a Pharmacotherapy of Anxiety Disorders: Promises and Concerns},
  author={Zachary T Rivers and Chengguo Xing and Sreekanth Chanickal Narayanapillai},
  journal={Medicinal Chemistry},
  year={2016},
  volume={6},
  pages={81-87}
}
Current standard pharmacotherapies for anxiety management come with a host of side-effects that may deter the patients from utilizing them. Kava, a traditional beverage from the South Pacific region, has been used as a natural medicine for centuries and has been hypothesized to contain anxiolytic properties. There are a few well-designed, randomly controlled trials that have evaluated the effectiveness of kava or its constituents against anxiety disorders. They have generally shown kava to be… 

Figures and Tables from this paper

Kava as a Clinical Nutrient: Promises and Challenges
TLDR
Given its growing popularity in clinical and recreational use, the urgent need for quality control and quality assurance of kava products, pharmacokinetics, absorption, distribution, metabolism, excretion, and foundational pharmacology is emphasized.
Kava for Generalized Anxiety Disorder: A Review of Current Evidence.
TLDR
Current evidence, although promising, is insufficient to confirm the effect of Kava for GAD treatment beyond placebo, and new evidence is expected from a large, multisite ongoing trial.
How Yoga Helps to Children to Avoid Stress
TLDR
The physical outcomes of mental anxiety and the likelihood of decreasing anxiety by yoga in youth are managed and it is presumed that the helpfulness of yoga is hypothetically bolstered.
Pilot in Vivo Structure-Activity Relationship of Dihydromethysticin in Blocking 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone-Induced O6-Methylguanine and Lung Tumor in A/J Mice.
TLDR
A pilot in vivo structure-activity relationship (SAR) relationship was explored, demonstrating that the methylenedioxy functional group in DHM is essential while the lactone functional group tolerates modifications.

References

SHOWING 1-10 OF 64 REFERENCES
Therapeutic Potential of Kava in the Treatment of Anxiety Disorders
TLDR
Clinical studies have shown that kava and kavalactones are effective in the treatment of anxiety at subclinical and clinical levels, anxiety associated with menopause and anxiety due to various medical conditions, and kava should be used with caution.
Kava consumption and its health effects.
TLDR
Kava beverage is made from the root of the pepper plant, Piper methysticum, and contains herbal ingredients for reliving anxiety and tension, reported to include sedative, anxiolytic, anti-stress, analgesic, local anaesthetic, anticonvulsant and neuroprotective properties.
Kava for the Treatment of Generalized Anxiety Disorder RCT: Analysis of Adverse Reactions, Liver Function, Addiction, and Sexual Effects
TLDR
There was a highly significant correlation between ASEX reduction (improved sexual function and performance) and anxiety reduction in the whole sample and kava significantly increased female's sexual drive compared to placebo, with no negative effects seen in males.
Kava in the Treatment of Generalized Anxiety Disorder: A Double-Blind, Randomized, Placebo-Controlled Study
TLDR
Standardized kava may be a moderately effective short-term option for the treatment of generalized anxiety disorder (GAD), and specific GABA transporter polymorphisms appear to potentially modify anxiolytic response to kava.
Kava hepatotoxicity--a clinical review.
A placebo-controlled study of Kava kava in generalized anxiety disorder
TLDR
Although kava was not superior to placebo, it would be premature to rule it out as efficacious in GAD, and both treatments were well tolerated.
Kava extracts: safety and risks including rare hepatotoxicity.
TLDR
A critical analysis of the suspected cases in Germany reveals that only in 1 single patient a very probable causal relationship could be established between kava treatment and the development of toxic liver disease due to a positive result of an unscheduled reexposure test, whereas in another patient there might be a possible association.
Risk of kava hepatotoxicity and the FDA consumer advisory.
TLDR
It appears that legislation-enforced quality standards for kava products are a first step for increasing their safety in human use, and there is now sound evidence that liver injury was caused by both the traditional water- based kava extracts of the South Pacific and the medicinal solvent-based kava extract of Western countries, with flavokavain B as one of the possible culprits.
Kava Anxiety Depression Spectrum Study (KADSS): a mixed methods RCT using an aqueous extract of Piper methysticum.
...
1
2
3
4
5
...