The acute effects of kava and oxazepam on anxiety, mood, neurocognition; and genetic correlates: a randomized, placebo‐controlled, double‐blind study

@article{Sarris2012TheAE,
  title={The acute effects of kava and oxazepam on anxiety, mood, neurocognition; and genetic correlates: a randomized, placebo‐controlled, double‐blind study},
  author={Jerome Sarris and Andrew Scholey and Isaac Schweitzer and Chad A. Bousman and E Laporte and Chee H. Ng and Greg Murray and Con Stough},
  journal={Human Psychopharmacology: Clinical and Experimental},
  year={2012},
  volume={27}
}
Kava (Piper methysticum) is a psychotropic plant medicine with history of cultural and medicinal use. We conducted a study comparing the acute neurocognitive, anxiolytic, and thymoleptic effects of a medicinal dose of kava to a benzodiazepine and explored for the first time specific genetic polymorphisms, which may affect the psychotropic activity of phytomedicines or benzodiazepines. 
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.
Does a Medicinal Dose of Kava Impair Driving? A Randomized, Placebo-Controlled, Double-Blind Study
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A medicinal dose of kava containing 180 mg of kavalactones does not impair driving ability, whereas 30 mg of oxazepam shows some impairment, and research assessing larger recreational doses of kva on driving ability should now be conducted.
The Pharmacology, Pharmacokinetics, Efficacy, and Adverse Events Associated With Kava
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  • 2018
Kava is a plant with numerous kavapyrones that can induce pharmacologic effects and drug interactions through the cytochrome P450 and P‐glycoprotein systems. Kava is used recreationally and for the
Herbal Anxiolytics with Sedative Actions
TLDR
This chapter will present evidence from human clinical trials regarding the efficacy of herbal treatments with a primarily sedative mode of action for chronic (everyday) supplementation to address anxiety symptoms.
Kava for the treatment of generalised anxiety disorder (K-GAD): study protocol for a randomised controlled trial
TLDR
If this study demonstrates positive findings in support of the superiority of kava over placebo in the treatment of GAD, and also is shown to be safe, then this plant-medicine can be considered a ’first-line‘ therapy for GAD.
Oxazepam for the Treatment of Substance Abuse and Depression: Is it Appropriate?
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    Journal of psychosocial nursing and mental health services
  • 2016
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Oxazepam is potentially useful in the treatment of substance abuse, especially in conjunction with the cortisol synthesis inhibitor metyrapone, and can be considered an appropriate medication to use in thereatment of depression.
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.
Herbal medicine for depression and anxiety: A systematic review with assessment of potential psycho‐oncologic relevance
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Black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk–benefit profiles compared to standard treatments, which may benefit cancer patients by minimizing medication load and accompanying side effects.
Plant-Based Medicines for Anxiety Disorders, Part 2: A Review of Clinical Studies with Supporting Preclinical Evidence
TLDR
A comprehensive narrative review of plant-based medicines that have clinical and/or preclinical evidence of anxiolytic activity and conclusions need to be tempered due to methodological issues such as small sample sizes, brief intervention durations and non-replication.
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References

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Kava (Piper methysticum) elicits dose‐dependent psychotropic effects and thus may potentially deleteriously affect cognitive performance. Clinical trials have assessed the effects of kava on
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: A Comprehensive Review of Efficacy, Safety, and Psychopharmacology
TLDR
The current weight of evidence supports the use of kava in treatment of anxiety with a significant result occurring in four out of six studies reviewed, and more studies are required to assess comparative efficacy and safety versus established pharmaceutical comparators.
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TLDR
Some significant findings indicate that presence of the long allele of the serotonin transporter (5-HTT) gene is associated with favorable response in anxiety disorders, and the most promising strategy in clinical practice appears to incorporate testing of functional CYP450 gene variants to avoid over- or under-dosing in poor or rapid metabolizers.
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TLDR
The aqueous Kava preparation produced significant anxiolytic and antidepressant activity and raised no safety concerns at the dose and duration studied, and appears equally effective in cases where anxiety is accompanied by depression.
The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum
TLDR
The aqueous Kava preparation produced significant anxiolytic and antidepressant activity and raised no safety concerns at the dose and duration studied, and appears equally effective in cases where anxiety is accompanied by depression.
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TLDR
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Volunteer subjects were assigned to receive a mixture of the intoxicating substance, kava, in a mixture with fruit juice, or juice alone. Subjects then undertook tasks of acute cognitive functioning,
Enhanced cognitive performance and cheerful mood by standardized extracts of Piper methysticum (Kava‐kava)
TLDR
Kava is a potent anxiolytic agent, which can facilitate cognitive functioning and can increase positive affectivity related to exhilaration, and unlike conventional benzodiazepine‐type anxIOlytics, which tend to impair cognitive performance and to increase the occurrence of negative affective states.
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