kava

Action and Spectrum

Actions and Spectrum: 

kava, also known as Piper methysticum, is a plant native to the South Pacific islands. It has been traditionally used for its sedative, anxiolytic (anti-anxiety), and muscle relaxant properties.  

• Kavalactones: kava contains a group of compounds known as kavalactones, which are believed to be responsible for their pharmacological effects. These compounds interact with various receptors in the brain, including gamma-aminobutyric acid (GABA) receptors. GABA is an inhibitory neurotransmitter that helps regulate brain activity and promotes relaxation.  
• Modulation of Neurotransmitters: kava may influence the levels and activity of various neurotransmitters in the brain, including serotonin and dopamine. Serotonin is involved in mood regulation, while dopamine is associated with reward and motivation.  
• Anti-Anxiety Effects: kava has been shown to have anxiolytic properties, which can reduce anxiety and promote relaxation. It may achieve this by modulating GABAergic activity, reducing excessive neuronal firing, and dampening the stress response. 
• Muscle Relaxation: kava is known for its muscle relaxant effects, which may be attributed to its ability to enhance GABAergic activity in the central nervous system. Kava may help relieve muscle tension and ease physical discomfort by promoting relaxation. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Dizziness 

Enlarged pupils 

Headache 

Hepatotoxicity 

Motor reflex impairment 

Allergic skin reactions 

Drowsiness 

Gastrointestinal upset 

Hepatitis (acute) 

Liver failure 

Black Box Warning

Black box warning: 

None 

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

• Liver Disease or Impairment: Individuals with existing liver disease or impairment should avoid using kava. Kava has been linked to cases of severe hepatotoxicity, including liver failure.  
• Alcohol Use or History of Substance Abuse: Combining kava with alcohol or other substances that can affect the liver may increase the risk of liver damage. If you have a history of substance abuse or currently consume alcohol, it is advisable to avoid using kava. 
• Parkinson’s Disease: Some evidence suggests that kava may worsen symptoms in individuals with Parkinson’s disease. 

Caution: 

• Hepatotoxicity: kava has been associated with cases of hepatotoxicity, including liver damage and liver failure. Although the exact mechanisms and risk factors are not fully understood, avoiding or using kava cautiously is advisable, especially if you have pre-existing liver conditions, consume alcohol regularly, or take medications that may affect liver function. 
• Allergic Reactions: Some individuals may be allergic to kava or components present in kava products. Allergic reactions can vary in severity, including symptoms such as rash, itching, swelling, or difficulty breathing. 
• Central Nervous System Depression: kava has soothing properties and can cause central nervous system depression. It may result in drowsiness, impaired coordination, and reduced reaction times. 

Pregnancy / Lactation

Pregnancy consideration: Not safe to use during pregnancy 

Lactation: Not safe to use during lactation 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

• GABAergic Activity: kava is thought to exert its effects by interacting with the brain’s gamma-aminobutyric acid (GABA) system. GABA is an inhibitory neurotransmitter that helps regulate brain activity and promotes relaxation. Kavalactones present in kava are believed to enhance the binding of GABA to its receptors, resulting in anxiolytic (anti-anxiety), soothing, and muscle relaxant effects. 
• Modulation of Neurotransmitters: kava may influence the levels and activity of various neurotransmitters in the brain, including dopamine and serotonin. Dopamine is associated with reward, motivation, and mood regulation, while serotonin plays a role in mood, anxiety, and stress response.  
• Inhibition of Monoamine Oxidase-B (MAO-B): kava has been shown somewhat to inhibit the enzyme monoamine oxidase-B (MAO-B) activity. MAO-B is involved in the breakdown of certain neurotransmitters, and inhibiting its activity may contribute to the potential effects of kava on mood and relaxation.

Pharmacokinetics: 

N/A 

Adminstartion

Administration: 

• Traditional kava Drink: The traditional method of consuming kava involves preparing a kava drink or infusion. The root of the kava plant is typically ground into a powder or grated, then mixed with water. The mixture is kneaded or strained to extract the active compounds and create a beverage.  
• kava Capsules or Tablets: kava is available as capsules or tablets, typically as a dietary supplement. These provide a convenient and standardized way of consuming kava.  
• Liquid Extracts or Tinctures: kava can be found as liquid extracts or tinctures. These concentrated forms of kava can be added to water or other beverages, following the instructions on the product label.  
• kava Tea Bags: Some commercial kava preparations are available as tea bags. These pre-packaged tea bags can be steeped in hot water, like other herbal teas, and consumed according to the instructions on the packaging. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: kava 

Why do we use kava? 

kava (Piper methysticum) has been traditionally used in the South Pacific islands for its potential relaxing, anxiolytic (anti-anxiety), and soothing properties. 

• Anxiety and Stress Reduction: kava is often used for its anxiolytic (anti-anxiety) properties. It is believed to help promote relaxation, reduce anxiety, and ease stress. kava’s effects on the central nervous system, particularly its interaction with GABA receptors, may contribute to its anxiolytic effects. 
• Sleep Aid: kava is sometimes used as a natural sleep aid. Its calming and soothing properties promote sleep and improve sleep quality.  
• Muscle Relaxation: kava has muscle relaxant properties and may help relieve muscle tension and promote relaxation. This effect is attributed to its interaction with GABA receptors, which can have a calming effect on muscle activity. 
• Social and Cultural Purposes: kava has been used for centuries in traditional ceremonies and social gatherings in the South Pacific islands. It plays a cultural and social role and is believed to foster a sense of relaxation, camaraderie, and connection.