Kava Study for Generalized Anxiety Disorder

Despite writing only referenced articles that are typically unemotional by nature, I find great joy in discovering and writing about studies that have to do with Kava. And, this one is a particularly interesting one to me because it claims to be the very first study that has conclusive evidence that Kava is an effective treatment for Generalized Anxiety Disorder (GAD).  The study is was published in the Journal of Clinical Psychopharmacology; a reputable peer-reviewed journal.  According to the study, despite Kava having shown it’s capability to reduce anxiety, there has been no placebo-controlled trial assessing the effectiveness of Kava in the treatment of generalized anxiety disorder.

Kava (piper methysticum) is a plant-based medicine, which has been previously shown to reduce anxiety.

In short, the study revealed this:

Short-term administration of kava significantly reduced participants’ anxiety on the HAMA (Hamilton Anxiety Rating Scale) with a large effect size.

Conducted at the University of Melbourne, researchers also found that Kava may be effective as an alternative to pharmaceutical products for the thousands of Australians who struggle with Generalized Anxiety Disorders (GAD). The lead researcher; Dr. Jerome Sarris stated that existing medications to help treat this complex disorder are few, and that “because of this, more treatment options are required.” Benzodiazepines and selective serotonin repute inhibitors (SSRI’s) are at the top of the treatment option list, followed by pregabalin and hydroxyzine.

He went on to say that “Plant-based medicines may provide a potential pharmacotherapeutic option, as evidenced by a recent positive, double-blind, Randomized Controlled sTudy (RCT) using Chamomile for GAD.” For someone not a complete stranger to anxiety issues, and who is as passionate about Kava as I am, this is extremely exciting news.

Another interesting point is the type of Kava that was used for this study. In 2007, the World Health Organization published a study the size of a book called “Assessment of the Risk of Hepatotoxicity With Kava Products”. In their summary (point 11), they stated that they could find absolutely no connection between liver damage and water-based extractions of Kava. Because of this finding, it’s not surprising that this study used an “aqueous extract of kava (120/240mg) of kavalactones per day, depending on the response.” This was from peeled rootstock of a noble variety, likely from Vanuatu.  The daily amount that the FDA recommends is 290mg, so they were well within the daily limits established by multiple agencies.

Also, for those who are interested in the “numbers” of kavalactones, the analysis of the kavalactones in the material administered during the study, revealed it was a 2-4-5 lineup. This means that dihydrokavain was most prevalent at 15.5mg or 26%, followed by kavain at 12.5mg or 21%, with dihydromethysticin at 11mg or 18%.

What About Liver Damage?

Although the study didn’t focus on liver damage, because of the still-lingering concerns over debunked reports that kava may cause liver damage, data was gathered. A researcher did clarify that the study was quite small, and only over a 3-week period, so any long-term inference of hepatotoxicity or the lack thereof required further study.  At a clinical level, though, cases in which kava hepatotoxicity have been gathered, actual kava hepatotoxicity is an “extremely rare occurrence with probable causation only linked in a few cases.”

Let me put this into perspective for a moment: In a Washington Post article entitled “Prescription Drugs’ Toll Among Deadliest“, the article opens with this shocker:

More than 2 million Americans become seriously ill every year because of toxic reactions to correctly prescribed medicines taken properly, and 106,000 die from those reactions, a new study concludes. That surprisingly high number [possibly] makes drug side effects the fourth most common cause of death in this country.

So, despite 3,000 years of safe use throughout Oceania, despite Kava never conclusively being linked with liver failure, and despite the World Health Organization unequivocally stating that there is no connection between liver damage and water-based extractions of Kava, the stigma of the debunked German study often remains.  But the researchers stated that a plant-based medicine with this stellar of a safety record that is also effective in fighting anxiety to demands more research.

Regardless, liver function tests at the start of week 2, and at the end of week 7 revealed no significant differences on any enzyme. To detail further: The difference between the kava group and the placebo group were “statistically nonsignificant.”

More Study Details

The study found that kava was well tolerated. The only side effect noted by participants were a few reports of headaches. But these headaches were determined not to be related to the kava itself. Also, despite the short-term period the study was conducted within, there was no withdrawal symptoms or kava habits formed during the study.

Also, some women reported an increase in libido. Although kava has been used as an aphrodisiac throughout Oceania for millennia, it would be impossible to directly link kava with this increase in libido. Researchers cautioned that a reduction in anxiety could easily be responsible for an increase in libido. A researcher noted; “Future research confirming the genetic romantic relationship to therapeutic response, and any libido-improving results from Kava is currently required.”

REFERENCES

Coulter D. Assessment of the risk of hepatotoxicity with kava products. WHO appointed committee 2007.

Sarris, Jerome, Con Stough, Chad A. Bousman, Zahra T. Wahid, Greg Murray, Rolf Teschke, Karen M. Savage, Ashley Dowell, Chee Ng, and Isaac Schweitzer. “Kava in the Treatment of Generalized Anxiety Disorder.” Journal of Clinical Psychopharmacology 33.5 (2013): 643-48. Web.

Sarris J., Kavanagh D., Byrne G., et al. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled, cross-over trial using an aqueous extract of Piper methysticum. Psychopharmacology (Berl). 2009; 205(3); 399-407.

Teschke R, Genthner A., Wolff A. Kava hepatotoxicity: comparison of aqueous, ethanolic, acetonic kava extracts and kava-herbs mixtures. J Ethnopharmacol, 2009; 123(3); 378-384.