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First Published Tuesday, 12 May 2009


Joan Robinson


Research conducted at the University of Queensland has found a traditional extract of Kava (Piper methysticum), a medicinal plant from the South Pacific, to be effective in reducing anxiety.


To be published in the journal Psychopharmacology are the results of a world-first clinical trial which found that a water-soluble extract of Kava was effective in treating anxiety and improving mood.


The Kava was prescribed in the form of tablets supplied by Queensland company MediHerb Pty Ltd.


Lead researcher Jerome Sarris, a PhD candidate from the University’s School of Medicine, said the placebo-controlled study found Kava to be an effective and safe treatment option for people with chronic anxiety and varying levels of depression.


We’ve been able to show that Kava offers a natural alternative for the treatment of anxiety, and unlike some pharmaceutical options, has less risk of dependency and less potential of side effects,” Mr Sarris said.


Each week participants were given a clinical assessment as well as a self-rating questionnaire to measure their anxiety and depression levels.


The researchers found anxiety levels decreased dramatically for participants taking five of the kava tablets daily compared to the placebo group.


We also found that Kava had a positive impact on reducing depression levels, something which had not been tested before,” Mr Sarris said.


In 2002 Kava was banned in Europe, the UK and Canada due to concerns over liver toxicity.


While the thee-week trial raised no major health concerns regarding the Kava extract used, the researchers said larger studies were required to confirm the drug’s safety.


When extracted in the appropriate way, Kava may pose less or no potential liver problems. I hope the results will encourage governments to reconsider the ban,” Mr Sarris said.


Ethanol and acetone extracts, which sometimes use the incorrect parts of the Kava, were being sold in Europe. That is not the traditional way of prescribing Kava in the Pacific Islands.


Our study used a water-soluble extract from the peeled rootstock of a medicinal cultivar of the plant, which is approved by the Therapeutic Goods Administration of Australia and is currently legal in Australia for medicinal use.


In addition to benefiting sufferers of anxiety, allowing the sale of Kava in Europe, the UK and Canada would significantly enhance Pacific Island economies, which have lost hundreds of millions of dollars by not being able to export the plant over the past several years.


Sarris J, Kavanagh DJ, Byrne G, *Bone KM, et al. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum. Psychopharmacology 2009;doi:10.1007/s00213-009-1549-9 [Abstract | Full text]

*Conflicts of interest: Kerry Bone is a co-founder of and consultant to MediHerb Pty Ltd, the supplier of the tablets used in this trial. He was not involved in the conduct of the study or the analysis of the data.
Comment:
In addition to the acute necrotizing hepatitis risk alluded to in the article, prolonged high doses may cause “kava dermopathy” a scaly skin rash [Kava monograph (PDF)]. It may also increase photo sensitivity, so excess sun exposure should be avoided.

Kava may be contraindicated if taking benzodiazepines, antipsychotics, buspirone (Buspar®) , some Parkinson Disease medications and antidepressants which act on noradrenaline/norepinephrine such as the tricyclics, desvenlafaxine (Pristiq®), duloxetine (Cymbalta®), mirtazapine (Remeron®), venlafaxine (Effexor®), and the dopaminergic antidepressant bupropion (Wellbutrin®). Consult a physician or pharmacist before taking a Kava supplement with these or other medications.

Abuse of Kava in the form of bulk tea/powder has had a devastating effect on some Australian (and North American) Indigenous communities where it has replaced alcohol. Its use is now restricted in some states.


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