The Kava plant is a member of the pepper family and has been a drink for thousands of years in the Pacific Islands. Kava is used for medicinal, religious, political, cultural and social purposes throughout the Pacific. The roots of the plant are used to produce a drink with sedative and anaesthetic properties. Kava relaxes the muscles and can provide a jolly and upbeat spirit.
People use kava for many reasons, in particular stress, anxiety, poor sleep, relaxation, improving mood, and as a social and ceremonial drink.
Some countries have taken kava off the market because it might cause liver damage. Many experts are unsure about kava’s safety, and whether kava alone, or in combination with other drugs/herbs or pre-existing health problems, could be dangerous.
Traditionally kava root is crushed, ground or powdered, then added to water and drunk like tea. Kava is also available in capsules, tablets and liquid extracts.
Kava might affect the level of neurotransmitters in the body. Neurotransmitters are chemicals that carry messages between nerve cells. Some neurotransmitters that kava can affect include noradrenaline, GABA and dopamine. These all affect our mood.
Chemicals in kava can, for example, help us relax, reduce anxiety, improve mood, make us sleepy, relax muscles and relieve pain.
Kava: Latest views
A recent world-first Australian study found kava is, according to its researchers, “safe and effective in reducing anxiety”, and reduces depression. Lead researcher Jerome Sarris said, “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.”
The type of kava extract used in this study was water-soluble, like the type traditionally prescribed in the Pacific Islands. The kava extracts used in other studies of kava, that found the plant may be unsafe, were extracts that might cause liver problems.
“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.
The University of Queensland conducted a 3-week placebo-controlled, double-blind study of a water-soluble extract of kava. Sixty adults with anxiety took part in the study. The group that took the kava were less anxious and less depressed than the group that took the placebo (dummy) pill. The study’s researchers said this type of kava extract “… was found to be safe, with no serious adverse effects”, and was not toxic to the liver.
The UMMC says some clinical studies have found that kava treats the symptoms of anxiety. In a review of seven scientific studies, researchers concluded that a standardized kava extract was better than a placebo in treating anxiety.
The UMMC says kava might help improve sleep quality and decrease the amount of time needed to fall asleep, but more studies are needed. As a conclusion kava is not the best choice for treating insomnia because of concern about its safety.
The Better Health Channel claims there is no evidence that people who often drink large amounts of kava become dependent. There does not seem to be a risk of withdrawal if a person suddenly stops taking kava. Medical supervision is, however, recommended.
In November 2008, the EU announced its’ lifting of the kava trade ban, which had been imposed due to accusations made in 2001 and since debunked through scientific review of the facts. Poland is the only country in the European Union (and probably the only country in the world) that explicitly bans sale, cultivation and possession of kava in any form and for any purpose.
Do not take kava unless you are under the supervision of a doctor, especially if you are being treated for any disease. Do not take kava with any prescription and non-prescription medications. Avoid drinking alcohol while taking kava. Alcohol may increase your risk of liver damage.
Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxants, and medicine for seizures, depression or anxiety can add to sleepiness caused by kava. Tell your doctor if you need to use any of these other medicines while you are taking kava.
Kava has not been evaluated by the FDA (US Food and Drug Administration) for safety, effectiveness, or purity. All potential risks and/or advantages of this product may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. Some marketed herbal supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.
If you choose to take kava, use it exactly as directed on the label, or as prescribed by your doctor, pharmacist, or other healthcare provider.
When used to treat insomnia, kava is usually taken one hour before bedtime. When used for other purposes, kava may be taken one to several times a day
The American Academy of Family Physicians says that short-term use of kava is okay for patients with mild to moderate anxiety — but not if you use alcohol or take medicines metabolised in the liver, including many cholesterol medicines. In fact, the FDA has issued a warning that using kava supplements has been linked to a risk for severe liver damage. Before taking kava, ask your doctor if kava is safe for you.
Variations in growing conditions (such as soil type and the amount of sunlight and water available) and different varieties of plant mean that the strength of kava lactones can vary widely. The strength of the dose also depends on how the drink is prepared and how much powdered kava is added to the water.
Side effects of kava
Small doses – relaxed muscles, sleepiness, feelings of wellbeing, mild loss of feeling in the throat and mouth, appetite loss.
Larger doses – dilated pupils, reddened eyes, nausea, stupor, induced sleep, reduced muscle control (ataxia).
Kava has been shown to cause severe liver injury including hepatitis, cirrhosis, and liver failure. Do not take kava if you have liver problems or take medications that can affect the liver. Stop taking kava and seek emergency medical attention if you have liver symptoms such as nausea, stomach pain, loss of appetite, itching, dark urine, clay-coloured stools, or jaundice (yellowing of the skin or eyes).
Kava should not be used for longer than three months without a doctor’s supervision. The long-term use of kava has reportedly led to “kawanism”, which is characterized by dry, flaking, discoloured skin; reddened eyes; a scaly skin rash; puffy face; muscle weakness; blood abnormalities; and feelings of poor health.
However, the University of Queensland found that a water-soluble kava extract – like the type used traditionally in the Pacific Islands – is safe and effective for treating anxiety and depression. People have had less side effects from this type of kava than from orthodox anti-anxiety medication.
Drug Info says chronic or heavy use of kava might cause:
- bloodshot eyes
- chest pain
- dry and scaly skin
- extreme tiredness
- high blood pressure
- increased risk of infection
- irreversible liver and kidney damage
- loss of muscle control
- severe weight loss
- shortness of breath
- stomach upset
Drug Info warns that high use of kava has been linked to mood swings and apathy. Mental problems such as depression and schizophrenia might be worsened.