PDR for Herbal Medicines

444/KAVA KAVA FDR FOR HERBAL MEDICINES

of anxiety according to the HAMA scale in all three groups.

There wasn't a statistically significant difference between the

three types of treatment in terms of reducing anxiety (Woelk,

1993).

A standardized Kava extract give'n 100 mg three times daily

was compared to placebo in a randomized, double-blind

study. The study included 58 patients with anxiety syn-

dromes not caused by mental disorders. The HAMA overall

score of anxiety symptoms revealed significant reduction in

the Kava treatment group compared to placebo after 1 week

of therapy. After 4 weeks of therapy, an even greater

reduction in anxiety symptoms was seen with the Kava

treatment group, with no adverse reactions (Lehmann, 1996).

INDICATIONS AND USAGE

• Nervousness and insomnia
  Kava Kava is used for nervous tension, stress and agitation.
  Unproven Uses: In folk medicine, the herb is used as a
  sleeping agent and sedative; for asthma, rheumatism, dys-
  peptic symptoms, chronic cystitis, syphilis, gonorrhea and
  weight reduction.
  Homeopathic Uses: Kava Kava is used for states of
  excitement and exhaustion. It is also used for gastritis and
  pain in the urethra.
  CONTRAINDICATIONS
  The drug is contraindicated in patients with endogenous
  depression because it increases the danger of suicide. It is
  also contraindicated during pregnancy and in nursing moth-
  ers. The herb is contraindicated in persons with endogenous
  depression, because there is an increased risk of suicide in
  this population.
  PRECAUTIONS AND ADVERSE REACTIONS
  General: No health hazards are known in conjunction with
  the proper administration of designated therapeutic dosages.
  Administration of the herb leads to rare cases of allergic
  reactions and gastrointestinal complaints. Slight morning
  tiredness can appear at the beginning of the therapy. Motor
  reflexes and judgment when driving may be reduced while
  taking the herb.
  Central Nervous System: Dyskinesia and choreoathetosis of
  the limbs, trunk, neck and facial musculature have been
  reported secondary to the administration of kava (Schelosky,
  1995; Spillane, 1997).
  Endocrine: Following long-term use of high doses of Kava
  extract, weight loss was reported (Mathews, 1988).

Hepatotoxicity: Increase in gamma-glutamyl transferase
(GGT) levels have been associated with high doses of Kava
extract (Mathews, 1988). Two cases of acute hepatitis with
an increase of liver enzymes were reported. Necrotizing

hepatitis was determined after a liver biopsy, and upon

discontinuation of Kava, liver tests normalized (Stahl, 1998).

Musculoskeletal: Minor inhibition of movement and im-

paired motor reflexes have been observed with the use of

Kava (Jamieson, 1990).

Ocular: Increase in pupil diameter, reduction of the near

point of accommodation and near point of convergence, and

disturbance to the oculomotor balance have been reported

with Kava (Garner, 1985). Eye irritation has been reported

with the heavy consumption of Kava (Ruze, 1990).

Skin: Heavy chronic consumption of Kava is associated with

a peculiar, scaly rash suggestive of ichthyosis (Ruze, 1990).

A reversible, slight yellowing of the skin has been associated

with long-term use of Kava. Sebotropic drug reactions

resulting from Kava-Kava extract therapy has been reported

(Jappe, 1998).

The drug should not be taken for longer than three months

without a doctor's supervision.

Drug Interactions:

Alcohol — Concomitant use of Kava Kava with alcohol

results in an increase in each other's hypnotic action. The

alcohol also increases the possibility for kava toxicity

(Jamieson, 1990).

Alprazolam —- Kava used simutaneously with alprazolam

has resulted in coma (Almeida, 1996).

CNS depressants, such as barbituates — The herb may

potentiate the effectiveness of substances that act on the

central nervous system.

Psychoactive agents — The intensity of psychoactive agents

may be intensified with kava (Jamieson, 1990).

Dopamine — Kava Kava has been reported to antagonize the

effect of dopamine. Patients with Parkinson's Disease taking

levodopa should avoid the use of the herb (Baum, 1998;

Cupp, 1999; Schelosky, 1995).

Pregnancy: The drug is contraindicated during pregnancy.

Nursing Mothers: The drug is contraindicated in nursing

mothers.

OVERDOSAGE

Overdosage can result in disorders of complex movement,

accompanied by undisturbed consciousness, later tiredness

and tendency to sleep.

DOSAGE

Mode of Administration: Comminuted rhizome and other

galenic preparations for oral use.