Kava-Kava extract LI 150 is as effective as Opipramol and Buspirone in Generalised Anxiety Disorder – An 8-week randomized, double-blind multi-centre clinical trial in 129 out-patients

Boerner, R. J.; Sommer, H.; Berger, William; Kühn, Ulrike; Schmidt, Ulrich; Mannel, Marcus

doi:10.1078/1433-187x-00309

Cited by 118 publications

(20 citation statements)

References 22 publications

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“…Of the 19 trials rejected at data selection, two presented duplicate data, 23 39 four presented insufficient data for extra ction, [44][45][46][47] and 13 presented insufficient network connections (that is, the only randomised controlled trials for a particular drug or the comparator in the study was inappropriate). [48][49][50][51][52][53][54][55][56][57][58][59][60] Table A on bmj.com gives details of the 27 included trials.…”

Section: Researchmentioning

confidence: 99%

Efficacy of drug treatments for generalised anxiety disorder: systematic review and meta-analysis

Baldwin

Woods²,

Lawson³

et al. 2011

BMJ

252

141

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Objective To appraise the evidence for comparative efficacy and tolerability of drug treatments in patients with generalised anxiety disorder. Design Systematic review of randomised controlled trials. Primary Bayesian probabilistic mixed treatment metaanalyses allowed pharmacological treatments to be ranked for effectiveness for each outcome measure, given as percentage probability of being the most effective treatment. Secondary frequentist mixed treatment metaanalyses conducted with random effects model; effect size reported as odds ratio and 95% confidence interval. Data sources Medline, Embase, BIOSIS, PsycINFO, Health Economic Evaluations Database, National Health Service Economic Evaluation Database, and Database of Abstracts of Reviews of Effects via DataStar, and Cochrane Database of Systematic Reviews via Cochrane Library (January 1980 to February 2009). Eligibility criteria Double blind placebo controlled randomised controlled trials; published systematic reviews and meta-analyses of randomised controlled trials. Randomised controlled trials including adult participants (aged ≥18) receiving any pharmacological treatment for generalised anxiety disorder. Data abstraction methods Titles or abstracts reviewed initially, followed by review of full text publications for citations remaining after first pass. A three person team conducted screening; an independent reviewer checked a random selection (10%) of articles screened. Data extracted for meta-analysis were also independently reviewed. Main outcome measures Proportion of participants experiencing ≥50% reduction from baseline score on Hamilton anxiety scale (HAM-A) (response), proportion with final HAM-A score ≤7 (remission), proportion withdrawing from trial because of adverse events (tolerability). Results The review identified 3249 citations, and 46 randomised controlled trials met inclusion criteria; 27 trials contained sufficient or appropriate data for inclusion in the analysis. Analyses compared nine drugs (duloxetine, escitalopram, fluoxetine, lorazepam, paroxetine, pregabalin, sertraline, tiagabine, and venlafaxine). In the primary probabilistic mixed treatment meta-analyses, fluoxetine was ranked first for response and remission (probability of 62.9% and 60.6%, respectively) and sertraline was ranked first for tolerability (49.3%). In a subanalysis ranking treatments for generalised anxiety disorder currently licensed in the United Kingdom, duloxetine was ranked first for response (third across all treatments; 2.7%), escitalopram was ranked first for remission (second across all treatments; 26.7%), and pregabalin was ranked first for tolerability (second across all treatments; 7.7%). Conclusions Though the frequentist analysis was inconclusive because of a high level of uncertainty in effect sizes (based on the relatively small number of comparative trials), the probabilistic analysis, which did not rely on significant outcomes, showed that fluoxetine (in terms of response and remission) and sertraline (in terms of tolerability) seem t...

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Section: Researchmentioning

confidence: 99%

Efficacy of drug treatments for generalised anxiety disorder: systematic review and meta-analysis

Baldwin

Woods²,

Lawson³

et al. 2011

BMJ

252

141

View full text Add to dashboard Cite

show abstract

“…nonspecific anxiety, tension, agitation, agoraphobia, specific phobia, GAD, adjustment disorder, and insomnia. It also has been demonstrated to have equivalent efficacy to buspirone and venlafaxine in the treatment of GAD (Boerner et al, 2003;Connor and Davidson, 2002). Additionally, kava has proven to be efficacious in the treatment of perimenopausal symptoms (Cagnacci et al, 2003).…”

Section: Kava (Piper Methysticum)mentioning

confidence: 99%

Clinical applications of herbal medicines for anxiety and insomnia; targeting patients with bipolar disorder

Baek

Nierenberg

Kinrys

2014

Aust N Z J Psychiatry

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Objectives: Patients with bipolar disorder frequently continue to experience residual anxiety and insomnia between mood episodes. In real-world practice, patients increasingly self-prescribe alternative medicines. Methods:We reviewed case reports, open-label, and placebo-controlled trials investigating the use of herbal medicines to treat anxiety and insomnia, and discussed their potential applications for bipolar disorder.Results: Eleven herbal medicines that have been studied in human subjects are included in this review. Mechanisms of action, efficacy, side effects, and drug-drug interactions are discussed. Based on currently available evidence, valerian seems to be the most promising candidate for insomnia and anxiety in bipolar disorder. Conclusions:Adjunctive herbal medicines may have the potential to alleviate these symptoms and improve the outcomes of standard treatment, despite limited evidence. Physicians need to have a more in-depth understanding of the evidence of benefits, risks, and drug interactions of alternative treatments.

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“…Kava has been widely used in western medicine to treat mild and moderate anxiety (Pittler and Ernst 2003;Boerner et al 2003;Connor et al 2006). However, suspected cases of hepatotoxicity in Germany led health authorities in Europe to ban kava products (Campo et al 2002).…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of genetic variation in kava (Piper methysticum) assessed by SSR and DArT reveals zygotic foundation and clonal diversification

Vandenbroucke

Mournet

Malapa

et al. 2015

Genome

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Kava (Piper methysticum) is a major cash crop in the Pacific. The aim of this study was to assess genetic variation among 103 accessions of kava using SSRs and DArTs. Genetic structure was determined using clustering analyses (WPGMA) and principal coordinate analyses (PCA). Thirteen SSR primers and 75 DArT markers were found polymorphic, and the two types of markers generated similar clustering patterns. Genetic distances ranged from 0 to 0.65 with an average of 0.24 using SSRs and from 0 to 0.64 with an average of 0.24 using DArT. Eleven genotypes were identified with SSR while 28 genotypes were identified with DArT markers. By combining the two sets of markers, a total of only 30 distinct genotypes were observed. In the Vanuatu archipelago, noble cultivars originating from different islands clustered together within a very narrow genetic base despite their diversity of morphotypes. SSR and DArT fingerprints allowed the identification of kava cultivars unsuitable for consumption, so called two-days, and clearly differentiated the wild types classified as P. methysticum var. wichmannii from the cultivars as var. methysticum. Molecular data reveals that all noble cultivars evolved by the predominance of clonal selection. Although they are represented by clearly distinct morphotypes, these cultivars are genetically vulnerable and their potential to adapt to forthcoming changes is limited. These newly developed markers provide high resolution and will be useful for kava diversity analyses and quality assessment.

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Kava-Kava extract LI 150 is as effective as Opipramol and Buspirone in Generalised Anxiety Disorder – An 8-week randomized, double-blind multi-centre clinical trial in 129 out-patients

Cited by 118 publications

References 22 publications

Efficacy of drug treatments for generalised anxiety disorder: systematic review and meta-analysis

Efficacy of drug treatments for generalised anxiety disorder: systematic review and meta-analysis

Clinical applications of herbal medicines for anxiety and insomnia; targeting patients with bipolar disorder

Comparative analysis of genetic variation in kava (Piper methysticum) assessed by SSR and DArT reveals zygotic foundation and clonal diversification

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