Kava treatment in patients with anxiety

Abstract

In several clinical trials, mainly conducted with a dose of 300 mg kava extract per day, kava has been employed successfully for the treatment of anxiety disorders. The goal of the placebo-controlled double-blind outpatient trial was to obtain more information on the dosage range and efficacy of a kava special extract WS 1490 in patients with non-psychotic anxiety. 50 patients were treated with a daily dose of 3 x 50 mg WS 1490 during a 4-week treatment period followed by a 2-week safety observation phase. In the active treatment group, the total score of the Hamilton anxiety scale (primary efficacy variable), showed a therapeutically relevant reduction in anxiety versus placebo (more than 4 points). In the secondary variables studied, HAMA 'somatic and psychic anxiety' subscales, the Erlangen anxiety, tension and aggression scale (EAAS), the brief personality structure scale (KEPS), the adjective checklist (EWL 60-S) and clinical global impressions scale (CGI), a trend in favour of the active treatment was detectable. WS 1490 was well tolerated and showed a safety profile with no drug-related adverse events or post-study withdrawal symptoms. It can be concluded that the applied 150 mg WS 1490 per day is an effective and safe treatment of non-psychotic anxiety syndromes in the described population.

Meta-analysis of the efficacy of the acetonic kava-kava extract WS®1490 in patients with non-psychotic anxiety disorders

“…2 present the mean improvement in the HAMA score during treatment and the difference between the verum mean and placebo mean by study. In all trials except Geier and Konstantinowicz (2004) the effect estimates are in favour of WS ® 1490. For the trials of Kinzler et al (1991) and Warnecke (1991) the zero is not within the 95% confidence interval for treatment effect.…”

“…The other 22 retrieved publications did not meet the criteria of our protocol. Two of the six trials and (Geier and Konstantinowicz, 2004;Lehrl, 2004), provided by the company, could not have been found using MEDLINE and EMBASE, because they were in press at the time.…”

“…Upon request, the pharmaceutical company provided documentation of the following six trials: (Geier and Konstantinowicz, 2004;Kinzler et al, 1991;Lehrl, 2004;Malsch and Kieser, 2001;Volz and Kieser, 1997;Warnecke, 1991). All of them met the established inclusion criteria and were used for the meta-analysis.…”

Flavokawains A and B from kava (Piper methysticum) activate heat shock and antioxidant responses and protect against hydrogen peroxide-induced cell death in HepG2 hepatocytes

“…Kava has several effects on the human body, both peripherally and on the central nervous system. Among its many central actions, kava has been demonstrated to possess anxiolytic, sedative-hypnotic and anticonvulsant properties (Geier & Konstantinowicz, 2004; Gleitz et al, 1996; Sarris et al, 2013). In the periphery, kava has documented immunosuppressive as well as anti-neoplastic effects (Folmer et al, 2006; Kwon et al, 2013).…”

Herbs for the Treatment of Insomnia

“…Research indicates that kava kava acts as a central nervous system depressant, and possesses muscle relaxant and analgesic effects in animals (Abebe, 2002). In several clinical trials, mainly conducted with a dose of 300 mg kava extract per day, kava has been employed successfully for the treatment of anxiety disorders (Gale and Oakley-Browne, 2004;Geier and Konstantinowicz, 2004). While the underlying mechanism is not entirely clear, it is possible that kava kava acts indirectly on GABA and benzodiazepine binding sites in the brain (Yuan et al, 2002).…”