Voyajer
Wed, Aug-14-02, 14:52
Kava is shown in clinical studies to be effective against Generalized Anxiety Disorder, but another study says it may hurt liver.
Journal of Clinical Psychopharmacology 2002; 22(4):443-444
Effects of a Traditional Herbal Supplement on Anxiety in Patients With Generalized Anxiety Disorder
Journal of Clinical Psychopharmacology 2002; 22(4):443-444
Anxiety disorders are one of the most common psychiatric disorders and the most common reason for usage of herbal remedies to treat psychiatric symptoms. 1 The results of a recent meta-analytic review article published in Journal of Clinical Psychopharmacology 2 indicated that kava extract was superior to placebo as a symptomatic treatment for anxiety. One of the studies reviewed showed positive effects of kava on anxiety symptoms in patients with a DSM-III-R-diagnosed anxiety disorder. 3 In response to this growing literature examining the potential effects of herbal supplements on psychiatric symptoms, as well as the scarcity of controlled studies in the area, 1, 2 we sought to examine the effects of a traditional herbal remedy specifically formulated to reduce symptoms of anxiety.
We report here the results of a randomized double-blind placebo controlled pilot study that examined the possible effectiveness of a traditional ayurvedic herbal medicine on trait and state anxiety in medication-free patients with DSM-IV diagnosed 4 Generalized Anxiety Disorder (GAD). Traditional herbal medicines are typically formulated with whole herbs rather than isolated ingredients and contain a combination of herbs rather than a single herb. The combination includes herbs that, in addition to targeting the specific symptom of interest, minimize or eliminate potential side effects that may accompany the benefits of the active herb(s). The herbal supplement used in this study (Worry Free; Maharishi Ayurvedic Products International, Colorado Springs, CO) contained withania somnifera (winter cherry), tinospora cordifolia (heart-leaved moonseed), herpestis monniera (thyme-leaved gratiola), nardostachys jatamansi (muskroot), convolvolus pluricalis (aloeweed), glycyrrhiza glabra (licorice), pearl pisti, and alpinia galangal (ginger). The protocol was approved by the Human Subjects Committee at the University of California, San Diego. Written informed consent was obtained from all patients.
Following a history and physical to rule out underlying physical illness, 10 patients were block randomized to either the supplement (n = 5) or to a placebo (n = 5). Patients took two tablets b.i.d for 3 months. In addition to trait anxiety (Hamilton Anxiety Scale 5), we also were interested in testing for acute anxiety responses (Speilberger State Anxiety Scale 6), so patients participated in a laboratory stressor protocol that involved giving short structured anxiety-provoking public speeches. Blood pressure, heart rate, and salivary cortisol were assessed.
Following the 3-month treatment period, four patients from the supplement group and two patients from the placebo group no longer met criteria for GAD. Patients in the supplement group showed a two-fold greater decrease in Hamilton ratings compared with the placebo group (-15.5, SD = 6; -6.8, SD = 8, respectively; p ¡Ü 0.05)]. Patients in the supplement group showed a decrease in state anxiety responses to a public speech on the topic of a specific anxiety-provoking situation they had encountered within the previous 3 months, whereas the patients in placebo group did not (supplement group 41.2, SD = 4.3, at rest to 54.6, SD = 8.7, post-speech at prerandomization to 36.0, SD = 16.7, at rest to 39.8, SD = 17.6, post-speech at post-randomization; placebo group 51.2, SD = 12.5, at rest to 52.8, SD = 7.5, post-speech at prerandomization to 46.6, SD = 16.6, at rest to 50.2, SD = 11.5, post-speech at post-randomization; p ¡Ü 0.01). However, state anxiety responses to a more hypothetical, nonspecific speech topic were unchanged in either group. Salivary cortisol levels decreased 2.77 nmol/l (SD = 3.2) in the supplement group and increased 1.88 nmol/l (SD = 1.61) in the placebo group (p ¡Ü 0.02). There were no changes in blood pressure or heart rate. None of the patients reported adverse effects.
These preliminary findings suggest that some traditional herbal medicines may ameliorate feelings of anxiety in patients suffering from anxiety disorders. Given that individuals with anxiety disorders are the second most common users of complementary therapies (after substance use disorders), we may pursue further studies in this area. It would be interesting to compare the efficacy of traditional medicine supplements that are comprised of a combination of herbs to isolated single ingredient herbal supplements such as kava. 2, 3
Paul J. Mills, PhD; Noha H. Farag, et al
---------------------------
Have you suffered from Kava usuage?
On Nov. 8, 2001 German scientists reported that kava, an herbal supplement promoted for stress reduction, may be responsible for 30 cases of liver toxicity in Germany and Switzerland. Switzerland pulled kava off the market. Britain asked for its voluntary withdrawal. And Germany warned manufacturers that it may soon ban kava. In early January 2002, France banned its sale. On January 16, 2002 Canada issued a formal warning that Kava can cause liver failure.
In the United States, the FDA is studying the adverse reactions in 60 kava-related cases reported in this country since 1998. They include hepatitis, jaundice and liver failure. Joseph A. Levitt, the director of the Center for Food Safety and Applied Nutrition at the agency, said, "Two of those cases do raise a signal for us that this is something that warrants a lot of further investigation."
In the last five years, it has become increasingly popular in the United States for alleviating anxiety and stress. Among herbal supplements, kava ranks ninth in sales. For the year ending in November, sales were more than $34 million, according to Spins, a San Francisco market research firm for the health industry, and ACNielsen.
http://www.kava-side-effects.com/
Journal of Clinical Psychopharmacology 2002; 22(4):443-444
Effects of a Traditional Herbal Supplement on Anxiety in Patients With Generalized Anxiety Disorder
Journal of Clinical Psychopharmacology 2002; 22(4):443-444
Anxiety disorders are one of the most common psychiatric disorders and the most common reason for usage of herbal remedies to treat psychiatric symptoms. 1 The results of a recent meta-analytic review article published in Journal of Clinical Psychopharmacology 2 indicated that kava extract was superior to placebo as a symptomatic treatment for anxiety. One of the studies reviewed showed positive effects of kava on anxiety symptoms in patients with a DSM-III-R-diagnosed anxiety disorder. 3 In response to this growing literature examining the potential effects of herbal supplements on psychiatric symptoms, as well as the scarcity of controlled studies in the area, 1, 2 we sought to examine the effects of a traditional herbal remedy specifically formulated to reduce symptoms of anxiety.
We report here the results of a randomized double-blind placebo controlled pilot study that examined the possible effectiveness of a traditional ayurvedic herbal medicine on trait and state anxiety in medication-free patients with DSM-IV diagnosed 4 Generalized Anxiety Disorder (GAD). Traditional herbal medicines are typically formulated with whole herbs rather than isolated ingredients and contain a combination of herbs rather than a single herb. The combination includes herbs that, in addition to targeting the specific symptom of interest, minimize or eliminate potential side effects that may accompany the benefits of the active herb(s). The herbal supplement used in this study (Worry Free; Maharishi Ayurvedic Products International, Colorado Springs, CO) contained withania somnifera (winter cherry), tinospora cordifolia (heart-leaved moonseed), herpestis monniera (thyme-leaved gratiola), nardostachys jatamansi (muskroot), convolvolus pluricalis (aloeweed), glycyrrhiza glabra (licorice), pearl pisti, and alpinia galangal (ginger). The protocol was approved by the Human Subjects Committee at the University of California, San Diego. Written informed consent was obtained from all patients.
Following a history and physical to rule out underlying physical illness, 10 patients were block randomized to either the supplement (n = 5) or to a placebo (n = 5). Patients took two tablets b.i.d for 3 months. In addition to trait anxiety (Hamilton Anxiety Scale 5), we also were interested in testing for acute anxiety responses (Speilberger State Anxiety Scale 6), so patients participated in a laboratory stressor protocol that involved giving short structured anxiety-provoking public speeches. Blood pressure, heart rate, and salivary cortisol were assessed.
Following the 3-month treatment period, four patients from the supplement group and two patients from the placebo group no longer met criteria for GAD. Patients in the supplement group showed a two-fold greater decrease in Hamilton ratings compared with the placebo group (-15.5, SD = 6; -6.8, SD = 8, respectively; p ¡Ü 0.05)]. Patients in the supplement group showed a decrease in state anxiety responses to a public speech on the topic of a specific anxiety-provoking situation they had encountered within the previous 3 months, whereas the patients in placebo group did not (supplement group 41.2, SD = 4.3, at rest to 54.6, SD = 8.7, post-speech at prerandomization to 36.0, SD = 16.7, at rest to 39.8, SD = 17.6, post-speech at post-randomization; placebo group 51.2, SD = 12.5, at rest to 52.8, SD = 7.5, post-speech at prerandomization to 46.6, SD = 16.6, at rest to 50.2, SD = 11.5, post-speech at post-randomization; p ¡Ü 0.01). However, state anxiety responses to a more hypothetical, nonspecific speech topic were unchanged in either group. Salivary cortisol levels decreased 2.77 nmol/l (SD = 3.2) in the supplement group and increased 1.88 nmol/l (SD = 1.61) in the placebo group (p ¡Ü 0.02). There were no changes in blood pressure or heart rate. None of the patients reported adverse effects.
These preliminary findings suggest that some traditional herbal medicines may ameliorate feelings of anxiety in patients suffering from anxiety disorders. Given that individuals with anxiety disorders are the second most common users of complementary therapies (after substance use disorders), we may pursue further studies in this area. It would be interesting to compare the efficacy of traditional medicine supplements that are comprised of a combination of herbs to isolated single ingredient herbal supplements such as kava. 2, 3
Paul J. Mills, PhD; Noha H. Farag, et al
---------------------------
Have you suffered from Kava usuage?
On Nov. 8, 2001 German scientists reported that kava, an herbal supplement promoted for stress reduction, may be responsible for 30 cases of liver toxicity in Germany and Switzerland. Switzerland pulled kava off the market. Britain asked for its voluntary withdrawal. And Germany warned manufacturers that it may soon ban kava. In early January 2002, France banned its sale. On January 16, 2002 Canada issued a formal warning that Kava can cause liver failure.
In the United States, the FDA is studying the adverse reactions in 60 kava-related cases reported in this country since 1998. They include hepatitis, jaundice and liver failure. Joseph A. Levitt, the director of the Center for Food Safety and Applied Nutrition at the agency, said, "Two of those cases do raise a signal for us that this is something that warrants a lot of further investigation."
In the last five years, it has become increasingly popular in the United States for alleviating anxiety and stress. Among herbal supplements, kava ranks ninth in sales. For the year ending in November, sales were more than $34 million, according to Spins, a San Francisco market research firm for the health industry, and ACNielsen.
http://www.kava-side-effects.com/