Anxiety disorders are the most common of all the mental disorders. An anxiety disorder may make you feel anxious most of the time, without any apparent reason. They can even make you feel as if you are going to die. Jonathan Davidson MD got an idea of taking the natural product of kava kava and using it as a drug to help treat anxiety and daily stress. In the South Pacific kava kava is used to help induce states of clam and as a ceremonial drug. Kava in fact might have clinically useful anxiety plummeting properties according to some European literature.
However, recent cases of severe liver damage have been found with the use of kava. It was even taken off the shelves in European countries. In Germany they are thinking of just using kava for prescription use only. In the United States they are taking a closer look at kava and, so far, have not made any determination on whether or not it is too harmful for every usage. Literature on kava for anxiety treatment was reviewed. The authors of this article required that all studies met certain acceptable standards for this particular study.
Fourteen double blind, randomized clinical trials were recognized, seven of which were excluded because they were either a reproduction of publications or were performed using a different form of kava. They had to exclude another study because a benzo-diazepine was used in combination. There were seven trials left of methodo-logic acceptability. Six of these scored at least three points out of a maximum of five to asses methodo-logic quality.
The Hamilton Anxiety scale was used in three of the studies as a 2 primary outcome measure. This made it possible to pool these statistics in a meta-analysis. An advantage to this trial was the use of a single form of kava. At first look the results looked really good. It looked good because of the weighted mean difference between kava and placebo. Looking at each of the individuals studies some surprising findings arouse.
In the first study the Hamilton anxiety scale went down from 25. 3 to 12. 6, while on the placebo the score was reduced to 24. 3 to 21. 0. In the second study anxiety was reduced from 31.
1 to 5. 5 on kava, in comparison to the reduction on placebo which was 30. 2 to 22. 5. The third study anxiety declined from 30. 7 to 9.
7 on kava in comparison to the reduction of the placebo which was 31. 4 to 14. 9. In anxiety disorder patients reduction of this magnitude is unusual. Differences of nine points between drug and placebo in GAD studies are most unusual.
Another unusual thing with the trials is their relatively high baseline Hamilton Anxiety scores. The third problem is the breakdown of all three trials to differentiate the anxiety disorders, or to present results in ways that enable the reader to compare kava versus placebo for each of the disorders. For example, it is known, that a drug such as buspirone, which may be useful in GAD, is not going to be helpful for anxiety disorders. Likewise, tricyclic antidepressants can assist patients with panic disorder, but are usually not helpful in social anxiety. One of the studies in the one of the articles has been published only as an abstract, and it is hard, without a lot of information to make a great deal of it. In conclusion kava kava might have a greater anxiolytic effect in comparison to placebo, but this is still far from certain.
At the moment psychiatrists have a very weak understanding about the kinds of anxiety that are most likely to benefit from kava kava. 3 Before kava kava is to become established as a credible drug, much more data of clearer provenance is needed. It all comes back to the safety question. The reports of liver damage cannot be overlooked. The liver damage kava might cause needs to be looked into further if kava is to have a future. Short term use of kava kava might be helpful as a stress-response.
This article relates to the chapter we are currently learning about. We are learning about the Psychological disorders chapter. In this chapter we are learning about anxiety disorders and how they differ from ordinary worries and fears that everyone experiences. The article I read and did my paper on is just another way that doctors are trying to help cure the horrible feeling people get when they experience an anxiety disorder.