Kava kava is an herb that has been used in the Pacific islands for hundreds of years for its purported relaxant effects. It is one of the few herbs for which the active chemicals have been identified. These chemicals, known as kavalactones or kavapyrones, interact with proteins in the central nervous system that are known as GABA-A receptors. These are the same proteins that mediate the effects of diazepam (Valium) and related anti-anxiety drugs. Several studies indicate that kava kava decreases mild anxiety. It does not appear to be effective for more severe forms of anxiety.
Kava kava sometimes is recommended for insomnia. However, its effects on insomnia have not been well studied. Another herb, valerian, has been more extensively studied for insomnia than kava kava (see the section on Valerian).
Most drugs that decrease anxiety also produce sedation. Surprisingly, kava kava itself does not appear to have this effect. However, kava kava may increase the sedating effects of alcohol and several medications that are frequently used in MS, including lioresal (Baclofen), tizanidine (Zanaflex), and diazepam (Valium). The effects of kava kava on MS fatigue are not known. Heavy use of kava kava over months may produce skin problems, red eyes, itching, and other difficulties.
Until recently, kava kava was thought to be generally well tolerated. In 2001, however, several reports surfaced of liver toxicity in association with kava kava use. Subsequently, more than 50 reports appeared of kava kava-associated liver toxicity. In some cases, people died or required liver transplants. Kava kava is now banned in Europe and Canada. In the United
States, the FDA has issued warnings about the herb. Due to these safety issues, kava kava should not be used.
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