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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by linkadge on October 4, 2002, at 14:03:50
I was wondering if it would be
safe to use Kava occasionally with
Celexa. I heard somewhere that
Kava is a MAO-B does this mean
there will be an interaction.
I am a little frightened because
I had Seritonin Syndrome on
St. John's Wort.Thanks
Linkadge
Posted by Shawn. T. on October 4, 2002, at 15:15:22
In reply to Celexa and Kava ?, posted by linkadge on October 4, 2002, at 14:03:50
Kava's active constituents are thought to affect GABA-A receptors. It may act by increasing levels of binding sites for these receptors in certain areas of the brain. Because it contains several different active ingredients, it may or may not affect other systems in the brain. One study has shown that kava may affect MAO-B in platelets, although this result has not been replicated to my knowledge. It awaits to be seen whether or not kava affects MAO-B in the brain in vivo. MAO-B metabolizes dopamine and phenylethylamine (found in small amounts in chocolate). MAO-A metabolizes serotonin, noradrenaline, and dopamine; so kava should not directly affect serotonin transmission because it does not interact with MAO-A. I don't believe that there are any reports of kava use resulting in serotonin syndrome symptoms.
An issue has come up that kava could cause liver damage. One thing to note is that the problem usually disappears after afflicted users stop taking the drug. If you have had hepatitis or liver problems in the past, it would generally be unwise to use kava. Discussing the issue with your doctor might be a wise thing to do. I personally regard alcohol as much more toxic to the body than kava, and there doesn't seem to be a big fuss by the FDA over what alcohol does to the liver. Mixing alcohol and kava probably isn't a smart choice. You definitely shouldn't mix benzodiazepines, which act on GABA-A receptors, and kava. Benzodiazepines include Valium, Xanax, Klonopin, Ativan, and similar drugs. I would argue that the potential effects of SSRI's on the gut are just as bad as what kava could possibly do to the liver if taken in large amounts. Mixing an SSRI such as Celexa with kava should pose no risk. SSRI's and benzodiazepines are generally not considered to interact, and kava does not affect GABA transmission as strongly as the benzodiazepines. So be aware that risks do exist, although this issue really applies to most drugs used in psychiatry today.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7701051&dopt=Abstracthttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9832350&dopt=Abstract
http://www.thorne.com/altmedrev/fulltext/kava2-5.html
Shawn
Posted by glenn on October 5, 2002, at 7:23:55
In reply to Celexa and Kava ?, posted by linkadge on October 4, 2002, at 14:03:50
I think shawns info is very sound, my experience of kava was not nice, I find the occasional xanax
much better, if you want to look at other alternatives maybe tryptozen or one of the other herbals might be useful. If its mainly for physical anxiety ie heart thumping sweating etc I find a very low dos -40mg of inderal excellent and for me it goes fine with ssris as does xanax.
glenn
Posted by Guy on October 5, 2002, at 15:10:20
In reply to Re: Celexa and Kava ?, posted by glenn on October 5, 2002, at 7:23:55
Kava kava has been banned in Canada because it has been found to cause liver damage.
Posted by Shawn. T. on October 5, 2002, at 17:16:25
In reply to Kava banned in Canada, posted by Guy on October 5, 2002, at 15:10:20
'Moderate' as-needed kava use should not pose a serious health risk. Taking "highly excessive" amounts can certainly cause liver problems, although reports are rare. Taking too much of anything on a chronic basis is generally not a healthy choice. I personally believe that the issue has been blown a bit out of proportion. This is especially true considering the fact that just about every psychoactive drug on the market has reports of negative health outcomes. What's good for Canada isn't necessarily good for everyone, so I believe kava remains a viable alternative to high-priced anti-anxiety drugs. In moderation, kava is relatively harmless. The risk is probably similar to taking high amounts of Tylenol every day for an extended period.
"Jerry Cott, PhD., former Chief of the Psychopharmacology Research Program at the National Institute of Mental Health said, “If the incidence of liver toxicity for kava is correct, then according to German researchers it is very similar to that of conventional pharmaceutical anti-anxiety and antidepressant prescription drugs. These are generally considered to be acceptable (though small) risks,” he said, referring to the risk-benefit comparison by which conventional medicines are evaluated."
http://www.herbalgram.org/browse.php/122001press/
Shawn
Posted by linkadge on October 6, 2002, at 12:57:40
In reply to But not in the USA..., posted by Shawn. T. on October 5, 2002, at 17:16:25
I went to a herb store
that still had some on their
shelf. I statched it up.The people who suffered liver
dammage used high doses
for a long time year+.
I'm not too worried about
occasional use.Linkadge
This is the end of the thread.
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