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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Will_Hung on March 24, 2002, at 20:24:11
Evening All.
I am a twenty-something blessed with social phobia and/or borderline AvPD.
I have been taking Moclobemide at a dosage of 750mg/day for some time now, which seemes to help a liitle. However, I am keen to try Kava Kava (a herbal supplement) which is reputed to relax and enhance 'social performance'.
Does anybody know of any risks in using the two concurrently?
Has anybody actually tried both at the same time?I really need to know if Kava has any effect on MAOI-B levels, as I am not currently following a MAOI diet, and I do not wish to.
If anyone can point me in the direction of studies on the actions of Kava Kava in the body it would be much appreciated (I'm sure there will have been some).
Thankya kindly
Will
Posted by JonW on March 24, 2002, at 22:16:03
In reply to Moclobemide/Kava Kava combination?, posted by Will_Hung on March 24, 2002, at 20:24:11
Hi Will,
I'm sorry you've suffered with such a horrible disorder. As far as I know, Kava is an MAO B inhibitor. I know that if *selegiline* (an MAO B inhibitor) is combined with moclobemide, dietary restrictions are necessary. That being said, I'd be hesitant to ignore the restrictions when using Kava. You may want to try klonopin or another benzo instead. How long have you been on moclobemide? It's my understanding that a fair trial for social phobia is no less than 12 weeeks at doses up to 1600mg if tolerated. Easier said than done, I know.
Good Luck,
Jonp.s. Here the titles of some relevant abstracts:
Uebelhack R, Franke L, Schewe HJ. Related Articles
Inhibition of platelet MAO-B by kava pyrone-enriched extract from Piper methysticum Forster (kava-kava).
Pharmacopsychiatry. 1998 Sep;31(5):187-92.
PMID: 9832350 [PubMed - indexed for MEDLINE]Korn A, Wagner B, Moritz E, Dingemanse J. Related Articles
Tyramine pressor sensitivity in healthy subjects during combined treatment with moclobemide and selegiline.
Eur J Clin Pharmacol. 1996;49(4):273-8.
PMID: 8857072 [PubMed - indexed for MEDLINE]> Evening All.
>
> I am a twenty-something blessed with social phobia and/or borderline AvPD.
>
> I have been taking Moclobemide at a dosage of 750mg/day for some time now, which seemes to help a liitle. However, I am keen to try Kava Kava (a herbal supplement) which is reputed to relax and enhance 'social performance'.
>
> Does anybody know of any risks in using the two concurrently?
> Has anybody actually tried both at the same time?
>
> I really need to know if Kava has any effect on MAOI-B levels, as I am not currently following a MAOI diet, and I do not wish to.
>
> If anyone can point me in the direction of studies on the actions of Kava Kava in the body it would be much appreciated (I'm sure there will have been some).
>
> Thankya kindly
> Will
Posted by TSA West on March 25, 2002, at 2:50:29
In reply to Moclobemide/Kava Kava combination?, posted by Will_Hung on March 24, 2002, at 20:24:11
Thank you for posting, Will.
Theoretically, kavalactones may have negative additive effects with inhibitors of MAO type B (moclobemide included). Also, some norepinephrine action may be going on with it. But these actions have yet to be proven with commercial extracts:
(Seitz U. "Monoamine uptake inhibition properties of kava pyrones. Planta Med 1997.")
Significantly, MAOI-type drugs interfere with normal sleep patterns. Kava may be a solution to this problem, because is believed to improve the quality of sleep in humans-- with deep sleep increased and rapid-eye-movement sleep unaffected:
(Kava drug monograph. Denver: Micromedex. Updated 1998 Sept).
If Moclobemide causes anxiety because of stimulant-action or otherwise, you should know that a few small, placebo-controlled, double-blind studies have shown kavalactones to be significantly better than placebo in patients suffering from anxiety of nonpsychotic origin. Importantly, the dosage used for anxiety in these trials was _70 mg_ of a purified kavalactone extract known as WS/1490 _three times daily_:
(Kinzler E. Double blind study of kava with placebo over 4 weeks. Arzneimittelforschung 1991).
I wish you luck with Kava and your journey in emotional wellness...
---------TSA West: Daily Self-Denial in Progress-----------------
Posted by Zo on March 26, 2002, at 17:14:15
In reply to Moclobemide/Kava Kava combination?, posted by Will_Hung on March 24, 2002, at 20:24:11
FDA Issues Warning on Kava-Containing Supplements
WASHINGTON (Reuters Health) - Following in the footsteps of Australia, Canada and several European nations, the US Food and Drug Administration (news - web sites) (FDA) warned American consumers on Monday against the use of products containing kava, a herbal ingredient most often promoted for relaxation and the alleviation of sleeplessness.
The FDA said it was issuing the warning because kava has been associated with liver-related injuries in the US and several other countries, including Germany, Switzerland, France, Canada and the United Kingdom.
"Although liver damage appears to be rare, FDA believes consumers should be informed of this potential risk," the agency said in a statement.
According to the FDA, a total of 25 reports were made in the other nations of liver-related problems such as hepatitis, cirrhosis and liver failure in people taking kava-containing products. The FDA said four of those people required liver transplants, following their liver-related injuries.
In the US, the agency added that it has received at least one case report that resulted in a liver transplant, involving a previously healthy young female, as well as several reports of liver-related injuries.
"Given these reports, persons who have liver disease or liver problems, or persons who are taking drug products that can affect the liver, should consult a physician before using kava-containing supplements," according to the federal agency. "Consumers who use a kava-containing dietary supplement and who experience signs of illness associated with liver disease should also consult their physician."
According to the FDA, "Symptoms of serious liver disease include jaundice (yellowing of the skin or whites of the eyes) and brown urine. Non-specific symptoms of liver disease can include nausea, vomiting, light-colored stools, unusual tiredness, weakness, stomach or abdominal pain, and loss of appetite."
Kava is an age-old herb from the family of peppers that historically has been used by islanders in the Pacific to concoct a mildly narcotic ritual drink.
Other commonly used names for the herbal supplement include ava, awa and kawa.
The FDA first announced its intention to investigate the potential link between kava and liver damage in early January. At the time, the agency said it was aware of about 38 cases of potential liver damage.
Advisors to the German government subsequently recommended that kava be made a prescription-only product.
In the statement issued on Monday, the FDA said it has not made any determination with respect to kava's ability to relieve stress, anxiety, tension or its other promoted uses.
Posted by djmmm on March 27, 2002, at 13:12:02
In reply to KAVA TOXICITY ALERT in today's news » Will_Hung, posted by Zo on March 26, 2002, at 17:14:15
I used Kava for about 2 years with no problems...this reminds me of the l-tryptophan scare.....
Posted by colin wallace on March 27, 2002, at 15:51:37
In reply to Re: KAVA TOXICITY ALERT in today's news, posted by djmmm on March 27, 2002, at 13:12:02
I used Kava as a muscle relaxant for years too- given that it's been used in Polynesia for many centuries, and drunk frequently during social interaction/ceramonies (in doses very much higher than the those found in typical health store products),and that liver toxicity has not (previously) been noted amongst its (few) side effects at these doses, it may perhaps point to something occurring during the mass-preparation process...
Posted by Hawkeye on March 28, 2002, at 6:18:57
In reply to Re: KAVA TOXICITY ALERT in today's news, posted by djmmm on March 27, 2002, at 13:12:02
Analysis of the Reported German Cases that Triggered the Kava Alert:
Posted by jane d on March 28, 2002, at 18:04:58
In reply to KAVA TOXICITY ALERT in today's news » Will_Hung, posted by Zo on March 26, 2002, at 17:14:15
Here's a link to another story about the FDA action (courtesy of Willow).
http://www.cnn.com/2002/HEALTH/diet.fitness/03/26/kava.warning.ap/index.html
This is the end of the thread.
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