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Kava, also known as Piper Methysticum or simply Kava Kava, is traditionally used in the South Pacific for relaxation. The Kava plant is a member of the pepper family, and has been used for thousands of years to relieve anxiety and promote sleep.
Kava for Anxiety
The first long term trial of Kava for anxiety, published in 1997, tested people with agoraphobia and other phobias, generalized anxiety disorder, and adjustment disorders in a randomized, placebo-controlled, double-blind trial. They measured the results with the Hamilton Anxiety Scale, and found Kava to be an effective remedy for anxiety. The researchers stated that Kava could be used as a treatment alternative to tricyclic antidepressants and benzodiazepines (Valium and Xanax) in anxiety disorders, with proven long-term efficacy and none of the tolerance problems associated with tricyclics and benzodiazepines. (Pharmacopsychiatry 1997 Jan;30(1):1-5)
Since then, multiple studies have confirmed the efficacy of Kava. The prestigious Cochrane Database compiled 6 studies and concluded that Kava significantly reduced anxiety compared to placebo (Cochrane Database Syst Rev 2003;1).
Kava for Insomnia
Patients suffering from insomnia with anxiety were tested in a randomized, double-blind, clinical study. Those given Kava had reduced total stress and significantly improved sleep. Safety and tolerability were good, with no Kava-related adverse events or changes in clinical or laboratory parameters. (J Affect Disord 2004 Feb;78(2):101-10).
Kava: Sedative Without Slowing of Reflexes
Kava is an interesting medicine because it seems to act as a sedative without reducing mental alertness or slowing reflexes. This was shown in a randomized, placebo-controlled, double-blind study that tested a medicinal dose of Kava versus placebo versus a standard sedative drug (oxazepam) on driving ability and driving safety. Those that took the oxazepam, (which is a benzodiazepine drug, similar to Valium and Xanax), had significantly slower braking reaction time. Neither the Kava group or the placebo group had a slower braking time. The results indicated that a medicinal dose of kava containing 180 mg of kavalactones did not impair driving ability, whereas 30 mg of oxazepam did cause impairment. (Traffic Inj Prev 2013;14(1):13-7)
Other researchers have reached the same conclusion. Based on a systematic review of Kava's effect on cognition, the researchers stated "The majority of evidence suggests that Kava has no replicated significant negative effects on cognition." (Human Psychopharmacology Clinical and Experimental 26(2):102-11)
Another paper stated that "controlled trials suggest that kava extracts do not impair cognitive performance and vigilance or potentiate the effects of central nervous system depressants." (Drug Saf. 2002;25(4):251-61)
Kava: Endorsed by the
American Academy of Family Physicians
In August 2007, The American Academy of Family Physicians published recommendations stating that short-term use of Kava is recommended for patients with mild to moderate anxiety -- but not if you use alcohol or take medicines metabolized in the liver, which includes many cholesterol medicines and Tylenol (acetaminophen).
You should get clearance from your Primary Care Provider before using Kava.
For most people, Kava offers a safe, effective alternative to prescription drugs for occasional anxiety and insomnia.
Valerian root has been used as a sedative and anti-anxiety treatment for more than 2,000 years. Valerian is a powerful nervine, stimulant, carminative and antispasmodic (muscle relaxant). Valerian allays pain and promotes sleep.
Valerian for Insomnia
In a study of 128 volunteers, patients were given an aqueous extract of valerian or a placebo. Compared with the placebo, the valerian extract resulted in a statistically significant reduction in time required to fall asleep, improved sleep quality, and decreased number of nighttime awakenings. (Pharmacology, Biochemistry and Behavior 17: 65-71, 1982)
In another study, patients with insomnia were evaluated for the effect of valerian on sleep onset. Results were based on nighttime motion, measured by motion sensors worn on the wrist. The valerian extract reduced average sleep onset from 16 to 9 minutes, which is similar to the activity of prescription benzodiazepine medications like Xanax and Valium. (Planta Medica 2: 144-148, 1985)
A 28 day study looked at longer-term effects in 121 participants with insomnia. Participants received either dried valerian root or placebo for 28 days. After 28 days, the group receiving the valerian extract showed a decrease in insomnia symptoms on all the assessment tools compared with the placebo group. (Psychopharmakotherapie 3: 109-115, 1996)
In a randomized, double-blind study, 75 participants with documented insomnia were randomly assigned to receive 600 mg of a standardized commercial valerian extract or 10 mg oxazepam (a benzodiazepine medication) for 28 days. Both groups had the same improvement in sleep quality but the valerian group reported fewer side effects than did the oxazepam group. (Forschende Komplementärmedizin und Klassische Naturheilkunde 7: 79-84, 2000)
In a randomized, double-blind, placebo-controlled, crossover study, researchers evaluated sleep parameters with polysomnographic techniques. Valerian caused a decrease in slow-wave sleep onset (13.5 minutes) compared with placebo (21.3 minutes). During slow-wave sleep, arousability, skeletal muscle tone, heart rate, blood pressure, and respiratory frequency decrease. Increased time spent in slow-wave sleep decreases insomnia symptoms. The valerian group reported fewer adverse events than did the placebo group. (Pharmacopsychiatry 33: 47-53, 2000)
Valerian for Anxiety
Valerian for anxiety has not been well studied, however one small study did show that Valerian may have a potential anxiolytic effect on the psychic symptoms of anxiety. (Phytotherapy Research 16: 7, 650-654, 2002)
As with Kava, you should get clearance from your Primary Care Provider before using Valerian.
Kava and Valerian,
Complimentary but Not Interchangeable
As you can see from the above information, Kava is considered safer for daytime use, especially if you will be driving. Valerian is often preferred for night time use.
Both will help sleep but Valarian is used more for help falling asleep and Kava more for help staying asleep. And yes, you can use both of them together. Valerian has more concern of causing impairment if you will be driving or using machinery.
Either Kava or Valerian are great for occasional anxiety or insomnia, and safer than most drug alternatives. But if you find yourself using these regularly, you need to get into your primary care provider and find out what the problem is.
The standard rule for all new medicines, applies to both Kava and Valerian:
Don't drive or use heavy equipment until you have taken the new medicine long enough to know how you respond to it.
Take care and BE HEALTHY!
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