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Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study.
J Clin Psychopharmacol 2013; 33(5):643-8JC

Abstract

Kava (Piper methysticum) is a plant-based medicine, which has been previously shown to reduce anxiety. To date, however, no placebo-controlled trial assessing kava in the treatment of generalized anxiety disorder (GAD) has been completed. A total of 75 participants with GAD and no comorbid mood disorder were enrolled in a 6-week double-blind trial of an aqueous extract of kava (120/240 mg of kavalactones per day depending on response) versus placebo. γ-Aminobutyric acid (GABA) and noradrenaline transporter polymorphisms were also analyzed as potential pharmacogenetic markers of response. Reduction in anxiety was measured using the Hamilton Anxiety Rating Scale (HAMA) as the primary outcome. Intention-to-treat analysis was performed on 58 participants who met inclusion criteria after an initial 1 week placebo run-in phase. Results revealed a significant reduction in anxiety for the kava group compared with the placebo group with a moderate effect size (P = 0.046, Cohen d = 0.62). Among participants with moderate to severe Diagnostic and Statistical Manual of Mental Disorders-diagnosed GAD, this effect was larger (P = 0.02; d = 0.82). At conclusion of the controlled phase, 26% of the kava group were classified as remitted (HAMA ≤ 7) compared with 6% of the placebo group (P = 0.04). Within the kava group, GABA transporter polymorphisms rs2601126 (P = 0.021) and rs2697153 (P = 0.046) were associated with HAMA reduction. Kava was well tolerated, and aside from more headaches reported in the kava group (P = 0.05), no other significant differences between groups occurred for any other adverse effects, nor for liver function tests. Standardized kava may be a moderately effective short-term option for the treatment of GAD. Furthermore, specific GABA transporter polymorphisms appear to potentially modify anxiolytic response to kava.

Authors+Show Affiliations

Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia. jsarris@unimelb.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23635869

Citation

Sarris, Jerome, et al. "Kava in the Treatment of Generalized Anxiety Disorder: a Double-blind, Randomized, Placebo-controlled Study." Journal of Clinical Psychopharmacology, vol. 33, no. 5, 2013, pp. 643-8.
Sarris J, Stough C, Bousman CA, et al. Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. J Clin Psychopharmacol. 2013;33(5):643-8.
Sarris, J., Stough, C., Bousman, C. A., Wahid, Z. T., Murray, G., Teschke, R., ... Schweitzer, I. (2013). Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. Journal of Clinical Psychopharmacology, 33(5), pp. 643-8. doi:10.1097/JCP.0b013e318291be67.
Sarris J, et al. Kava in the Treatment of Generalized Anxiety Disorder: a Double-blind, Randomized, Placebo-controlled Study. J Clin Psychopharmacol. 2013;33(5):643-8. PubMed PMID: 23635869.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. AU - Sarris,Jerome, AU - Stough,Con, AU - Bousman,Chad A, AU - Wahid,Zahra T, AU - Murray,Greg, AU - Teschke,Rolf, AU - Savage,Karen M, AU - Dowell,Ashley, AU - Ng,Chee, AU - Schweitzer,Isaac, PY - 2013/5/3/entrez PY - 2013/5/3/pubmed PY - 2014/4/2/medline SP - 643 EP - 8 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 33 IS - 5 N2 - Kava (Piper methysticum) is a plant-based medicine, which has been previously shown to reduce anxiety. To date, however, no placebo-controlled trial assessing kava in the treatment of generalized anxiety disorder (GAD) has been completed. A total of 75 participants with GAD and no comorbid mood disorder were enrolled in a 6-week double-blind trial of an aqueous extract of kava (120/240 mg of kavalactones per day depending on response) versus placebo. γ-Aminobutyric acid (GABA) and noradrenaline transporter polymorphisms were also analyzed as potential pharmacogenetic markers of response. Reduction in anxiety was measured using the Hamilton Anxiety Rating Scale (HAMA) as the primary outcome. Intention-to-treat analysis was performed on 58 participants who met inclusion criteria after an initial 1 week placebo run-in phase. Results revealed a significant reduction in anxiety for the kava group compared with the placebo group with a moderate effect size (P = 0.046, Cohen d = 0.62). Among participants with moderate to severe Diagnostic and Statistical Manual of Mental Disorders-diagnosed GAD, this effect was larger (P = 0.02; d = 0.82). At conclusion of the controlled phase, 26% of the kava group were classified as remitted (HAMA ≤ 7) compared with 6% of the placebo group (P = 0.04). Within the kava group, GABA transporter polymorphisms rs2601126 (P = 0.021) and rs2697153 (P = 0.046) were associated with HAMA reduction. Kava was well tolerated, and aside from more headaches reported in the kava group (P = 0.05), no other significant differences between groups occurred for any other adverse effects, nor for liver function tests. Standardized kava may be a moderately effective short-term option for the treatment of GAD. Furthermore, specific GABA transporter polymorphisms appear to potentially modify anxiolytic response to kava. SN - 1533-712X UR - https://www.unboundmedicine.com/medline/citation/23635869/Kava_in_the_treatment_of_generalized_anxiety_disorder:_a_double_blind_randomized_placebo_controlled_study_ L2 - http://Insights.ovid.com/pubmed?pmid=23635869 DB - PRIME DP - Unbound Medicine ER -