Natural Medicines Newsletter

Volume 1, Issue 21, 06/11/2009

Question

How can the use of kava (Piper methysticum) supplements increase the risk for CNS depression and/or coma in patients taking the benzodiazepine, alprazolam (Xanax®)?

Answer

Kava (Piper methysticum) is a member of the pepper family that is native to the South Pacific.  It is used to treat anxiety, insomnia and symptoms related to menopause.(1)  Data from the United States National Comorbidity Survey showed the one year prevalence of anxiety to be approximately 17% and the lifetime prevalence to be up to 25%.(2)  While many of these patients will be treated with benzodiazepines initially by a general practitioner, others may seek treatment with a homeopathic or natural medicine/supplement such as kava extract.(1,3,4)  The problem occurs when patients choose to treat their anxiety with both a kava supplement and a benzodiazepine, such as alprazolam (Xanax®), that was prescribed by their physician or when the prescribing physician initiates standard doses of alprazolam without the knowledge that the patient is also taking a kava extract.(3,4) For example, one case report describes a patient who required hospitalization after taking a combination of kava and alprazolam for 3 days that caused the patient to enter a semicomatose state.(3)   How does kava interact with benzodiazepines (e.g., alprazolam) to cause a degree of central nervous system (CNS) depression that may result in a coma?

The active ingredients found in kava supplements include a group of chemicals called.....To read the full answer please LOGIN or SUBSCRIBE NOW.