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Do You Need a Kava "Cocktail"?

Q. What do you think of supplement "cocktails" that combine kava, St.-John's-wort, and other herbal soothers in one pill? Isn't that like mixing Valium and Prozac?

Kava, from the root of the Piper methysticum, a tropical plant related to black pepper, is a natural relaxant and sleep aid that may prove to be an effective, nonaddictive alternative to Valium and other antianxiety drugs. Saint-John's-wort (Hypericum perforatum) seems to be as effective as Prozac in relieving depression in some patients. Psychiatrists sometimes prescribe antidepressants and antianxiety drugs to people suffering from anxiety and depression at the same time.

Still, I don't think the kava/Saint-John's-wort "cocktails" on the market make much sense. If you're experiencing these symptoms simultaneously, you would be better off getting professional help rather than treating yourself with herbal combos. There's no reason not to combine Saint-John's-wort and kava for the treatment of mixed anxiety and depression, but such herbal cocktails should not be used casually as mood tonics. They should be recommended by someone trained in using drugs and herbs, and skilled at diagnosing emotional and mental health problems. You should also let your doctors know which supplements you're taking -- some herb and drug combinations can be dangerous.

Also, keep in mind that kava won't alleviate severe anxiety or panic attacks. Similarly, studies in Germany have shown that Saint-John's-wort can be as effective as Prozac for relieving mild to moderate depression, but it isn't recommended for severe depression.

If you want to try kava, it comes in a powder, pills, or dried chips from the root. Look for tablets that supply 40 to 70 mg of kavalactones (the active ingredients). Don't exceed 300 mg of kava daily. Higher doses can be a bit intoxicating, but you're unlikely to get the high experienced by Polynesians who use the fresh root in their preparations.

You might notice your level of anxiety diminishing within a week after you begin to take kava, but the maximum benefit usually doesn't appear for four to eight weeks. Low doses of kava are safe, but you should avoid it with alcohol or if you are pregnant (or nursing). Don't take it if you're on prescription tranquilizers or sedatives, or if you're taking levodopa for Parkinson's disease.


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