Combinations - Kava Kava & ssri interactions

[ianzombie]

SWIM recently ordered 16oz of kava.
They are on two ssri's 'lexapro' & 'zispin'.
When the Kava arrived there was a warning that it should not be used by anyone taking anti depressant medication.
SWIM has ordered it in the past and had never seen such a warning before.

I have done a search and all i can not find any specific reason for this, only that it is not advised. Perhaps someone could shed some light on this for me?

Thank you.

[OccularFantasm]

Kava poteniates antidepressant drugs. The saftey has to do with your current dosage and how your body handles it. The safest way to go here is probably just to ask your doctor. If your realy hesitant about that for some reason, take a really small dose and each successive time try a little bit more. Be careful though, antidepressants can change your reactions to most everything. I'd advise the doctor talking thing, or perhaps a phramacist, as they tend to have a more complete knowledge of drug interaction than some doctors, at least general practioners; however swim did the same thing n jus tried it n was fine, so i guess its whatever you feel better doing. Also, swim knows nothing about zispin, as he has never heard of it. From what swim does know, you shouldn't take kava regularly, especially with concurrent antidepressants. Kava has been known to cause liver damage when overused, especially in conjunction with other medications the affect the liver. Selective Seratonin Reuptake Inhibitors are broken down through the liver and are therefore on the list. All in all, it probably won't kill you, but it won't be good for you either.
Also, if you start tripping rediculously hard and you have ssri's in your system, drink water! All it means is you did somethign wrong and got really dehydrated. This can happen real easy if you smoke weed or drink with SSRIs, especially since they stay in your system without you being noticable fucked up from it.

[Bajeda]

Originally Posted by OccularFantasm

Kava has been known to cause liver damage when overused, especially in conjunction with other medications the affect the liver.

Please take a look at this thread.

[ianzombie]

thanks guys for your replys, i cant thank you enough for your honest replys.
i hope i can be of benefit at a later date

[OccularFantasm]

I stand corrected, my bad. Also, yay; more kava for OF now.

[poison1981]

I would like to know more about using kava kava and high doses of ssri's anyonee know if its safe?

[Nagognog2]

Kava does not work along the serotonin pathways as do SSRI's. There should be no problem.

[Bajeda]

Just be careful taking SSRIs and Kava in close proximity to each other. I don't know what the usual dosing schedule is for most SSRIs, but if you take it in the morning lets say, use Kava in the afternoon instead. You don't need any unnecessary potentiation from CYP450 inhibition.

[hoodabudda]

there probably talking about how they both are sedating. no real risk just trying to cover there asses i bet.

[disarm000]

swin is on 40 mg of paxil and have had no bad reaction when taking kava, even in large doses.

[psyche]

http://www.drugs-forum.com/forum/showthread.php?t=41699

In that thread there is a study concluding that kavapyrones in kava-kava have MAO-B inhibiting properties. So I ask the same question I asked there, can this be seen as an indication that kava-kava only inhibits MAO-B? Does anyone know it it has other alkaloids that inhibit MAO-A since I have thought that kavalactones are the principal active alkaloids in kava, but the study held that it's kavapyrones? If it's only a MAO-B inhibitor then that shouldn't be a problem with serotonergic drugs like SSRI's. I presume that it was the possible MAO-effect that is considered in this thread.

[zornthro]

Originally Posted by psyche

http://www.drugs-forum.com/forum/showthread.php?t=41699

In that thread there is a study concluding that kavapyrones in kava-kava have MAO-B inhibiting properties. So I ask the same question I asked there, can this be seen as an indication that kava-kava only inhibits MAO-B? Does anyone know it it has other alkaloids that inhibit MAO-A since I have thought that kavalactones are the principal active alkaloids in kava, but the study held that it's kavapyrones? If it's only a MAO-B inhibitor then that shouldn't be a problem with serotonergic drugs like SSRI's. I presume that it was the possible MAO-effect that is considered in this thread.

Kava does not effect serotonin very much. In one study kava caused serotonin levels to either decrease slightly or to remained the same. High enough kawain levels could cause a decrease in serotonin levels (kawaine appears to inhibit calcium and sodium channels).

Kava can however raise dopamine levels outside the cerebral cortex (ie while not affecting dopamine in the cerebral cortext) and can also raise noradrenaline levels. Both of these actions could be contradicted by MAOIs, but serotonin itself should remain unchanged.

"Three kavapyrones, the natural compounds (+)-methysticine and (+)-kavain, and the synthetic racemate (±)-kavain, were tested concerning their action on in vitro uptake of monoamines in synaptosomes prepared from the cerebral cortex and hippocampus of rats. Both synthetic and isolated kavain potently inhibited the uptake of noradrenaline but none of the kavalactones efficiently blocked the uptake of [3H]-serotonin. Uptake of [3H]-noradrenaline was inhibited in the following order of potency: (±)-kavain = (+)-kavain (up to 70–80% of control)>(+)-methysticine. The results indicate a pyrone-specific non-stereo-selective inhibition of the [3H]-noradrenaline uptake which might be responsible for or, at least, contribute to the psychotropic properties of kavalactones [23]."

There is some info here: http://www.drugs-forum.com/forum/showthread.php?t=60614 (I plan to update that thread eventually)

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[thirteenthfloor]

Swim is currently on lexapro and was thinking of getting some kava in addition. Does anyswiy have experience with this combo. Saw that some have had experience with other antidepressants not sure if it makes a difference which one it is. He is doing better on the lexapro, but still has to take a benzo for social anxiety, he would rather use something not addictive but does not want to screw up his progress with the lexapro.