May 15 2009
The Good, the Bad, and the Stupid of a Kava Study
A news release about a new study on Kava as a treatment for anxiety caught my attention. In it I found some bad and some stupid. Fortunately–and contrary to what usually happens–there was a link to the published article itself, and there I found a bunch of good. Usually I tend to encounter hidden bad when I dig deeper.
First, the bad. Then the good. Finally, the stupid.
The bad. The news release reported that “the placebo-controlled study found Kava to be an effective and safe treatment option for people with chronic anxiety and varying levels of depression.” Beyond that general statement, the report gave zero numbers. No precision with that element of scientific language. “It worked,” is not very helpful in evaluating a treatment.
Also, while the study was deemed “safe,” raising “no major health concerns,” the trial lasted a pathetically brief three weeks. Three weeks!
Upon clicking a link to an abstract from the Springer journal Psychopharmacology, I found the option to view the full text in .pdf. And so I did. And, surprise, surprise! I discovered that the researchers did some very good science.
The good. Besides being placebo-controlled, the trial was randomized and double-blinded. Okay, there were only 37 subjects that completed the trial. Still, it is good to know, and reasons for drop-outs were explicitly stated.
And the treatment was indeed significantly effective. For example, on the primary measure (Hamilton Anxiety Scale: total range of 0 to 56) anxiety scores fell an .8 points in the placebo group and 9.9 points in the Kava group. That indeed rates as “effective.”
Now for the stupid. Statements like this, made by the lead researcher, perpetuate ignorance and folklore:
“We’ve been able to show that Kava offers a natural alternative for the treatment of anxiety, and unlike some pharmaceutical options, has less risk of dependency and less potential of side effects,” Mr. Sarris said.
First, no, Mr. Sarris, you have not shown less risk of dependency and side effects with a single, three-week trial of 37 subjects.
Second, “a natural alternative”? Oh come on. Please. Be a little more scientific and don’t perpetuate stupid misunderstandings. Here is the difference between “natural” and “conventional” medicines: the connotations of words. Natural brings to mind forests and flitting fairies perhaps, conventional conjures up images of laboratories.
Any safe medicine consists of chemicals manufactured or extracted to a concentrated and standardized dose. In terms of this study, the “natural Kava” came in tablets containing 250 mg. kavalactones. Subjects didn’t drink it out of a coconut shell while listening to tribal drumming.
Seen another way, alternative treatment are simply para- and/or pre-conventional. They have yet to be fully tested and distilled to higher potency. And safer form as well, for many raw, alternative treatments contain undesirable chemicals along with the effective ones.
Science done well provides so much good. But yes, along with the good we can find doses of bad and stupid. Maybe some day there will be a way to better extract and concentrate the good, for the good of the general public.
I’ve had Kava out of a coconut shell, listening to 80s pop, does that count?
I was at a party for some Fijian Indians (that is, Indian culture who lived in Fiji for a few generations before migrating to Australia), and it appears they picked up a taste for Kava while there. It was hard to get apparently.
It tasted like dirty water.
Thanks for your well thought out critique of the published paper. The lead researcher should definitely be brought to task for statements like the one you’ve highlighted.
By the way, I’ve had kava myself, drunk from a coconut shell while listening to drums. Despite tasting like dirty water, it was rather a nice experience.
I too have drank kava also refered to as grog,when i visited fiji. I had a good time in was a calming effect, however the plp who drink it daily are all rather skinny so I can def see why it is common for weight loss. But after learning the side effects
What I garnered about intentions of the acute study and from the lead researcher’s comments (and from what I believe is now a chronic-dose study that the same researchers are undertaking), that this same intention is existent – the extract & refine the good, up the potency, and do so with some good methodology that clinical trials involving nutraceuticals all too often fall short.
I really think he is speaking of kava bioactive constituents present *relative* to synthesized pharmaceuticals when looking at anxiety treatments and associated the dependency that such drugs may elicit.
Really, most of the above opinion is splitting veritables, and to call it ‘stupid’ is hardly constructive.
Karen, while I agree that the term “stupid” is rather . . . harsh, this is a blog and the etiquette for such an outlet is rather informal.
Additionally, I think a bit of exasperation is called for. The use of terms such as “natural alternative” is evidence of a version of the naturalistic fallacy. I expect if from companies in the marketing business (who also use such words like “green” and “organic” and “earth-friendly”) but not in a scientific paper. Sales and science don’t mix. In my opinion. Active ingredients are molecules–chemicals–aren’t they?
P.S. From your use of “veritables” and “nutraceuticals,” I would guess you live in …Europe? (Not that there’s anything wrong with that! :)