Kava and Wellbutrin Questions

[saltminerrr]

Hi all!

I am relatively new to Kava. I had my first shell in Fiji when visiting several years ago and more recently had poorly prepared a kava from Kona Kava Farms. I cannot remember the strand, but after educating myself I purchased from some better vendors here and will be attempting better products. Anyways, I have SOME experience with how Kava makes me feel, but not much, and am trying to use it to help relax me at the end of the day (used to drink heavily, now over 2 years without it). I have diagnosed anxiety and have also been prescribed Wellbutrin for non-stim ADHD (forgot I was not on it for depression, was coincidence). Since being prescribed Wellbutrin I have only had the Kava Tea from Yogi which is incredibly weak, but better than nothing.

I am wondering if Kava has any important reactions with Wellbutrin. I have done a good bit of searching through the internet and here on the forums and cannot seem to find any evidence of there being danger. There is just a lot of people saying "ohhh maybe, not sure, ask your pdoc" or "IT'LL KILL YO LIVER"(lol). I honestly do not care to ask my pdoc and probably will, but I am not sure how knowledgeable he is regarding Kava.

Has anyone else had similar experiences, situations, or enlightening information?

TLDR - Want to use Kava to relax and somewhat help with my urge for alcohol. Haven't had any significant dose of Kava since being on Wellbutrin. Concerned about possible interactions and unable to find any reliable or concrete descriptions or discussions online so far.

Thanks everyone!

 

[verticity]

Hello and welcome to the forum.

- Kava is not harmful to the liver by itself. If combined with things that are harmful to the liver such as alcohol or acetaminophen it could aggravate the liver toxic effect of those things, though.

- In considering the interaction of kava with any medicine you need to think about 2 things: First, whether the medicine is metabolized in the same way as kava, in which case kava could cause levels of the medicine to be higher than normal. Second, in the case of psychiatric medications, are the neurological actions similar so that there could be additive effects with kava. To address these:

1) Kavalactones are metabolized by many liver enzymes, including: CYP 1A2, 2C9/19, 2D6, 3A4/5, 4A9/11 and possibly 2E1.
Reference: http://kavaforums.com/forum/threads/which-specific-cyp450-enzymes-does-kava-inhibit-induce.7084/
Bupropion (Wellbutrin) is metabolized primarily by CYP2B6 (https://en.wikipedia.org/wiki/Bupropion), which as far as I know has not been implicated in kavalactone metabolism. But bupropion is also metabolized by CYP2C19, which is involved in KL metabolism. So the fact that bupropion is metabolized partially by one of the enzymes that kava is metabolized by means that if there is kava in your system, it could cause Wellbutrin to be metabolized more slowly. You should be careful with the combination, because elevated levels of Wellbutrin can cause seizures, as well as unpleasant side effects such as making you feel like you just drank 10 cups of coffee. If you do choose to take kava with Wellbutrin, you might need to take a lower dose of Wellbutrin than otherwise to avoid problems.

2) Kava acts as a very mild reversible MAOI. That means it can cause levels of neurotransmitters like serotonin, norepinephrine and dopamine to be elevated. Since Wellbutrin also causes elevated dopamine (and norepinephrine) levels, there is some potential for interaction there also. On the other hand, kava also acts on cation channels and GABA receptors which would tend to counteract the stimulating and seizure promoting effect of Wellbutrin.

Also, I just have to say: I'm still not a doctor, but as a patient I have taken Wellbutrin in the past. I also have problems with anxiety and depression. The Wellbutrin did help with the depression to some extent, but it also made me extremely jittery. It was just a very poor choice for someone like me with severe anxiety problems.

 

[saltminerrr]

Thank you for your detailed reply! That helps a lot.

Right now I am on a 150mg XL, which is the lowest dose of extended release available. I have taken up to 450mg before and I was incredibly irritable, but that is also a huge jump from where I am at now. In fact, I am working on getting off of Wellbutrin as I do not believe its pros outweigh its cons.

I may try a small dose of Kava and see what that feels like. Since I have experience with high levels of Wellbutrin, I may be able to recognize when the Kava is interfering too much. Theoretically, it could possibly help someone ween off of Wellbutrin, no?

 

[verticity]

Well, in my experience kava is helpful for treating both anxiety and depression, so I find I don't need to take any prescription meds any more. ymmv

 

[saltminerrr]

Well, in my experience kava is helpful for treating both anxiety and depression, so I find I don't need to take any prescription meds any more. ymmv

That would ultimately be my goal! That sounds great! Do you have a specific type of Kava or regiment that works best?

I really appreciate your replies and help!

 

[verticity]

That would ultimately be my goal! That sounds great! Do you have a specific type of Kava or regiment that works best?

I really appreciate your replies and help!

I don't have a specific regimen. I drink all kinds of kava. For anxiety, Borongoru from Kalm with Kava, or Nene or Vanuatu Borogoru from Gourmet Hawaiian Kava are good. Headier ones are good for depression. Good vendors to check out are, in addition to KWK and GHK: Cactus Kava, Kava Time, Bula Kava House.

 

[saltminerrr]

Awesome! I definitely will make my rounds and check out those vendors. I tried 1 tablespoon measured out with 700ml of water of Dua Na Bilo's Waka. I intentionally made it weak and did feel some slight effects. I do not believe I felt any interaction with Wellbutrin, but I cannot be certain. I will be talking to my doc soon to get off of Wellbutrin as well. It was prescribed to me initially as a non-stim ADHD medication, but doesn't do too much. The face that it was an antidepressant as well was just a coincidence.

 

[saltminerrr]

As an update, I am currently weaning off of Wellbutrin by doctor instructions. It takes a bit of restraint, but I will more than likely wait the few weeks before indulging too much in Kava simply to keep my mind at ease. I did not feel any bad side effects after 2tbs of Waka, but am slightly concerned that there could be elevated enzyme levels in my liver due to the shared enzyme. I don't think anything would go wrong, but I get a little on the hypochondriac side, lol.

I will without a doubt be around the forums the whole time though. You all sound like a great bunch and I will enjoy getting to know you all! Thank you for all your help @verticity !