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Kava Physiology How seriously should I treat Kava as a MAO-B inhibitor?

MikeB

I like Mo'i
I've read that certain alkaloids in Kava act as MAO-B inhibitors, which may contribute partly to the pharmacologic effects of the plant.

If this is true, then it's a very big deal and very important to know. MAOI's exhibit significant interaction with a HUGE number of other medications, supplements, and even foods. As an example, someone taking an MAOI needs to avoid eating certain types of cheese. A really extraordinary number of things are contraindicated for someone taking an MAOI, as there is real danger of developing serotonin syndrome and/or acute hypertensive crisis.

However, when I look up "kava kava" in most online drug interaction checkers, such as WebMD's interaction checker and drugs.com's interaction checker, I don't see any of the normal contraindications that are usually listed for MAOI's. I have also heard that as an MAO-B inhibitor, Kava is very weak, and that "it's not worth worrying about."

I would appreciate any sort of references to the literature that quantify Kava's strength as an MAO-B inhibitor and give any possible technical insight into the types of interactions that I can expect when I use it. Thank you!
 

Whitewater

Kava Curious
I was curious about this as well. I believe it's Desmethoxyangoin that is an maoi-b, but I could be wrong. In any case I think the reason it's not a talked about phenomenon is because it's a pretty weak interaction. Still, given the serious of taking the wrong medication with an maoi, I would be interested in knowing more about it.

I think we would see more problems associated with kava if it were a strong interaction. Since we don't suggests there is nothing to worry about, however that isn't great logic for piece of mind.

I saw your other thread too. There could very well be some different interaction between kava and amphetamines using a different pathway. Or as someone mentioned the particular strain of kava you're using might not agree with you. Have you used that kava before? The feelings induced by kava and Adderall are very different. Maybe they just don't mesh well.

Either way be safe and good luck. It might take a little experimenting to find our what works for you.

Also I'm too rooted to dig into the literature right now lol. Sorry! I have access to most journals. if you don't I can look stuff up for you later.
 

MikeB

I like Mo'i
@Whitewater - it was GHK's Mo'i micro, which is my favorite strain. I've been drinking it for a year now and rarely buy anything else. I had also mixed it earlier in the day with some Ozia candies, which I usually tolerate decently well.

I've been keeping fairly detailed logs of my experiences since I started the Adderall. I'm now a bit skeptical that it was really a kava-amphetamine interaction that caused the symptoms I was experiencing. The reason is that a few days earlier, at the end of the day, I had also taken Boroguru for the first time and didn't have any adverse reaction - although I spread the two out so they weren't located as closely together in time. I'm also having some pretty irritating adverse effects from the amphetamine alone, such as insomnia, so some of it may be from that too.

I have seen a few other anecdotal reports of adverse effects from the kava/Adderall combo, but as per usual that only gets you so far.

I unfortunately do not have access to virtually any journals. If you can find any literature that manages to quantify how strong the MAOI effect from Kava is, I'd greatly appreciate it.
 

kilakila

Kava keeps me going.
Bad effects from boroguru lasted two days for me. Moi also has a tendency to rev me up -not always though!
I don't take Adderall. Just tapering diazepam - down to 1mg.
Oh and sadly I haven't found a mate tea that doesn't also give me the jitters. I will try that stuff again further down the road.
Meanwhile I find waka, 'Ono, Eva, mahakea and hanakapa'ai work very well for me:
 

verticity

I'm interested in things
There are actually two types of MAOIs: irreversible and reversible. The old school antidepressants like Nardil and Parnate are irreversible, which means that they form a chemical bond to MAO and never let go, so the MAO cannot do it's normal job (especially metabolizing neurotransmitters) until the brain synthesizes more MAO. They are extremely potent drugs, and can be dangerous if the diet is not followed. But there is another type of MAOI: reversible, which do not bind strongly to MAO, and thus are much less dangerous (but also less effective as antidepressants). The kavalactone desmethoxyyangonin or DMY, is a "modest", reversible MAOI, The other KLs are weaker MAOIs. So there should be no need to worry about following an MAOI diet when using kava, but it is possible that kava's MAOI effect could give you something of a "jacked up" feeling, which might exacerbate the stimulating effect of Adderal.
 

MikeB

I like Mo'i
OK. So as a very rough pass, you would venture a guess that it would be good to avoid medications contraindicated for MAOI's when using Kava, but not foods?
 

verticity

I'm interested in things
OK. So as a very rough pass, you would venture a guess that it would be good to avoid medications contraindicated for MAOI's when using Kava, but not foods?
If I were a conservative doctor, I might say that. However I am not a doctor (nor am I conservative) Personally I take Effexor, which is an antidepressant, and all other antidepressants are contraindicated by MAOIs. I have not encountered any problems with this. In your case, if you find yourself getting excessively jittery with the combination of kava + Adderall, just be aware this could be one cause. Your options then would be to stop or reduce the Adderall, or stop or cut back on the kava. Just pay attention to what your body is telling you, and did I mention that I am not a doctor? I'm not a doctor.
 

MikeB

I like Mo'i
You seem to know a lot about this stuff. Are you a doctor?

Actually, I'm just being paranoid here. My doctor, and every resource that I can find on the internet, says that Kava is **NOT** contraindicated for things that MAOI's usually are. I mixed Kava and Adderall today and had pretty good results, so I think my adverse reaction before probably not associated. I do think they tend to potentiate one another a **tiny** bit, but not the end of the world.

I would discontinue Adderall if it meant I could never take Kava again. Kava is simply too effective for managing anxiety, and in my view it should be the first-line treatment for anxiety. The second-line treatment should be benzodiazepenes, which have numerous associated problems that Kava does not.
 

MikeB

I like Mo'i
Here is a GREAT study that compares the potency of a number of natural MAO-B inhibitors:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521852/table/T1/

You can see that Kava is listed as "strong," or Level 2.

While it's listed as weaker than green tea, curry, and black pepper, I'm not sure how misleading this is because we typically consume much more kava than black pepper.

Green tea, however, seems like a decent benchmark. However, how much kava do we consume, relative to a dose of green tea? Like how much is in a shell?
 

aviavieu

Kava Enthusiast
Kava Kava has about 1.5% IMAO. Is this a lot? How much does IMAO have, for example, Yerba mate, green tea, currant juice ...?
 

ProjectK

Kava Enthusiast
I have read that Kava interacts like alot of medications. But you also read everywhere that it causes significant liver damage in a short amount of time. So you just dont know what to trust unfortunately.
 
@Whitewater - it was GHK's Mo'i micro, which is my favorite strain. I've been drinking it for a year now and rarely buy anything else. I had also mixed it earlier in the day with some Ozia candies, which I usually tolerate decently well.

I've been keeping fairly detailed logs of my experiences since I started the Adderall. I'm now a bit skeptical that it was really a kava-amphetamine interaction that caused the symptoms I was experiencing. The reason is that a few days earlier, at the end of the day, I had also taken Boroguru for the first time and didn't have any adverse reaction - although I spread the two out so they weren't located as closely together in time. I'm also having some pretty irritating adverse effects from the amphetamine alone, such as insomnia, so some of it may be from that too.

I have seen a few other anecdotal reports of adverse effects from the kava/Adderall combo, but as per usual that only gets you so far.

I unfortunately do not have access to virtually any journals. If you can find any literature that manages to quantify how strong the MAOI effect from Kava is, I'd greatly appreciate it.
I've taken both without any interaction or unpleasant side effects.
 

Maria Daniel

Kava Curious
There are actually two types of MAOIs: irreversible and reversible. The old school antidepressants like Nardil and Parnate are irreversible, which means that they form a chemical bond to MAO and never let go, so the MAO cannot do its normal job (especially metabolizing neurotransmitters) until the brain synthesizes more MAO. They are extremely potent drugs, and can be dangerous if the diet is not followed. But there is another type of MAOI: reversible, which do not bind strongly to MAO, and thus are much less dangerous (but also less effective as antidepressants). The kavalactone desmethoxyyangonin or DMY, is a "modest", reversible MAOI, The other KLs are weaker MAOIs. So there should be no need to worry about following an MAOI diet when using kava, but it is possible that kava's MAOI effect could give you something of a "jacked up" feeling, which might exacerbate the stimulating effect of Adderal.
Would Kava be a good MAOi to use alongside PEA then to elongate its effects? I don't think I would actually combine the two as I prefer to feel Kava's effects on their own. But just for theory's sake.
 

The Kap'n

The Groggy Kaptain (40g)
KavaForums Founder
Has anyone used kava with cold medicine? Cause the maoi thing
Interesting that this thread is brought up.

For real the effect is so so light I don't even see a need to warn about things we would normally say not to combine with MAOIs.
 
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