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Comment by exception_e | Hacker News Reader

People with Bipolar: Seriously talk with your psychiatrist before trying Kava - it was great for me at first, but then I noticed some undesirable mood changes. I wish we knew more about Kava and also drug interactions.

(This comment doesn't really need a thread or arguments about natural solutions :-P ... just a note/data point to maybe save someone a bit of trouble)

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Thanks for the anecdote; it's probably the first one I've read from someone who's Bipolar. There are a lot of anecdotes from people with OCD (mostly positive). The latest study found kava to be ineffective in the treatment of Generalised Anxiety Disorder (GAD), although the authors of the study (and countless anecdotes online) still recommend it for situational anxiety (say before public speaking or an interview).

Like you, I wish we knew more about drug interactions. One to keep in mind is the grapefruit rule. Drugs that are incompatible with grapefruit are incompatible with kava.

Thank you for bringing up the grapefruit rule. I only learned about it recently. At first it sounds kind of silly, but then when you hear the stories you realize it has to be taken seriously.

If you regularly eat grapefruit, make sure your doctor knows. Be careful ramping medications up or down without discussion first.

And definitely go research this for yourself as well. :)

Nice! It sounds like you are keeping tabs on this anecdotally/with studies for multiple mental disorders. Maybe my comment is sort of useful to some! Also, I'd like to expand a bit, actually. My "version" of BP is "Type 1 with Psychotic Features" - it's a rough one, so doc recommended __total__ sobriety (for me, that was only quitting marijuana). The reasoning was because of potential med interactions and a higher chance of going into mania/depression. My comment above says "[Kava] was great for me at first" because it was like 20% of a marijuana high, very calming, and I thought it was safe/not a "drug". I actually felt like I was cheating and then noticed instabity pretty quickly after that.

I've been sober for over a year and a half (strictly for my disorder, not because of typical reasons e.g.: drug addiction). At this point, I'll take stability over any tea (or anything) that provides a light high. :-)

For everyone else, I'm hopeful Kava is a helpful medicine.

> Maybe my comment is sort of useful to some

It definitely is. And thank you for the extra details. In Fiji (where I live), kava is a recreational beverage and there is almost no info on medicinal use. As kava use grows in the west we're slowly learning from anecdotes like yours.

Based on the studies I've read kavalactones, the group of related psychoactive compounds in kava, indirectly activates the GABA-A receptors without directly binding to the benzodiazepine receptors. So it produces the same effect as a mild benzodiazepine, similar to Xanax. But the exact mechanism is still unknown, so there's definitely a risk of interactions with medications, especially benzodiazepines or medication or supplements that interact with the GABA receptors. Plus one of the kavalactones, yangonin, binds to the cannabinoid receptors. It's a selective agonist of the CB1 cannabinoid receptors and a full agonist of the CB2 receptors.

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