You’ve probably heard that kava shouldn’t be taken in combination with prescription tranquilizers like Valium, anti-psychotics, or depressants like alcohol. However, that still leaves the question, where does the medical evidence stand when it comes to combining kava and Prozac or other anti-depressants? As many as 30 million Americans have faced depression or anxiety at some point in their lives, and many have taken prescription anti-depressants or anti-anxiety medications to treat these conditions. Prozac is probably the most well known brand of a class of anti-depressants called SSRIs, or selective serotonin reuptake inhibitors, which act to relieve depression by increasing the brain’s amount of the neurotransmitter serotonin.

In our increasingly medicated society, many people are becoming interested in natural ways to relieve anxiety and depression that don’t involve prescription drugs. For many, kava is becoming the herb of choice for its clinically verified anxiolytic and tranquilizing properties, which have been proven to be as effective as certain classes of prescription tranquilizers but without the raft of side effects. However, many kava products also come with warnings not to consume them if you are taking prescription tranquilizers or anti-depressants such as Prozac. There are two reasons why this precaution has been put in place: the first is that, like any psychoactive oral herb, kava must be metabolized by the liver, so taking it in combination with certain drugs can put an undue load on the liver. The second reason is that kava activates pathways in the brain to produce its relaxing and anxiolytic effects, and there is a chance it could interact harmfully with other drugs that affect the central nervous system. We’ll examine both of these areas of concern in more detail below.

You may have heard scary things about kava’s effect on the liver in connection with a 2001 Swiss-German study that linked use of European kava supplements to liver damage in some 30 cases examined in Switzerland. Subsequent research discovered that many of the subjects in the study were taking kava supplements in combination with prescription tranquilizers such as Valium and other benzodiazepines, and/or heavy alcohol consumption. We know now that kava should not be taken in combination with a drug that already puts a metabolic load on the liver, such as alcohol or benzodiazepines, because it can cause harm to the liver. By the same token, the liver must also process anti-depressant SSRIs like Prozac, as well as an older class of anti-depressants called tricyclics. It is possible that taking kava and Prozac could produce a heavy metabolic demand on the liver, so we recommend you consult a doctor before using kava if you already take Prozac or a related anti-depressant.

Furthermore, kava kava is a psychoactive herb, which means it affects chemical pathways in the brain to generate its calming effects. Studies have shown that kava can amplify the effects of central nervous system depressants like alcohol, which contributes to a reduction in anxiety but also slows breathing and heart rate. Doctors already advise against combining kava with CNS depressants, but it’s less clear if kava interacts with SSRI anti-depressants in a significant way. Prozac and other SSRIs work to elevate mood by increasing the brain’s levels of the neurotransmitter serotonin. Kava studies suggest that kavalactones do not interact with the brain’s serotonin pathways; in fact, kavain, a common kavalactone, actually seems to slightly decrease the brain’s amount of serotonin in high amounts. Instead, researchers have suggested that kavalactones reduce anxiety by increasing the brain’s levels of dopamine and norepinephrine. However, the older class of tricyclic anti-depressants can act as monoamine oxidase inhibitors (MAOIs) and have the potential to amplify kava kava’s effects by allowing a greater concentration of kavalactones to pass through the digestive system into the bloodstream.

Kava is not so much an anti-depressant herb (such as St. John’s Wort or kanna) as it is an anxiolytic and tranquilizing herb: kavalactones have been shown to work along the same brain pathway as tranquilizers such as Valium, but without the attendant mental dulling, drowsiness, or potential for habituation. Like synthetic tranquilizers, kava seems to target the amygdala: the region of the brain responsible for regulating fear and anxiety responses, as well as memories with emotional content. While Valium increases the brain’s levels of gamma aminobutyric acid (GABA), a neurotransmitter with anxiolytic properties, kava seems to work by a different pathway. It’s possible that it may interact directly with the voltage-gated ion channels of nerve cells that regulate nerve impulses in order to deliver its anti-convulsant, analgesic, anxiolytic, and muscle relaxant effects.

So far, no one in the medical community is sure what the effects of using kava and Prozac in combination might be. The bottom line is that any herb or medicine that affects your brain will interact with other CNS drugs to some degree. There are already precautions against using kava in combination with CNS depressants or tranquilizers, anti-psychotic medications, and drugs to treat Parkinson’s such as levodopa, but as yet there is very little literature regarding any harmful interactions between kava and Prozac or another SSRI. However, as with any potential drug-herbal combination, we recommend that you refer to a physician for the last word on whether to try kava if you currently use an anti-depressant such as Prozac.

Often cited as a symptom of chronic stress in our go go go society, muscle tension occurs when a person experiences persistent tightness, and sometimes pain, in one or several muscles or muscle groups. Muscle tension can be anything from a minor nuisance to a debilitating condition that makes it almost impossible to go about your daily activities. Some people experience severe muscle tension to the point where they may have to spend days in bed. Several factors often combine to induce muscle tension, including chronic inactivity, mental stress and anxiety, and sometimes neuromuscular disorders. Luckily, there are also multiple methods to relieve muscle tension stress: taking a relaxing herbal supplement like kava is just one way to free yourself from persistent muscle tension, along with exercise and mental techniques you can use to destress your life.

Muscle tension is a physical phenomenon that quite often has psychological roots, although medical conditions such as polio and musculoskeletal disorder may also cause muscle tension. Furthermore, women sometimes experience tight or painful muscles as they undergo the hormonal changes associated with menopause, especially if they’re experiencing stress as a result of these changes. However, by and large the biggest cause of muscle tension for most of us is the everyday stress of modern living. For instance, jobs that require people to perform the same repetitive motions, such as working as a mail carrier, janitor, store clerk or waiting tables (to name only a few high-activity jobs), can cause their muscles to tense up and make it hard to relax at the end of the day. Those of us who work at a desk often don’t fare any better: sitting in front of a computer all day can make you hunch over and cause tension in the muscles of the back, neck, and shoulders as well as tension headaches. Emotional stress from pressures at work or difficulties in your home life can also cause you to carry an undue load of tension in your muscles.

For the unfortunately large number of people who suffer from anxiety disorders of one kind or another, muscle tension can also be a somatic symptom of mental distress. Our psychological state has an amazing amount of influence over our bodies: when your brain is experiencing a prolonged or heightened anxiety response, it frequently spills over into physical reactions including muscle tension and weakness, tremors, heart palpitations and even rashes. The good news is that there are as many ways to relieve muscle tension as there are causes: physical exercise and massage, meditation techniques, and relaxing herbal remedies including kava can all help to mitigate muscular tension and pain.

Physical exercise may seem like an obvious remedy; after all, it stretches out your muscles and improves flexibility if done regularly. Yoga is especially effective for muscle tension because it focuses not only on stretching the muscles, but also trains practitioners to breathe effectively and focus their minds on the present pose. Effective breathing and meditation (with or without yogic exercises) are both proven techniques for reducing stress and improving your alertness and energy levels. Other than getting enough sleep every night, there are few things more effective in reducing your levels of stress and tension than regular exercise. Consistent meditation is also a great way to relieve tense muscles, as psychology suggests that muscle tension is often a manifestation of inner mental stress, and taking a few minutes a day to focus your mind can help you feel less tense and harried.

Of course, people who work full-time often feel like they have no time to engage in tension-reducing exercise. Our answer is that there are a multitude of small but equally beneficial exercises you can do at your desk to relieve muscle stress and reenergize your body. Try taking an hourly break to stretch the muscles of your shoulders, neck and back by sitting up straighter and lifting your arms above your head with fingers interlocked. If you don’t want to be so conspicuous, you can try smaller exercises such as breathing in deeply from your belly: this will massage your ribs and reoxygenate your whole body. Slightly parting your lips is another small exercise with big effects: when you part your lips it relaxes your jaw, tongue, and neck and prevents you from unconsciously grinding your teeth or clenching your jaw.

Finally, herbal relaxants like passionflower, chamomile and of course, kava, can help you recoup after a long day or act as daytime remedies for muscle stress and tension. Studies have shown that kava, taken either in a brew, capsules or tincture, has a direct effect in alleviating muscle tension. Kava root contains compounds called aryethylene pyrones with muscle relaxant properties similar to benzodiazepines such as Valium. Even better, kava root comes without the side effects of impaired thought and slowed reaction time which people often exhibit with tranquilizers. Clinical studies have shown that people suffering from anxiety perform better on tests that require memory and concentration after taking kava as compared to a benzodiazepine. However, we still recommend you don’t drive or operate machinery after using kava, as it can impair reaction times for these activities.

Though the average bowl of kava contains enough kavalactones to moderately sedate you, there are also less concentrated kava capsules or tinctures you can use during the day to take advantage of kava’s anxiolytic effects. The modest dose of kavalactones in a kava capsule can banish anxiety and offer relief from stress while not interfering with your alertness or ability to be productive, making kava capsules a perfect workday herb.

Everyone has stress to some degree, and we all manifest it in tense muscles and tired bodies on occasion. Part of the reason our muscles may get tense when we’re stressed is to make our brains aware of this inner state; once you become aware of the tension you’re carrying in your body and mind, you can take steps to reduce it. The important thing to remember is that ultimately, there are many ways you can decrease your levels of stress and muscle tension: exercise, meditate, breathe deep and take a sip of kava to watch your tension melt away… it’s all up to you!