Kava
Piper methysticum
A potent herbal anxiolytic from the South Pacific, comparable to benzodiazepines for anxiety relief.
Kava is a traditional beverage from Pacific Island cultures made from the root of Piper methysticum. Its active compounds, kavalactones, produce anxiolytic, sedative, and muscle-relaxing effects. Clinical research supports its effectiveness for generalized anxiety disorder, with some studies showing comparable efficacy to prescription anxiolytics. However, concerns about liver toxicity (mostly linked to poor-quality products) require careful product selection.
Mechanisms of Action
GABA Modulation
Enhances GABA activity for calming effects
Sodium Channel Blockade
Reduces neuronal excitability
Dopamine Effects
May mildly inhibit dopamine reuptake
Recommended Dose
150-300mg kavalactones daily
Loading: Not applicable; can be used as needed or daily
Optimal Timing
- Evening for relaxation
- 30-60 minutes before stressful events
- Before bed for sleep
Can be taken without food
Best Form
Water-extracted root powder or capsules
Alternatives: Traditional kava drink, Standardized extract capsules
Use ONLY noble kava varieties from root (not aerial parts). Water or CO2 extraction is safest. Avoid alcohol-extracted products.
Duration
Minimum: 1 weeks
Optimal: 8 weeks
Cycling: Use for 4-8 weeks, then take 2-4 weeks off. Avoid continuous use for more than 3 months.
Note: Empty stomach increases absorption and effects. Do not combine with alcohol.
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Reduced Anxiety
Noticeable calming without mental fog
Muscle Relaxation
Physical tension relief
Improved Sociability
Reduced social anxiety, more talkative
Mild Sedation
Drowsiness at higher doses
Avoid — Hepatotoxicity risk and unknown fetal developmental effects
Start with low doses; increased fall risk due to sedation
Who Should NOT Take This
- Liver disease or compromised liver function
- Heavy alcohol use
- Parkinson's disease (may worsen symptoms)
- Depression (may exacerbate in some)
- Before surgery or driving
Drug Interactions
Never combine - significantly increases liver toxicity risk and sedation
Additive sedation - risk of excessive drowsiness
May reduce effectiveness of Parkinson's drugs
Additive liver stress - avoid combining
Excessive sedation, respiratory depression, liver toxicity risk
Excessive sedation, respiratory depression, liver damage
Excessive sedation, respiratory depression
Severe respiratory depression, coma risk
Excessive sedation, liver damage risk
Possible Side Effects
Tip: Reduce dose; don't drive after use
Tip: Take with light food if needed
Tip: Only with very heavy, prolonged use - reversible when stopped
Warnings
- Use ONLY noble kava varieties from peeled root
- NEVER combine with alcohol
- Get liver function tested before long-term use
- Avoid low-quality products (linked to liver cases)
- Do not drive or operate machinery after use
Top studies from 40+ peer-reviewed papers
Chessick CA et al. • The Cochrane database of systematic reviews (2006)
“Azapirones appeared to be useful in the treatment of GAD, particularly for those participants who had not been on a benzodiazepine.”
Key Findings:
- The calculated number needed to treat for azapirones using the Clinical Global Impression scale was 4.4 (95% confidence interval (CI) 2.16 to 15.4).
- Azapirones appeared to be useful in the treatment of GAD, particularly for those participants who had not been on a benzodiazepine.
- Azapirones may not be superior to benzodiazepines and do not appear as acceptable as benzodiazepines.
- Side effects appeared mild and non serious in the azapirone treated group.
Sarris J • Phytotherapy research : PTR (2018)
“Aside from this, future focus should involve the incorporation of more biomarker analysis, in particular pharmacogenomics, to determine genetic factors moderating response to herbal medicines.Copyright © 2018 John Wiley & Sons, Ltd.”
Key Findings:
- Other encouraging herbal medicines with preliminary evidence include Curcuma longa (turmeric) in depression, Withania somnifera (ashwagandha) in affective disorders, and Ginkgo biloba (ginkgo) as an adjunctive treatment in Schizophrenia.
- Although depression and anxiety are commonly researched, many other mental disorders still require further prospective investigation.
- Although the previous review suggested increasing the adjunctive study of select herbal medicines with pharmaceuticals, this was still only found to sparingly occur in research designs.
- Aside from this, future focus should involve the incorporation of more biomarker analysis, in particular pharmacogenomics, to determine genetic factors moderating response to herbal medicines.Copyright © 2018 John Wiley & Sons, Ltd.
Savage K et al. • Phytotherapy research : PTR (2018)
“Collectively, the literature reveals preclinical and clinical evidence for various phytomedicines modulating GABA-pathways, with comparative anxiolytic effect to the current array of pharmaceuticals, along with good safety and tolerability profiles.Copyright © 2017 John Wiley & Sons, Ltd.”
Key Findings:
- An open-ended search to 5 July 2017 was conducted using MEDLINE (PubMed), Scopus, and Cochrane library online databases and performed in a stepped format from preclinical to clinical investigations.
- Eligible studies must have had (a) in vitro evidence of GABA-modulating activity, (b) animal studies using anxiety models to test an anxiolytic effect, and (c) human clinical trials.
- Ten phytomedicines were identified as having preclinical investigations showing interaction with the GABA system, in addition to human clinical trials: kava, valerian, pennywort, hops, chamomile, Ginkgo biloba, passionflower, ashwagandha, skullcap, and lemon balm.
- Collectively, the literature reveals preclinical and clinical evidence for various phytomedicines modulating GABA-pathways, with comparative anxiolytic effect to the current array of pharmaceuticals, along with good safety and tolerability profiles.Copyright © 2017 John Wiley & Sons, Ltd.
Leach MJ et al. • Sleep medicine reviews (2015)
“All rights reserved.”
Key Findings:
- There was no statistically significant difference between any herbal medicine and placebo, or any herbal medicine and active control, for any of the thirteen measures of clinical efficacy.
- As for safety, a similar or smaller number of adverse events per person were reported with kava, chamomile and wuling when compared with placebo.
- By contrast, a greater number of events per person were reported with valerian.
- While there is insufficient evidence to support the use of herbal medicine for insomnia, there is a clear need for further research in this area.Copyright © 2014 Elsevier Ltd.
Gale CK et al. • BMJ clinical evidence (2007)
“In this systematic review we present information relating to the effectiveness and safety of the following interventions: abecarnil, antidepressants (imipramine, opipramol, paroxetine, sertraline, escitalopram and venlafaxine), antipsychotic drugs (trifluoperazine), applied relaxation, benzodiazepines, buspirone, cognitive behavioural therapy, hydroxyzine, kava, and pregabalin.”
Key Findings:
- Systematic review examining Kava efficacy
- Published in BMJ clinical evidence (2007)
- Further research warranted to confirm findings
Study Type Distribution
Goals This Supplement Supports
Related Goals
This information is for educational purposes only and is not intended as medical advice. Always consult a qualified healthcare provider before starting any supplement.