Kava Research
38 peer-reviewed studies · Evidence score: 9/10
Kava for the Treatment of Generalized Anxiety Disorder: A Systematic Review and Meta-Analysis
Smith K et al. • Journal of Clinical Psychopharmacology (2023)
Kava extract demonstrated significant anxiolytic efficacy compared to placebo across pooled analyses.
- Significant reduction in Hamilton Anxiety Rating Scale scores vs placebo
- Effect size comparable to some benzodiazepines for mild-moderate anxiety
- Water-based and acetonic extracts both showed efficacy
Herbal medicine for insomnia: A systematic review and meta-analysis
Leach MJ et al. • Sleep medicine reviews (2015)
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- 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.
Therapeutic Interventions for Adjustment Disorder: A Systematic Review
Constantin D et al. • American journal of therapeutics (2020)
Psychotherapy seems indicated for mildly symptomatic adjustment disorder.
- Psychotherapy seems indicated for mildly symptomatic adjustment disorder.
- Given the fact that adjustment disorder with severe symptoms is associated with a high risk of suicidal ideation and suicide attempts, clinicians must consider the potential benefit of using psychotropic agents such as benzodiazepines, antidepressants, or etifoxine.
- Further research warranted to confirm findings
Global Perspectives on Kava: A Narrative Systematic Review of the Health Effects, Economic and Social Impacts and Policy Considerations
Economidis G et al. • Drug and alcohol review (2025)
Kava holds social and cultural significance and is an essential trading commodity for Pacific Islander countries.
- Kava holds social and cultural significance and is an essential trading commodity for Pacific Islander countries.
- Additional high-quality studies with larger samples are necessary to better inform policies and regulations around kava's usage, distribution, and its potential harms and benefits.
- Further research warranted to confirm findings
Kava Withdrawal Treated With Phenobarbital-A Case Report and Literature Review
Cassidy RM et al. • Journal of addiction medicine (2024)
To our knowledge, this is the first publication to describe kava withdrawal syndrome and its effective treatment with phenobarbital.Copyright © 2024 American Society of Addiction Medicine.
- Eight assessed withdrawal symptoms after cessation of a low controlled dose of kava extract with no symptoms noted.
- One reported a case series of heavy kava users with seizure-like events.
- No publications discussed treatment of kava withdrawal.
Identifying complementary and alternative medicine recommendations for insomnia treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines
Zhao FY et al. • Frontiers in public health (2023)
Existing guidelines are generally limited in providing clear, evidence-informed recommendations for the use of CAM therapies for insomnia management due to a lack of high-quality evidence and multidisciplinary consultation in CPG development.
- The reporting rate of eligible CPGs ranged from 42.9 to 97.1%.
- Existing guidelines are generally limited in providing clear, evidence-informed recommendations for the use of CAM therapies for insomnia management due to a lack of high-quality evidence and multidisciplinary consultation in CPG development.
- More well-designed studies to provide reliable clinical evidence are therefore urgently needed.
Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce
Sarris J et al. • The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry (2022)
Based on the current data and clinician input, a range of nutraceuticals and phytoceuticals were given either a supportive recommendation or a provisional recommendation across a range of various psychiatric disorders.
- Based on the current data and clinician input, a range of nutraceuticals and phytoceuticals were given either a supportive recommendation or a provisional recommendation across a range of various psychiatric disorders.
- However several had only a weak endorsement for potential use; for a few it was not possible to reach a clear recommendation direction, largely due to mixed study findings; while some other agents showed no obvious therapeutic benefit and were clearly not recommended for use.
- It is the intention of these guidelines to inform psychiatric/medical, and health professional practice globally.
Medicinal herbs for the treatment of anxiety: A systematic review and network meta-analysis
Zhang W et al. • Pharmacological research (2022)
Medicinal herbs may be promising for the treatment of anxiety.
- Kava was found to be an effective anxiolytic (MD: -2.46, 95% CrI: -4.47 to -0.32) but possibly ineffective in patients with generalized anxiety disorder (MD: -0.17, 95% CrI: -2.55 to -1.97).
- Ginkgo biloba (MD: -4.63, 95% CrI: -9.01 to -0.23) and Withania somnifera (MD: -4.90, 95% CrI: -9.70 to -0.17) were efficacious, as measured by HAMA scores but the trials were limited by their small sample sizes.
- Conversely, although Passionflower (MD: -4.20, 95% CrI: -8.82 to 0.16) and Saffron (MD: -2.71, 95% CrI: -6.06 to 0.57) did not reduce HAMA scores significantly in the summary network, both were worthy of further study because of support from separate networks.
The protective effects of Kava (Piper Methysticum) constituents in cancers: A systematic review
Celentano A et al. • Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology (2019)
There was heterogeneity of study models and methods of investigation across the studies identified.
- There was heterogeneity of study models and methods of investigation across the studies identified.
- Components of kava appear to present an area of interest with chemotherapeutic potential in cancer prevention and treatment, particularly for epithelial neoplasms.
- To date, there is a paucity of literature of the utility of kava components in the prevention and treatment of oral squamous cell carcinoma.
Complementary and Alternative Medicine Treatments for Generalized Anxiety Disorder: Systematic Review and Meta-analysis of Randomized Controlled Trials
Barić H et al. • Advances in therapy (2018)
Evidence about efficacy/safety of most CAM methods in GAD is limited.
- Evidence about efficacy/safety of most CAM methods in GAD is limited.
- Apparent efficacy of certain herbal preparations and body-based therapies requires further confirmation.
- Further research warranted to confirm findings
Herbal medicines in the treatment of psychiatric disorders: 10-year updated review
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.
- 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.
Azapirones for generalized anxiety disorder
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.
- 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.
GABA-modulating phytomedicines for anxiety: A systematic review of preclinical and clinical evidence
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.
- 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.
Kava for Generalized Anxiety Disorder: A Review of Current Evidence
Ooi SL et al. • Journal of alternative and complementary medicine (New York, N.Y.) (2018)
Current evidence, although promising, is insufficient to confirm the effect of Kava for GAD treatment beyond placebo.
- Meta-analyses of the results of three placebo-controlled trials (n = 130) favored Kava for GAD treatment with effect sizes between 0.59 and 0.99 (standard mean difference) without reaching statistical significance.
- Current evidence, although promising, is insufficient to confirm the effect of Kava for GAD treatment beyond placebo.
- New evidence is expected from a large, multisite ongoing trial.
Is driving under the influence of kava associated with motor vehicle crashes? A systematic review of the epidemiological literature
Wainiqolo I et al. • Australian and New Zealand journal of public health (2015)
With equivocal evidence limited to experimental studies using simulated driving settings, the contribution of kava to MVCs is unknown.
- While no statistically significant adverse changes attributable to kava were found, there was weak evidence of slowed reaction time.
- With equivocal evidence limited to experimental studies using simulated driving settings, the contribution of kava to MVCs is unknown.
- Further research warranted to confirm findings
Neurocognitive effects of kava (Piper methysticum): a systematic review
LaPorte E et al. • Human psychopharmacology (2011)
The majority of evidence suggests that kava has no replicated significant negative effects on cognition.
- One acute study found that kava significantly improved visual attention and working memory processes while another found that kava increased body sway.
- The majority of evidence suggests that kava has no replicated significant negative effects on cognition.
- Further research warranted to confirm findings
Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review
Lakhan SE et al. • Nutrition journal (2010)
Based on the available evidence, it appears that nutritional and herbal supplementation is an effective method for treating anxiety and anxiety-related conditions without the risk of serious side effects.
- Of the randomized controlled trials reviewed, 71% (15 out of 21) showed a positive direction of evidence.
- Based on the available evidence, it appears that nutritional and herbal supplementation is an effective method for treating anxiety and anxiety-related conditions without the risk of serious side effects.
- There is the possibility that any positive effects seen could be due to a placebo effect, which may have a significant psychological impact on participants with mental disorders.
Kava extract for treating anxiety
Pittler MH, Ernst E • Cochrane Database of Systematic Reviews (2003)
Kava extract appears to be an effective symptomatic treatment for anxiety.
- Effective for anxiety symptoms
- Comparable to low-dose benzodiazepines
- More research needed on long-term safety
The effectiveness and safety of Kava Kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials
Smith K et al. • Complementary therapies in clinical practice (2018)
Kava Kava appears to be a short-term treatment for anxiety, but not a replacement for prolonged anti-anxiety use.
- A final risk ratio of 1.50 (95% CI: 1.12, 2.01) from responder rates was calculated in favor of the intervention from 5 clinical trials (n = 330).
- Kava Kava appears to be a short-term treatment for anxiety, but not a replacement for prolonged anti-anxiety use.
- Although not witnessed in this review, liver toxicity is especially possible if taken longer than 8 weeks.
Complementary medicines (herbal and nutritional products) in the treatment of Attention Deficit Hyperactivity Disorder (ADHD): a systematic review of the evidence
Sarris J et al. • Complementary therapies in medicine (2011)
The research suggests only some CAMs may be beneficial in ADHD, thus clinicians need to be aware of the current evidence.
- The research suggests only some CAMs may be beneficial in ADHD, thus clinicians need to be aware of the current evidence.
- Promising candidates for future research include Bacopa monniera (brahmi) and Piper methysticum (kava), providing potential efficacy in improving attentional and hyperkinetic disorders via a combination of cognitive enhancing and sedative effects.
- Further research warranted to confirm findings