Kava is a plant in the pepper family. The roots and stems are made into a traditional drink from the Pacific Islands known as Kava. It has been used to ease feelings of anxiety and depression. Kava can be taken as a pill, powder, or extract. It can also be made into tea.
120 to 240 milligrams once daily
What Research Shows
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It may not be safe to take kava for a short or long period of time. Drying and yellowing of the skin and liver failure may happen. Kava should not be used during pregnancy or breastfeeding.D1-D7
Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:
A1. Sarris J, Kavanagh DJ, et al. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum. Psychopharmacology (Berl). 2009;205(3):399-407.
A2. Lakhan SE, Vieira KF. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J. 2010;7(9):42.
A3. Sarris J, Scholey A, et al. The acute effects of kava and oxazepam on anxiety, mood, neurocognition; and genetic correlates: a randomized, placebo-controlled, double-blind study. Hum Psychopharmacol. 2012 May;27(3):262-269.
A4. Sarris J, Stough C, et al. Kava for the treatment of generalized anxiety disorder RCT: analysis of adverse reactions, liver function, addiction, and sexual effects. Phytother Res. 2013;27(11):1723-1728.
A5. Sarris J, Stough C, et al. Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. J Clin Psychopharmacol. 2013;33(5):643-648.
A6. Ooi SL, Henderson P, Pak SC. Kava for Generalized Anxiety Disorder: A Review of Current Evidence. J Altern Complement Med. 2018 Aug;24(8):770-780.
A7. Smith K, Leiras C. The effectiveness and safety of Kava Kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials. Complement Ther Clin Pract. 2018 Nov;33:107-117.
B. Attention Deficit Hyperactivity Disorder
B1. Sarris J, Kean J, et al. Complementary medicines (herbal and nutritional products) in the treatment of Attention Deficit Hyperactivity Disorder (ADHD): a systematic review of the evidence. Complement Ther Med. 2011 Aug;19(4):216-227.
C1. Leach MJ, Page AT. Herbal medicine for insomnia: A systematic review and meta-analysis. Sleep Med Rev. 2015 Dec;24:1-12.
D1. Teschke R. Kava hepatotoxicity--a clinical review. Ann Hepatol. 2010 Jul-Sep;9(3):251-265.
D2. Sarris J, LaPorte E, et al. Kava: a comprehensive review of efficacy, safety, and psychopharmacology. Aust N Z J Psychiatry. 2011;45(1): 27-35.
D3. Teschke R, Wolff A, et al. Herbal hepatotoxicity: a tabular compilation of reported cases. Liver Int. 2012 Nov;32(10):1543-1556.
D4. Bunchorntavakul C, Reddy KR. Review article: herbal and dietary supplement hepatotoxicity. Aliment Pharmacol Ther. 2013 Jan;37(1):3-17.
D5. Fasinu PS, Gurley BJ, et al. Clinically Relevant Pharmacokinetic Herb-drug Interactions in Antiretroviral Therapy. Curr Drug Metab. 2015;17(1):52-64.
D6. Stickel F, Shouval D. Hepatotoxicity of herbal and dietary supplements: an update. Arch Toxicol. 2015 Jun;89(6):851-65. doi: 10.1007/s00204-015-1471-1473.
D7. Brown AC. Liver toxicity related to herbs and dietary supplements: Online table of case reports. Part 2 of 5 series. Food Chem Toxicol. 2017 Sep;107(Pt A):472-501.
Last reviewed February 2020 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated: 5/27/2020
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