Kava

Also known as: kava kava, Piper methysticum, kavalactones

Grade A — Strong Evidenceherbanxiety

Recommended Dosage

120280 mg kavalactones

Evening or situational use. Cycle: 4 weeks on, 2 weeks off minimum.

Cochrane-validated anxiolytic: significant anxiety reduction comparable to benzodiazepines. Use noble cultivar water extracts to minimize liver risk.

Last reviewed: 2026-03-09

Evidence Rating: Grade A — Strong Evidence

Multiple high-quality RCTs, systematic reviews, or meta-analyses with consistent findings.

Interaction Warnings

AlcoholHigh Risk

AVOID — additive CNS depression and greatly increased hepatotoxicity

Benzodiazepines / sedativesHigh Risk

Additive sedation; risk of respiratory depression

Hepatotoxic drugs (acetaminophen, statins)High Risk

Additive liver stress; extreme caution

CYP enzymes (broad)Moderate

Inhibits CYP1A2, 2C9, 2C19, 2D6, 3A4; multiple drug interactions

⚠️ Important Notes

  • ⚠️ HEPATOTOXICITY RISK — use noble cultivar water extracts only
  • CONTRAINDICATED with alcohol and liver disease
  • Do not drive after use
  • Banned/restricted in some countries

Clinical Evidence (2 studies)

Meta-analysis of kava RCTs for anxiety

Pittler MH, Ernst E (2003) — J Clin Psychopharmacol

Significant vs placebo for anxiety; HAM-A reduction in 7 RCTs

View on PubMed

Noble kava water extract for GAD

Sarris J et al. (2013) — J Clin Psychopharmacol

Significant anxiolytic effect; hepatically safe in controlled RCT

View on PubMed

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