Benefits of Kava for AnxiousnessJul 16, 2021
Henry Emmons, MD
Kava, also known as “kava kava,” is really known for two things:
- A ceremonial drink
- A treatment for anxiety
It comes from a shrub that is in the pepper family, and it was used by traditional societies in ceremonies or at social gatherings, likely due to its relaxant properties. In that way, it is similar to how alcohol is used in our society and some people still use large quantities of kava as an intoxicant.
When used in moderate amounts, many people find that kava relaxes them and takes the edge off of anxiety, without sedation or other signs of intoxication. And likely because it calms anxiety, many people also find it useful for sleep issues.
Kava and Anxiety
Fear and anxiety are likely as old as the human race, so it should be no surprise that our ancestors would have happened upon substances that freed them, at least temporarily, from the effects of fear. Kava is one of those substances, and it has been used over the ages in the Pacific islands, where it grew as a native plant.
More recently, it has been promoted as a safe and effective option for anxiety for those who wish to avoid medications. There are actually some potential risks, discussed below, and as with most things, the dose and the frequency of use make a huge difference in terms of safety. But there is little doubt as to its effectiveness against anxiety.
A double blind, placebo-controlled study (the gold standard for research on a treatment's effectiveness), showed kava to give a “significant reduction in anxiety” for the treatment group vs. the control group. The participants in this study were all carefully diagnosed to have generalized anxiety disorder (GAD), which can be a challenge to treat effectively with medications. It is believed that the active ingredient in kava, known as “kavalactones,” work through the GABA system. Most prescription anxiolytics also work on GABA (e.g. Ativan, Xanax, Valium), and are highly effective, but also highly addictive. That does not seem to be a problem with kava.
There is also evidence that kavalactones may have a neuroprotective effect that is separate from its GABA activity. If that is supported by further research, there could potentially be a role in protecting the brain cells in neurodegenerative diseases like Alzheimer’s disease or stokes.
Kava Dosage and Use
Kava can be taken as a tea, liquid, or extract. There are many “calming” herbal teas that include kava, but its effectiveness is dependent on the freshness of the tea, and it’s hard to find good quality, fresh kava tea.
Most people use kava as an extract standardized to 30% kavalactones. That’s what I recommend, so that you know just what you are getting. The typical dose range of kava is between 70 mg to 250 mg daily.
I generally prefer to use kava as part of a combination of herbs so that you get the synergistic effect of several different plant species, as well as soften any of the downsides by not relying on a single, high-dose herb like kava.
Kava Risks and Side Effects
There are known risks with kava, especially its potential effects on the liver. There were several incidents reported in the early 2000s of people developing liver toxicity while taking kava, prompting the FDA to evaluate and consider banning its use in the US. On further review, it appeared as if the problem occurred in people with known liver disease and/or those with excessive alcohol use, or with use of very high doses for long periods of time. The FDA chose to continue to let it be sold without prescription as a nutritional supplement. I do take those risks seriously, however, and recommend limiting kava to occasional, short-term use at moderate doses.
Kava may be somewhat sedating or, in high doses, even intoxicating. I think it is similar in that way to prescription sedatives: if you only take a modest dose while you’re anxious, it is likely to take the edge off the anxiety but not cause sedation. Still, one should be cautious about driving after use of kava, and be very careful not to combine with alcohol or other sedating medications.
It is not recommended during pregnancy, nursing or for children.
Kava Supplements at Natural Mental Health
Calm Days is a blend of several calming herbs, including kava, chamomile, hops, passionflower and valerian root. All are standardized extracts with the recommended amounts of the active ingredients. I usually recommend using it only as needed to calm the system, rather than using it as a regular, daily treatment. I find it quite effective, fast-acting and relatively side-effect-free, unless it causes mild sedation.
*Note: Some of the supplements discussed in this article can cause side effects, but many people tolerate them much better than prescription medications. They are generally considered safe, however, they should not be started without your doctor’s knowledge and supervision. If you are taking medication already, be sure to talk with your doctor before adding any of these items. If you are considering going off medication, remember never to stop your medication suddenly—always consult with your doctor about how to safely taper off any psychiatric medication. See terms.
**These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Ashwagandha for Anxiousness: An Herb for Our Times
In Ayurvedic medicine, Ashwagandha is thought to be one of the most valued remedies for a variety of conditions. It is one of my favorite herbs, and one of the few that I use personally as part of my daily regimen. It is known as an “adaptogen” or a “tonic” herb. That means that it isn’t considered to be a medicinal herb, per se, but is rather a general health tonic, one that is used to improve the body’s ability to adapt to stress.
- Sarris, J., Stough, C., Bousman, C. A., Wahid, Z. T., Murray, G., Teschke, R., Savage, K. M., Dowell, A., Ng, C., & Schweitzer, I. (2013). Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. Journal of clinical psychopharmacology, 33(5), 643–648. https://doi.org/10.1097/JCP.0b013e318291be67
Tzeng, Y. M., & Lee, M. J. (2015). Neuroprotective properties of kavalactones. Neural regeneration research, 10(6), 875–877. https://doi.org/10.4103/1673-5374.158335
Ulbricht, C., Basch, E., Boon, H., Ernst, E., Hammerness, P., Sollars, D., Tsourounis, C., Woods, J., & Bent, S. (2005). Safety review of kava (Piper methysticum) by the Natural Standard Research Collaboration. Expert opinion on drug safety, 4(4), 779–794. https://doi.org/10.1517/147403184.108.40.2069