OtherAnxiolyticBotanicalKavalactone

Kava (Kavalactones)

Also known as Kava kava · Piper methysticum · Awa · Yaqona

Written by enwyReviewed 5 Aug 20262 sources0 comments

Kava is a Pacific Island beverage and extract from Piper methysticum root, used traditionally and as a supplement for anxiety and relaxation. Its active kavalactones produce anxiolysis and muscle relaxation. Several trials support short-term anxiety relief, but concerns about rare severe hepatotoxicity have driven regulatory restrictions in some countries.

01 Overview

Kavalactones such as kavain, dihydrokavain and methysticin underlie kava's calming, mildly euphoric and muscle-relaxant effects. Meta-analyses of aqueous or ethanolic extracts show a modest reduction in anxiety versus placebo over a few weeks.

The principal safety issue is idiosyncratic liver injury, which led to bans or warnings in several European countries and Canada in the early 2000s; traditional water-based preparations of noble cultivars appear lower risk than some solvent extracts. It should not be combined with alcohol or hepatotoxic drugs.

02 Mechanism

Kavalactones enhance GABA-A receptor binding, block voltage-gated sodium and calcium channels, and weakly inhibit monoamine oxidase and noradrenaline reuptake, producing anxiolysis and muscle relaxation.

03 Dosing

Tier	Dose	Route	Notes
Anxiety (extract)	100–250 mg/day	Oral	Standardised to kavalactones; trials often used ~120-280 mg kavalactones/day.

04 Effects

Effect	Magnitude	Evidence
AnxiolysisShort-term reduction in anxiety symptoms in randomised trials and meta-analysis.	Modest vs placebo	Clinical
Muscle relaxation and calmTraditional and reported use for relaxation and sociability without heavy sedation.	Moderate	Observational

05 Side effects

Effect	Severity	Frequency	Evidence	Countermeasures
HepatotoxicityIdiosyncratic liver injury, occasionally severe, reported with some extracts.	Severe	Rare but serious	Observational
Dermopathy (kava dermopathy)Dry, scaly, yellow skin with heavy long-term consumption.	Mild	With heavy chronic use	Observational

06 Legal status

United States

Dietary supplement (with FDA advisory)

Legal but subject to an FDA consumer advisory on liver risk. · as of Jan 2026

Germany

Restricted / historically banned

Regulatory status has shifted; historically withdrawn over hepatotoxicity. · as of Jan 2026

07 References

Kava extract for treating anxietyCochrane Database of Systematic Reviews, 2003

Kava hepatotoxicity: a clinical reviewAnnals of Hepatology, 2010

08 Discussion0 comments

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This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.