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

May Be Effective

Not Enough Data to Assess

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Safety Notes

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:

  • Kava should not be taken 24 hours before surgery. It has a sedative effect.
  • People taking blood thinners should talk to their doctors before taking kava. It may increase the risk of bleeding.
  • People taking antidepressants, medicine to relax the muscles, pain pills, or anxiety medicine should talk to their doctor before taking kava. It may overwhelm the body’s central nervous system.
  • People with schizophrenia or other mental health problems should talk to their doctor before taking kava. It may interact with their medicines.


REFA Anxiety

REFA1 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.

REFA2 Lakhan SE, Vieira KF. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J. 2010;7(9):42.

REFA3 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.

REFA4 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.

REFA5 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.

REFA6 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.

REFA7 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.

REFB Attention Deficit Hyperactivity Disorder

REFB1 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.

REFC Insomnia

REFC1 Leach MJ, Page AT. Herbal medicine for insomnia: A systematic review and meta-analysis. Sleep Med Rev. 2015 Dec;24:1-12.

REFD Safety

REFD1 Teschke R. Kava hepatotoxicity--a clinical review. Ann Hepatol. 2010 Jul-Sep;9(3):251-265.

REFD2 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.

REFD3 Teschke R, Wolff A, et al. Herbal hepatotoxicity: a tabular compilation of reported cases. Liver Int. 2012 Nov;32(10):1543-1556.

REFD4 Bunchorntavakul C, Reddy KR. Review article: herbal and dietary supplement hepatotoxicity. Aliment Pharmacol Ther. 2013 Jan;37(1):3-17.

REFD5 Fasinu PS, Gurley BJ, et al. Clinically Relevant Pharmacokinetic Herb-drug Interactions in Antiretroviral Therapy. Curr Drug Metab. 2015;17(1):52-64.

REFD6 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.

REFD7 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.

Revision Information

  • Reviewer: EBSCO NAT Review Board Eric Hurwitz, DC
  • Review Date: 02/2020
  • Update Date: 05/27/2020