Kava
Piper methysticum
also known as Kava-kava, Awa, Ava
Moderate (anxiety) — but real safety concerns
A Pacific Island ceremonial root with strong anxiety-relief evidence — but liver injury risk has led to bans in several countries.
- Strong evidence for short-term anxiety relief
- Modulates GABA receptors without sedation in low doses
- Used ceremonially across the Pacific for centuries
- Comparable to anxiolytic drugs in some trials
Active in Kavalactones (kavain, methysticin, dihydrokavain).
Liver injury risk — banned in several countries
Avoid with any liver condition or hepatotoxic drugs
Avoid alcohol and acetaminophen with kava
Use caution with sedatives and Parkinson's medications
Avoid in pregnancy and nursing
Limit continuous use to 4 weeks
Use only roots (aqueous extracts) — not leaves or stems
Related literature · not reviewed for these claims
These papers were imported by topic. They may concern plants, laboratory work, or different preparations. Inclusion here does not establish a human health benefit or support the claims above. How to read our sources →
- Green analytical method development and validation for Flavokawain A using RP-HPLC in bulk and in-house tablet dosage forms.
- Increase in Poison Center Reports Linked to Kratom-Containing Kava Products - National Poison Data System, United States, 2000-2025.
- Kava-potentiated Withdrawal in Persons Using Multiple Substances: A Case Series of Kava and Kratom Co-ingestion.
- Signals of Diagnostic Product Ions of Kavalactones in Their ESI Mass Spectra-Implications for Isomer Differentiation and Identification of Kavalactone Conjugates.
- Kava consumption and the rise of sociopolitical complexity in Oceania.
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Common questions
This is the one where the honest answer is "with real caution." Kava has genuinely strong evidence for short-term anxiety relief, but it also carries a real risk of liver injury, serious enough that it's been banned in several countries. It should never be combined with alcohol, acetaminophen, or anything else hard on the liver.
NIH NCCIH
Guidance generally limits continuous use to 4 weeks. This isn't a supplement meant for indefinite daily use.
No. Avoid kava entirely with any liver condition or alongside any medication that's hard on the liver.
Only the root, prepared as an aqueous (water-based) extract, not the leaves or stems, which carry more risk without the same benefit profile.