The Pros and Cons of Kava for Anxiety

Kava is a traditional intoxicant and ceremonial substance which has been used by South Pacific islanders for generations. In its traditional form, roots of the kava plant are ground and mixed with water to form a thick drink that when consumed, produces mild euphoria, improved well being and slight intoxication.

Beyond traditional uses, Kava extract or kava powder capsules can now be purchased legally as an herbal supplement in most countries. In addition to producing pleasurable effects, research demonstrates that kava is an effective treatment for anxiety, depression and insomnia.

Kava sounds like a perfect antidote to anxiety – a natural substance with a centuries long history of safe use that provides mild but effective anxiety relief without impairing cognitive abilities - and reflecting these positive qualities sales of the supplement reached $50 million in the US in 1998 alone.

Unfortunately, what seemed too good to be true perhaps was, and by 2002 the FDA had issued an advisory about possible liver damage associated with the use of the substance after kava use was linked to a number of deaths and cases of liver failure requiring transplant.¹

Research Backing Kava’s Effectiveness as a Treatment for Anxiety

A Cochrane Reviews literature review study on 12 clinical studies of Kava as a treatment for anxiety found that Kava was worked well as a treatment for anxiety and that people taking kava enjoyed significantly greater reductions in anxiety symptoms than people taking placebo.

No subjects in any of the studies experienced any significant adverse effects and any minor adverse side effects experienced were minor and short lasting.

The Cochrane study authors suggest that based on the evidence from the studies they reviewed, kava seems safe when used for between 1 and 24 weeks (short term treatment) but they suggest a need for further studies to clarify existing questions on safety and on the possible safety of longer term treatment.²

Safety Concerns

Reports from health authorities in the UK, Canada and in various European countries have linked the use of Kava to liver damage; with hepatic toxicity severe enough in some cases to require liver transplant, and in some cases proving fatal.

Based on this, the FDA has issued an advisory on the possible dangers of kava. The FDA says that kava is associated with a risk of liver damage and through hepatic effects are relatively rare, they warn that people with liver damage or people taking medications which can affect the liver need to be especially careful about using kava.³

In 2007, a World Health organization safety panel concluded that kava use had been associated with a number of deaths and cases of liver failure, but noted that in most cases damage occurred after the use of preparations which were based on the whole kava plant. Traditionally, South Pacific islanders would grind only the peeled root for use and some experts believe that by using other parts of the pant, and by extracting compounds with more than just cold water, health risks are amplified.

Unfortunately, since the FDA does not regulate or inspect kava as a herbal product there is no way to know for sure if products labeled as derived from the root only are adulterated with leaves and stems.

Should You Use Kava?

Kava works but it’s not without risks, and unfortunately, the experts don’t yet agree on whether those risks are worth taking.

Even those who would recommend its use, however, would always counsel you to talk with your doctor before using kava, to ensure that you do not use any medication or have a pre existing condition that would increase your risks of liver damage following kava use.⁴