Approximately 40 million American adults suffer from some form of anxiety disorder, according to the Anxiety and Depression Association of America. These disorders include generalized anxiety, panic disorders, social anxiety, specific phobias, obsessive-compulsive disorders and post-traumatic stress. At these rates, anxiety disorders are the most common mental health issues in the United States. Many people with anxiety disorders have other conditions as well, such as depression, Attention Deficit Hyperactivity Disorder (ADHD) and eating disorders.1

While conventional therapies and benzodiazepine medications such as Alprazolam (Xanax) or Clonazepam (Klonopin) are most often recommended for anxiety and related disorders, there is growing interest in complementary and alternative approaches to mental health care. Many people are increasingly searching for natural remedies for anxiety.

Among those that show promise for treating mild to moderate and generalized anxiety is the botanical supplement known as kava or kava-kava.

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What is Kava?

Kava originates from the root of a plant indigenous to South Pacific areas of the world, where it is used to make a popular beverage drunk socially and ritualistically during religious ceremonies. Researchers have tooled out a number of active ingredients found in kava, including kavalactones, kavapyrones, kawains, flavokawains, and others. These compounds are continuously being studied for their safety and effectiveness in treating a variety of mental and physical health conditions.

What is an Appropriate Dose?

But how do you know what an appropriate dose is when it comes to using kava for anxiety? While numerous science-based studies have proven kava’s effectiveness at reducing symptoms of anxiety and related conditions, they all used different doses of different formulas and preparations, expressed in different ways. For instance, after three weeks, at a dose of 250 mg kavalactones a day, given as five supplemental tablets daily for three weeks, kava significantly improved anxiety and depression in 60 adult study participants who had experienced generalized anxiety or anxiety accompanied by symptoms depression for at least one month.

But other studies have reported significant improvement of anxiety symptoms from 50 mg a day of dry extract standardized to 35 mg kavalactones, 90-110 mg dry kava extract standardized to 70 mg kavalactones, 150 mg a day special kava extract standardized to 35 mg kavalactones, 280 mg a day standardized to 30% kavalactones, and 400 mg a day standardized to 30% kavapyrones.2,3  While there is no official recommendation for kava dosage, the American Botanical Council advises 60 to 120 mg of kavapyrones (or kavalactones) as a safe and potentially effective range for no longer than three months, unless otherwise prescribed and taken under medical supervision.4

Forms of Kava

Various forms and strengths of kava are sold on the internet and in health food stores, including loose powders and tea bags used to make warm drinks, liquid extract added to water and other cool beverages, and capsules that are taken as dietary supplements. If you find yourself in New York’s East Village, you can visit the city’s first kava bar, where bartenders serve up bowls of kava garnished with a slice of pineapple. Since there are no official dose recommendations for using kava for anxiety, and different brands, forms, and batches contain different amounts of active ingredients, the product you select may or may not be effective for your purposes.

Before taking any over-the-counter kava preparations, speak with your primary or mental health care provider. Generally, kava is considered safe for short-term use but there are concerns about its long-term use and effectiveness. Kava has sedative qualities and may impair motor skills at high doses, especially in combination with other sedating drugs.

Potential Concerns

“Our concern about using kava supplements is related to the ways they may interact in medicated and/or highly sensitive patients,” says health psychologist David Bresler, Ph.D., LAc, founder of The Bresler Center in Los Angeles. “Individual differences in sensitivity can be huge, and while one patient may be completely unaffected by 40 mg of an anti-anxiety medication, another will drop quickly into sleep by taking just 0.25 mg of the same medication.”

As Dr. Bresler is keen to point out, much more research is necessary before the benefits and potential dangers of kava are completely understood. If you would like to try kava, a health professional who is knowledgeable about alternative and complementary medicines can give you advice and help you choose a product and dose that’s right for you. Recommended doses should be based on the type of kava taken, as well as individual factors such as age, weight, clinical diagnosis, and other drugs or supplements taken.

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Last Updated: Dec 4, 2019