In traditional Polynesian cultures Kava is used for ceremonial purposes and as an inebriant. In contrast to prescription sedative-hypnotic medications (e.g. lorazepam and diazepam), when Kava is taken at recommended doses (typically between 60 and 300mg/day) patients do not experience mental slowing or impaired cognitive functioning. Kava as a treatment of anxiety has been extensively reviewed in the biomedical and alternative medical literature. Kava interferes with norepinephrine reuptake and binds with both GABA and NMDA receptors in the brain reducing the severity of anxiety. A systematic review of 11 controlled double-blind studies concluded that Kava was superior to placebo for the short-term management of generalized anxiety. Kava preparations standardized to 70% kava lactones at doses between 70mg to 240mg/day effectively reduce symptoms of “stress” and moderate generalized anxiety, but are probably not effective against severe anxiety.
Kava compares favorably to benzodiazepines and other conventional anti-anxiety medications. The findings of a small double-blind controlled study suggest that persons who have generalized anxiety adequately manage their symptoms by gradually increasing their daily dose of kava (up to 300mg/day) while slowly tapering off of a sedative-hypnotic medication such as lorazepam or diazepam, without experiencing worsening anxiety or withdrawal from their prescription medication. A randomized placebo-controlled multi-center study enrolling 129 outpatients concluded that a standardized Kava preparation (LI 150) was as effective as two commonly prescribed anti-anxiety agents (Buspirone™ and Opipramol™) in the treatment of generalized anxiety. Three fourths of patients in both the Kava group and the conventional treatment group were classified as “treatment responders,” and experienced 50% or greater reductions in standardized measures of anxiety.
Kava is generally well tolerated. Uncommon adverse effects include gastrointestinal upset, rash, headaches and dizziness. Individuals who take Kava on an on-going basis should limit their alcohol intake and use conventional sedative-hypnotics medications only under supervision from a physician.
You can find out more about Kava and other safe and effective complementary and alternative treatments of anxiety and learn practical tips for using them in “Anxiety: the Integrative Mental Health Solution,” by James Lake M.D.