Kava

Also known as: kava kava, Piper methysticum, kavalactones

Grade A — Strong Evidenceherbanxiety
120–280 mg kavalactonesEvening or situational use. Cycle: 4 weeks on, 2 weeks off minimum.

Cochrane-validated anxiolytic: significant anxiety reduction comparable to benzodiazepines. Use noble cultivar water extracts to minimize liver risk.

🧘Stress & Anxiety🌙Sleep
Last reviewed: 2026-03-11

Evidence

Grade A

Studies

2

Interactions

4

Forms

1

Evidence Rating: Grade A — Strong Evidence

Multiple high-quality RCTs, systematic reviews, or meta-analyses with consistent findings.

Cycling Protocol

4 weeks on/2 weeks off

Hepatoprotective precaution; clinical trials limit exposure to 4-8 week courses

Interaction Warnings

AlcoholHigh Risk

AVOID — additive CNS depression and greatly increased hepatotoxicity

Benzodiazepines / sedativesHigh Risk

Additive sedation; risk of respiratory depression

Hepatotoxic drugs (acetaminophen, statins)High Risk

Additive liver stress; extreme caution

CYP enzymes (broad)Moderate

Inhibits CYP1A2, 2C9, 2C19, 2D6, 3A4; multiple drug interactions

⚠️ Important Notes

  • ⚠️ HEPATOTOXICITY RISK — use noble cultivar water extracts only
  • CONTRAINDICATED with alcohol and liver disease
  • Do not drive after use
  • Banned/restricted in some countries

Clinical Evidence (2 studies)

Meta-analysis of kava RCTs for anxiety

Pittler MH, Ernst E (2003) — J Clin Psychopharmacol

Significant vs placebo for anxiety; HAM-A reduction in 7 RCTs

View on PubMed

Noble kava water extract for GAD

Sarris J et al. (2013) — J Clin Psychopharmacol

Significant anxiolytic effect; hepatically safe in controlled RCT

View on PubMed

Alternatives to Consider

These supplements target similar goals and may be worth considering alongside or instead of Kava.

Ashwagandha

Grade A

Ayurvedic adaptogen with strong clinical evidence for cortisol reduction (15-30%), stress relief, and exercise performance.

🧘 Stress & Anxiety🌙 Sleep

Valerian Root

Grade B

Traditional sleep herb with moderate RCT support. Comparable to low-dose benzodiazepines. Not acutely sedating — builds over weeks.

🌙 Sleep🧘 Stress & Anxiety

Passionflower

Grade B

Gentle anxiolytic herb comparable to low-dose oxazepam. Effective for pre-surgical anxiety and sleep without next-day impairment.

🌙 Sleep🧘 Stress & Anxiety

Related Supplements

Passionflower

Grade B — Moderate Evidence

Gentle anxiolytic herb comparable to low-dose oxazepam. Effective for pre-surgical anxiety and sleep without next-day impairment.

Lemon Balm

Grade B — Moderate Evidence

Gentle anxiolytic herb that provides calmness without sedation. Pairs well with valerian for sleep. Watch thyroid interactions.

Ashwagandha

Grade A — Strong Evidence

Ayurvedic adaptogen with strong clinical evidence for cortisol reduction (15-30%), stress relief, and exercise performance.

Valerian Root

Grade B — Moderate Evidence

Traditional sleep herb with moderate RCT support. Comparable to low-dose benzodiazepines. Not acutely sedating — builds over weeks.

🧪 Get Your Personalized Stack

See how Kava fits with your goals and current supplements — AI-powered, evidence-graded recommendations.

⚕️ Important Disclaimer

This information is for educational purposes only. It is not medical advice. Always consult a healthcare provider before starting any supplement regimen, especially if you take medications or have health conditions.

DoseGrade does not sell supplements and has no affiliate relationships with supplement manufacturers.