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Kava (Piper methysticum)

Synonyms/Common Names/Related Substances:

  • 11-Methoxy-5,5-hydroxydihydrokawain, 6-dihydroyangonin, alkaloids, antares, ava, ava pepper, ava pepper shrub, ava root, awa, bornyl cinnamate, Cavain, chalcone methylesters, desmethoxyyangonin, dihydrokavain, dihydrokawain (DHK), dihydromethysticin (DMH), (+)-dihydrokawain-5-ol, Fijian kava, flavokavine A, flavokavine B, flavonoids, gea, gi, grog, intoxicating long pepper, intoxicating pepper, kao, kava kava extract LI 140, kava kava rhizome, kava root, kavain, kavakava, kavalactones, kavapiper, kavapyrones, kavarod, kavasporal forte, kave-kave, kawa, kawa kawa, kawa pepper, Kawa Pfeffer, kawain, kew, lactones, LI150, long pepper, Macropiper latifolium, malohu, maluk, maori kava, meruk, methysticin, milik, pepe kava, Piper methysticum, Piper methysticum G.Forst, Piperis methystici rhizoma, pipermethystine, pyrones, Rauschpfeffer, rhizoma Piperis methystici, Rhizome Di Kava-Kava sakaua, sakau, tonga, WS 1490, wurzelstock, yagona, yangona, yangonin, yaqona, yongona.

Clinical Bottom Line/Effectiveness

Brief Background

  • Kava beverages, made from dried roots of the shrub Piper methysticum, have been used ceremonially and socially in the South Pacific for hundreds of years and in Europe since the 1700s. The drink is reported to have pleasant, mild psychoactive effects (1), similar to alcoholic beverages. Recreational use of kava has spread over the last 20 years to Aboriginal communities in Australia (2), where it is often consumed in combination with alcohol (3). In Fiji, kava is still used today during welcome ceremonies for local and international political and religious dignitaries. In 2002, local annual sales in Fiji were reported in the range of $30 million, with exports amounting to $17 million. Kava generated almost 100 million euros in 2001 (IKC Report).
  • Several well-conducted human trials and meta-analysis (4;5;6;7) have shown that kava can effectively treat anxiety, with effects observed after as few as 1-2 doses, and progressive improvements over 1-4 weeks. Preliminary evidence suggests that kava's effectiveness may be equivalent to benzodiazepines (8). The pharmaceutical preparations of kava were widely used in Europe and the United States as anxiolytics, but they have since been withdrawn in several European markets and Canada due to safety concerns (9;10;11;12;13;14;15).
  • There is promising preliminary evidence for the use of kava for cognition (16), depression (17;18), and hot flashes (19). Further studies are needed to make firm conclusions.
  • Although kava has been studied as a possible treatment for insomnia, many experts believe that kava is neither sedating nor tolerance-forming in recommended doses (20). Some trials have reported occasional mild sedation, although preliminary data from small studies suggest a lack of neurological-psychological impairment (21;22;23). Chronic or heavy use of kava has been associated with cases of neurotoxicity, pulmonary hypertension, and dermatologic changes (24). However, most human trials have been shorter than two months, with the longest study being six months in duration (25).
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Dosing/Toxicology

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Precautions/Contraindications

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Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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Mechanism of Action

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History

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Evidence Table

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Evidence Discussion

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Products Studied

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.