KAVA
Traditional Pacific Islander root beverage with anxiolytic and sedative effects from kavalactones, used for centuries in ceremonial and social contexts.
Multiple randomized placebo-controlled trials support kava extract as superior to placebo for generalized anxiety disorder, with effect sizes of 0.59-0.99 in meta-analyses. Short-term use (4-8 weeks) at 120-280mg kavalactones daily is generally well tolerated with mild, transient adverse events. However, rare but serious hepatotoxicity has been reported, leading to regulatory restrictions in several countries; the mechanism remains unclear and may relate to non-kavalactone constituents or specific extract preparations. Evidence for anti-inflammatory and anticancer effects is preliminary and based largely on preclinical data. Long-term safety data are insufficient, and product standardization remains a significant challenge.