KAVA KAVA

Multiple placebo-controlled trials and a Cochrane meta-analysis suggest kava extract is superior to placebo for generalized anxiety disorder, with effect sizes of 0.59-0.99. Short-term use (4-8 weeks) at 120-280 mg/day kavalactones appears well tolerated with mild, transient adverse events. However, evidence is insufficient to confirm efficacy beyond placebo, and one negative trial exists. Rare but severe hepatotoxicity cases led to bans in several countries, though causative mechanisms remain unclear and may relate to non-root plant parts or poor extraction methods. A 2024 case report documented kava withdrawal syndrome requiring phenobarbital treatment in a heavy user, suggesting dependence potential with excessive consumption. Product standardization remains a major challenge.