Kava Kava for Anxiety Treatment: Effective Short-Term But Uncertain Long-Term

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Kava kava, an herbal supplement made from the root of Piper methysticum, has gained popularity as an alternative treatment for anxiety and insomnia.

A recent systematic review and meta-analysis re-examined kava kava’s effectiveness and safety for anxiety disorders.

The authors concluded that kava kava is effective for short-term anxiety relief but long-term safety remains uncertain.

Key Facts:

  • Kava kava was more effective than placebo for anxiety in 6 out of 8 randomized controlled trials examined.
  • Pooled response rates showed a 50% improvement in anxiety symptoms with kava kava versus placebo.
  • No difference in side effects was found between kava kava and placebo groups.
  • Hepatotoxicity from kava kava is a concern but was not observed in the reviewed studies under 8 weeks.
  • Kava kava may work better for mild anxiety and in younger, female patients.
  • Daily doses above 200 mg of kavalactones could potentially improve effects.

Source: Complement Ther Clin Pract.

Kava Kava & Anxiety Disorders

Anxiety disorders such as generalized anxiety disorder (GAD), social anxiety, panic disorder, and phobias affect over 19% of US adults each year.

These disorders cause excessive worry, tension, insomnia, fatigue, and impaired social/occupational functioning.

Many patients try herbal remedies like kava kava to manage symptoms and avoid side effects of prescription medications.

Kava kava contains kavalactones that act on GABA receptors and reduce brain activity.

Smaller studies show kava kava reduces anxiety at doses of 60-300 mg kavalactones daily.

But regulatory agencies have warned about potential liver damage from kava supplements.

This prompted an updated review of kava kava’s safety and effectiveness for anxiety.

Systematic Review: Kava for Anxiety (Methods)

The authors searched 3 scientific databases for randomized controlled trials published between 2000-2017 that compared kava kava to placebo or anti-anxiety medications for anxiety disorder treatment.

11 studies with a total of 660 participants met the pre-defined inclusion criteria:

  • Published in English
  • Peer-reviewed journals
  • Compared kava kava to placebo or anti-anxiety medication
  • Included only participants with diagnosed anxiety disorders
  • Assessed anxiety using standard scales like the Hamilton Anxiety Scale

Data from the studies were pooled and analyzed to determine kava kava’s efficacy and safety profile relative to comparators.

Subgroup and sensitivity analyses were also performed.

Limitations include the small number of eligible studies, variability in study methods, and short trial durations assessing long-term safety.

Nonetheless, the review followed rigorous systematic review and meta-analysis methodology to provide the highest level of evidence possible.

Kava Effective for Anxiety Treatment (Short-Term)

Compared to placebo, kava kava significantly improved anxiety symptoms in 3 of these studies.

A meta-analysis of 5 trials found kava kava had a 50% responder rate (50% improvement on anxiety scale) compared to 33% for placebo.

Kava kava reduced anxiety measures such as the Hamilton Anxiety Scale (HAMA) slightly more than placebo in most trials.

In 2 studies, kava kava had mixed results compared to anti-anxiety medications like oxazepam and buspirone.

But no major differences in effectiveness were found.

No Increase in Side Effects from Kava vs. Placebo

Overall adverse events were no different between kava kava and placebo groups.

The most common side effects were GI distress, headaches, and muscle aches.

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Liver toxicity is the main safety concern with kava kava.

But liver function tests showed no significant differences from baseline except in 2 studies.

The current evidence did not indicate liver issues from kava kava use under 8 weeks.

Better Results with Higher Doses in Younger, Female Patients

Additional analyses found kava kava’s anxiolytic effects increased at daily doses over 200 mg kavalactones.

Younger age and female gender also enhanced kava kava’s efficacy, consistent with previous research.

The duration of the double-blind trial phase did not impact results.

Kava Kava Appears Safe and Effective Short Term for Anxiety

This updated review indicates kava kava effectively reduces anxiety compared to placebo over 1-8 weeks treatment.

Side effects did not exceed placebo.

But the authors caution kava kava’s long-term safety is uncertain due to past liver toxicity cases.

They conclude kava kava is beneficial for short-term anxiety relief but not prolonged use.

More research on potential liver effects with extended treatment is needed.

Until then, they suggest limiting kava kava to 8 weeks or less.

Takeaways: Using Kava Kava for Anxiety Disorders

Kava kava may help relieve anxiety disorder symptoms but is not a cure.

It should complement other lifestyle, therapy, and medication treatments as needed.

Benefits appear most significant for milder anxiety. It may not be as effective for severe anxiety or panic attacks.

Doses above 200 mg kavalactones daily may produce better results. But follow product label directions.

Limit use to 8 weeks or less until more safety data is available. Stop immediately if any side effects develop.

Consult your doctor before using kava kava, especially if taking other medications or supplements.

Avoid kava kava entirely if you have liver disease.

Look for preparations labeled as using the root of Piper methysticum.

Avoid products containing stems or leaves which are more toxic.

Moving Forward: Establishing Kava Kava’s Role in Anxiety Treatment

Anxiety disorders are debilitating and conventional treatments are ineffective for many.

Many patients look to complementary medicine options like kava kava to avoid prescription medication side effects.

This updated review indicates kava kava is effective for short-term anxiety relief.

But key questions remain unresolved, notably the risk of liver damage with prolonged use.

Kava kava shows promise for anxiety management.

Further research will help establish if it can be used safely long term.

In the meantime, patients should view kava kava as a complementary therapy for anxiety rather than a stand-alone treatment or cure.

Work closely with your doctor to determine if kava kava is appropriate for your individual symptoms and health status.

Alert them to any side effects that develop with its use.

While kava kava appears relatively safe and effective for mild anxiety relief in the short term, more data is needed to recommend it as a routine long-term anxiety disorder treatment.

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