Table of ContentsView AllTable of ContentsHow Do People Use Kava?Kava Health BenefitsSide Effects of KavaPrecautions and ContraindicationsDrug InteractionsDosage and PreparationWhat to Look ForOther Questions About Kava

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Table of Contents

How Do People Use Kava?

Kava Health Benefits

Side Effects of Kava

Precautions and Contraindications

Drug Interactions

Dosage and Preparation

What to Look For

Other Questions About Kava

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Kava (Piper methysticum) is a tall shrub in the pepper family native to the Pacific islands, where it’s traditionally used in ceremonies for relaxation. Here’s what to know about kava.

Traditionally, people use kava root to make beverages that cause mild to moderate sedation and feelings of euphoria. In some traditional cultures, people drink kava like those in other parts of the world drink coffee.

Now that kava has become more widely known, many people buy kava supplements for the plant’s purported ability to reduceanxiety.

Verywell / Brianna Gilmartin

side effects of kava kava

Kava Is Also Known AsKava kavaKawa kawa’Ava (Samoa)‘Awa (Hawaii)Malak (Vanuatu)Rauschpfeffer (Germany)Sakao (Pohnpei)Yaqano (Fiji)

Kava Is Also Known As

Kava kavaKawa kawa’Ava (Samoa)‘Awa (Hawaii)Malak (Vanuatu)Rauschpfeffer (Germany)Sakao (Pohnpei)Yaqano (Fiji)

Alternative medicine practitioners use kava as a natural anxiolytic (anxiety-reducing) drug. It may also improve sleep in people with insomnia, often with fewer side effects than pharmaceutical or over-the-counter sleep aids.

The compounds in kava root believed to offer mood-altering properties are called kavalactones,of which 18 have been identified thus far. Little research has been done to pinpoint their exactmechanisms of actionor evaluate which compounds are more active than others.

Anxiety

The current body of evidence suggests that kava may aid in the treatment of anxiety.

Insomnia

Most of the research devoted to the use of kava for insomnia is limited to animal studies. It is believed that a specific type of kavalactone, called kevain, may provide the drug’s sedative effect.

Of the available human research, one small study from Germany concluded that people provided a daily 200-milligram kava extract experienced significant relief from insomnia after 14 days.

Inflammation

Kava also has anti-inflammatory properties,which might help with conditions in which inflammation plays a role. Some research suggests that modifying kava compounds might increase these anti-inflammatory effects. However, more research is needed, and some reports suggest that kava exposure caninducean inflammatory response.

Cancer

A 2019 review of 39 studies revealed promising results in preventing and treating some cancers.Many other studies showed that kava had possible preventative effects on lung,prostate, colon, and urothelial cells as well.However, researchers caution that more research is needed to understand kava’s mechanism of action and its effects in humans.

The use of kava remains controversial. Proponents believe that kava is safe for the short-term treatment of anxiety; others contend that the potential risks outweigh the benefits.

Even for short-term use, side effects such as indigestion, mouth numbness, rash, headache, drowsiness, and visual disturbances are common.The consequences of long-term use may, in some cases, be catastrophic.

Liver Damage

In March 2002, the U.S. Food and Drug Administration (FDA) warned consumers and health professionals about the risk of liver damage associated with kava use.Case reports have linked kava with liver toxicity, including hepatitis, cirrhosis, liver failure, and even death.

Many of these cases were linked to pre-existing liver disease, excessive kava doses, and heavy alcohol use. It is still unclear whether the liver toxicity was the result of kavalactones, contaminants found in low-quality extracts, or the organic solvents (such as acetone or ethanol) used to make kava extracts and supplements.

Even though the WHO suggests that water-based kava beverages are “safer,” the agency concedes that moderate to heavy consumption can significantly raise liver enzymes. The WHO also warned that toxicity appears linked to the quality of the raw kava root, contamination of the root during storage, and the use of otherherbal drugswith kava.

In the aftermath of the warning, several countries have restricted the sale of kava within their borders. To date, only Germany, Canada, Poland, and Switzerland have banned the use of kava in any form. In the United States, kava is classified as a dietary supplement and can be purchased for personal use legally.

Call your doctor if you experience signs of liver toxicity, including persistent fatigue, weakness, nausea, vomiting, loss of appetite, dark urine, clay-colored stools, or the yellowing of the skin or eyes (jaundice).

Although kava in its traditional form poses an “acceptably low level of health risk” according to the World Health Organization (WHO), kava extracts and supplements may cause liver toxicity if overused or consumed on an ongoing basis.

If you intend to use kava for recreational or medicinal purpose, there are several things you should consider beforehand:

Due to the lack of safety research, kava should never be used in children, pregnant women, or nursing mothers. Some studies have suggested that kava can be readily transmitted in breastmilk.

Speak with your doctor if you are using (or intend to use) kava with any of the following medications:

There are no guidelines for the appropriate use of kava. Kava is generally sold in the United States in capsule, soft gel caps, extract, powder, and tea forms. There are also “wild-crafted” dried roots used to make tinctures, teas, and beverages.

Kava means “bitter” in the Tongan language.

Most capsule formulations are offered in doses ranging from 50 milligrams to 100 milligrams. Most experts recommend that you take no more than 250 milligrams per day and limit your use to no more than three months.

Liver damage appears to be more likely in people who consume kava for more than eight weeks than in those who use it for a shorter time.

Kava is largely unregulated in the United States, but don’t assume kava is safe. The classification simply means that the manufacturer is responsible for ensuring the safety of the supplement, not the FDA. Although this relieves the manufacturer of the burden of clinical research, it can leave the consumer vulnerable to harm, both known and unknown.

Because the quality and safety of kava can vary from one brand to the next, stick with manufacturers you know and trust. Buy products that are certified organic under the regulations of the U.S. Department of Agriculture (USDA). This is especially true of wild-crafted dried kava.

Given its rise in popularity and usage beyond the South Pacific, here are a few things you might wonder about kava.

How do I make kava tea or beverage?

Traditionally, kava drinks in the South Pacific are made from fresh root that is chewed or pulverized before water is strained through the fibrous pulp.

Although fresh kava root is rarely available in the United States, you can make it make it with dried kava. You’ll need cheesecloth, a tea strainer, and some wild-crafted kava chips or powder (available online or in specialty stores).

To make a 6- to 8-ounce glass of traditional kava drink:

Does kava produce a high?

Taken in normal doses, kava may help induce a sense of well-being and reduce anxiety. It does not necessarily produce a “high,” but some people may experience pleasant feelings or a sense of calm and relaxation. Higher doses may produce more significant effects but should be avoided due to the serious risk of liver damage.

What does kava do to the brain?

Although kava’s neurological effects are well-recognized, their exact mechanisms remain poorly understood. In the brain, kava modulates gamma-aminobutyric acid (GABA) receptors and inhibits monoamine oxidase B. Specific kava compounds may also affectdopaminelevels, hippocampal neurons, and acetylcholinesterase,

Some research has shown that kava may have neuroprotective effects.

17 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.A guide to herbal remedies.World Health Organization. Food and Agriculture Organization of the United Nations.Kava: A review of the safety of traditional and recreational beverage consumption: Technical Report.Burton N, Sneed K, Pathak Y.Systemic Review of the Use of Kava Kava for the Reduction of Anxiety Disorder.Medicon Medical Sciences. 2023;5(2):37-46.Sarris J, LaPorte E, Schweitzer I.Kava: A Comprehensive Review of Efficacy, Safety, and Psychopharmacology.Aus N Z J Psychiatry.2011;4(1):27-35. doi:10.3109/00048674.2010.522554.Sarris J, Stough C, Bousman CA, Wahid ZT, Murray G, Teschke R, Savage KM, Dowell A, Ng C, Schweitzer I.Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study.J Clin Psychopharmacol. 2013;33(5):643-8. doi:10.1097/JCP.0b013e318291be67Burton N, Sneed KB, Pathak Y.Systemic Review of the Use of Kava Kava for the Reduction of Anxiety Disorder.Medicon Medical Sciences. 2023;5(2):37-46.Lehrl S.Clinical efficacy of kava extract WS 1490 in sleep disturbances associated with anxiety disorders. Results of a multicenter, randomized, placebo-controlled, double-blind clinical trial.J Affect Disord. 2004;78(2):101-110. doi:10.1016/s0165-0327(02)00238-0Huck O, Han X, Mulhall H, Gumenchuk I, Cai B, Panek J, Iyer R, Amar S.Identification of a kavain analog with efficient anti-inflammatory effects.Sci Rep. 2019;9(1):12940. doi:10.1038/s41598-019-49383-8Shimoda LM, Park C, Stokes AJ, Gomes HH, Turner H.Pacific island ‘Awa (Kava) extracts, but not isolated kavalactones, promote proinflammatory responses in model mast cells.Phytother Res. 2012;26(12):1934-41. doi:10.1002/ptr.4652Celentano A, Tran A, Testa C, et al.The protective effects of Kava (Piper methysticum) constituents in cancers: A systematic review.J Oral Pathology Medicine. 2019;48(7):510-529. doi:10.1111/jop.12900Narayanapillai SC, Lin SH, Leitzman P, Upadhyaya P, Baglole CJ, Xing C.Dihydromethysticin (DHM) blocks tobacco carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-induced O6-methylguanine in a manner independent of the aryl hydrocarbon receptor (AhR) pathway in C57BL/6 female mice.Chem Res Toxicol. 2016;29(11):1828-1834. doi:10.1021/acs.chemrestox.6b00203.Bian T, Corral P, Wang Y, Botello J, Kingston R, Daniels T, Salloum RG, Johnston E, Huo Z, Lu J, Liu AC, Xing C.Kava as a clinical nutrient: Promises and challenges.Nutrients. 2020;12(10):3044. doi:10.3390/nu12103044National Center for Complementary and Integrative Health.Kava.Shinde P, Patil P, Bairagi V.Herbs in pregnancy and lactation: A review appraisal.Int J Pharm Sci Res. 2012;3(9):3001-3006. doi:10.13040/IJPSR.0975-8232.3(9).3001-06Cleveland Clinic.Kava Kava, Piper mesthystricum oral dosage forms.Smith K, Leiras C.The effectiveness and safety of kava kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials.Complementary Therapies in Clinical Practice. 2018;33:107-117. doi:10.1016/j.ctcp.2018.09.003Tzeng YM, Lee MJ.Neuroprotective properties of kavalactones.Neural Regen Res. 2015;10(6):875-7. doi:10.4103/1673-5374.158335

17 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.A guide to herbal remedies.World Health Organization. Food and Agriculture Organization of the United Nations.Kava: A review of the safety of traditional and recreational beverage consumption: Technical Report.Burton N, Sneed K, Pathak Y.Systemic Review of the Use of Kava Kava for the Reduction of Anxiety Disorder.Medicon Medical Sciences. 2023;5(2):37-46.Sarris J, LaPorte E, Schweitzer I.Kava: A Comprehensive Review of Efficacy, Safety, and Psychopharmacology.Aus N Z J Psychiatry.2011;4(1):27-35. doi:10.3109/00048674.2010.522554.Sarris J, Stough C, Bousman CA, Wahid ZT, Murray G, Teschke R, Savage KM, Dowell A, Ng C, Schweitzer I.Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study.J Clin Psychopharmacol. 2013;33(5):643-8. doi:10.1097/JCP.0b013e318291be67Burton N, Sneed KB, Pathak Y.Systemic Review of the Use of Kava Kava for the Reduction of Anxiety Disorder.Medicon Medical Sciences. 2023;5(2):37-46.Lehrl S.Clinical efficacy of kava extract WS 1490 in sleep disturbances associated with anxiety disorders. Results of a multicenter, randomized, placebo-controlled, double-blind clinical trial.J Affect Disord. 2004;78(2):101-110. doi:10.1016/s0165-0327(02)00238-0Huck O, Han X, Mulhall H, Gumenchuk I, Cai B, Panek J, Iyer R, Amar S.Identification of a kavain analog with efficient anti-inflammatory effects.Sci Rep. 2019;9(1):12940. doi:10.1038/s41598-019-49383-8Shimoda LM, Park C, Stokes AJ, Gomes HH, Turner H.Pacific island ‘Awa (Kava) extracts, but not isolated kavalactones, promote proinflammatory responses in model mast cells.Phytother Res. 2012;26(12):1934-41. doi:10.1002/ptr.4652Celentano A, Tran A, Testa C, et al.The protective effects of Kava (Piper methysticum) constituents in cancers: A systematic review.J Oral Pathology Medicine. 2019;48(7):510-529. doi:10.1111/jop.12900Narayanapillai SC, Lin SH, Leitzman P, Upadhyaya P, Baglole CJ, Xing C.Dihydromethysticin (DHM) blocks tobacco carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-induced O6-methylguanine in a manner independent of the aryl hydrocarbon receptor (AhR) pathway in C57BL/6 female mice.Chem Res Toxicol. 2016;29(11):1828-1834. doi:10.1021/acs.chemrestox.6b00203.Bian T, Corral P, Wang Y, Botello J, Kingston R, Daniels T, Salloum RG, Johnston E, Huo Z, Lu J, Liu AC, Xing C.Kava as a clinical nutrient: Promises and challenges.Nutrients. 2020;12(10):3044. doi:10.3390/nu12103044National Center for Complementary and Integrative Health.Kava.Shinde P, Patil P, Bairagi V.Herbs in pregnancy and lactation: A review appraisal.Int J Pharm Sci Res. 2012;3(9):3001-3006. doi:10.13040/IJPSR.0975-8232.3(9).3001-06Cleveland Clinic.Kava Kava, Piper mesthystricum oral dosage forms.Smith K, Leiras C.The effectiveness and safety of kava kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials.Complementary Therapies in Clinical Practice. 2018;33:107-117. doi:10.1016/j.ctcp.2018.09.003Tzeng YM, Lee MJ.Neuroprotective properties of kavalactones.Neural Regen Res. 2015;10(6):875-7. doi:10.4103/1673-5374.158335

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

MedlinePlus.A guide to herbal remedies.World Health Organization. Food and Agriculture Organization of the United Nations.Kava: A review of the safety of traditional and recreational beverage consumption: Technical Report.Burton N, Sneed K, Pathak Y.Systemic Review of the Use of Kava Kava for the Reduction of Anxiety Disorder.Medicon Medical Sciences. 2023;5(2):37-46.Sarris J, LaPorte E, Schweitzer I.Kava: A Comprehensive Review of Efficacy, Safety, and Psychopharmacology.Aus N Z J Psychiatry.2011;4(1):27-35. doi:10.3109/00048674.2010.522554.Sarris J, Stough C, Bousman CA, Wahid ZT, Murray G, Teschke R, Savage KM, Dowell A, Ng C, Schweitzer I.Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study.J Clin Psychopharmacol. 2013;33(5):643-8. doi:10.1097/JCP.0b013e318291be67Burton N, Sneed KB, Pathak Y.Systemic Review of the Use of Kava Kava for the Reduction of Anxiety Disorder.Medicon Medical Sciences. 2023;5(2):37-46.Lehrl S.Clinical efficacy of kava extract WS 1490 in sleep disturbances associated with anxiety disorders. Results of a multicenter, randomized, placebo-controlled, double-blind clinical trial.J Affect Disord. 2004;78(2):101-110. doi:10.1016/s0165-0327(02)00238-0Huck O, Han X, Mulhall H, Gumenchuk I, Cai B, Panek J, Iyer R, Amar S.Identification of a kavain analog with efficient anti-inflammatory effects.Sci Rep. 2019;9(1):12940. doi:10.1038/s41598-019-49383-8Shimoda LM, Park C, Stokes AJ, Gomes HH, Turner H.Pacific island ‘Awa (Kava) extracts, but not isolated kavalactones, promote proinflammatory responses in model mast cells.Phytother Res. 2012;26(12):1934-41. doi:10.1002/ptr.4652Celentano A, Tran A, Testa C, et al.The protective effects of Kava (Piper methysticum) constituents in cancers: A systematic review.J Oral Pathology Medicine. 2019;48(7):510-529. doi:10.1111/jop.12900Narayanapillai SC, Lin SH, Leitzman P, Upadhyaya P, Baglole CJ, Xing C.Dihydromethysticin (DHM) blocks tobacco carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-induced O6-methylguanine in a manner independent of the aryl hydrocarbon receptor (AhR) pathway in C57BL/6 female mice.Chem Res Toxicol. 2016;29(11):1828-1834. doi:10.1021/acs.chemrestox.6b00203.Bian T, Corral P, Wang Y, Botello J, Kingston R, Daniels T, Salloum RG, Johnston E, Huo Z, Lu J, Liu AC, Xing C.Kava as a clinical nutrient: Promises and challenges.Nutrients. 2020;12(10):3044. doi:10.3390/nu12103044National Center for Complementary and Integrative Health.Kava.Shinde P, Patil P, Bairagi V.Herbs in pregnancy and lactation: A review appraisal.Int J Pharm Sci Res. 2012;3(9):3001-3006. doi:10.13040/IJPSR.0975-8232.3(9).3001-06Cleveland Clinic.Kava Kava, Piper mesthystricum oral dosage forms.Smith K, Leiras C.The effectiveness and safety of kava kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials.Complementary Therapies in Clinical Practice. 2018;33:107-117. doi:10.1016/j.ctcp.2018.09.003Tzeng YM, Lee MJ.Neuroprotective properties of kavalactones.Neural Regen Res. 2015;10(6):875-7. doi:10.4103/1673-5374.158335

MedlinePlus.A guide to herbal remedies.

World Health Organization. Food and Agriculture Organization of the United Nations.Kava: A review of the safety of traditional and recreational beverage consumption: Technical Report.

Burton N, Sneed K, Pathak Y.Systemic Review of the Use of Kava Kava for the Reduction of Anxiety Disorder.Medicon Medical Sciences. 2023;5(2):37-46.

Sarris J, LaPorte E, Schweitzer I.Kava: A Comprehensive Review of Efficacy, Safety, and Psychopharmacology.Aus N Z J Psychiatry.2011;4(1):27-35. doi:10.3109/00048674.2010.522554.

Sarris J, Stough C, Bousman CA, Wahid ZT, Murray G, Teschke R, Savage KM, Dowell A, Ng C, Schweitzer I.Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study.J Clin Psychopharmacol. 2013;33(5):643-8. doi:10.1097/JCP.0b013e318291be67

Burton N, Sneed KB, Pathak Y.Systemic Review of the Use of Kava Kava for the Reduction of Anxiety Disorder.Medicon Medical Sciences. 2023;5(2):37-46.

Lehrl S.Clinical efficacy of kava extract WS 1490 in sleep disturbances associated with anxiety disorders. Results of a multicenter, randomized, placebo-controlled, double-blind clinical trial.J Affect Disord. 2004;78(2):101-110. doi:10.1016/s0165-0327(02)00238-0

Huck O, Han X, Mulhall H, Gumenchuk I, Cai B, Panek J, Iyer R, Amar S.Identification of a kavain analog with efficient anti-inflammatory effects.Sci Rep. 2019;9(1):12940. doi:10.1038/s41598-019-49383-8

Shimoda LM, Park C, Stokes AJ, Gomes HH, Turner H.Pacific island ‘Awa (Kava) extracts, but not isolated kavalactones, promote proinflammatory responses in model mast cells.Phytother Res. 2012;26(12):1934-41. doi:10.1002/ptr.4652

Celentano A, Tran A, Testa C, et al.The protective effects of Kava (Piper methysticum) constituents in cancers: A systematic review.J Oral Pathology Medicine. 2019;48(7):510-529. doi:10.1111/jop.12900

Narayanapillai SC, Lin SH, Leitzman P, Upadhyaya P, Baglole CJ, Xing C.Dihydromethysticin (DHM) blocks tobacco carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-induced O6-methylguanine in a manner independent of the aryl hydrocarbon receptor (AhR) pathway in C57BL/6 female mice.Chem Res Toxicol. 2016;29(11):1828-1834. doi:10.1021/acs.chemrestox.6b00203.

Bian T, Corral P, Wang Y, Botello J, Kingston R, Daniels T, Salloum RG, Johnston E, Huo Z, Lu J, Liu AC, Xing C.Kava as a clinical nutrient: Promises and challenges.Nutrients. 2020;12(10):3044. doi:10.3390/nu12103044

National Center for Complementary and Integrative Health.Kava.

Shinde P, Patil P, Bairagi V.Herbs in pregnancy and lactation: A review appraisal.Int J Pharm Sci Res. 2012;3(9):3001-3006. doi:10.13040/IJPSR.0975-8232.3(9).3001-06

Cleveland Clinic.Kava Kava, Piper mesthystricum oral dosage forms.

Smith K, Leiras C.The effectiveness and safety of kava kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials.Complementary Therapies in Clinical Practice. 2018;33:107-117. doi:10.1016/j.ctcp.2018.09.003

Tzeng YM, Lee MJ.Neuroprotective properties of kavalactones.Neural Regen Res. 2015;10(6):875-7. doi:10.4103/1673-5374.158335

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