Rankings / Mood, Anxiety & Stress

Kava (Piper methysticum)

Mood, Anxiety & Stress · GABA-A modulator / TRPV1

Tier C+

gabadopaminenmda-modulatorbannedotc
5.5 / 10
Tier C+
Ev 6 Bn 5 Sf 5

Bottom line

Read Off Label grades Kava (Piper methysticum) as C+ (5.5/10) based on moderate evidence, moderate benefit magnitude, and a med-risk safety profile.

Hepatotoxicity reputation driven by pre-2002 use of acetone/ethanol extracts of stem peelings and basal stumps (higher pipermethystine content).

Typical use: 100-300 mg kavalactones/day — Variable by country — OTC US; heavily regulated/banned in UK, Germany, Australia, Canada.

What this is

Hepatotoxicity reputation driven by pre-2002 use of acetone/ethanol extracts of stem peelings and basal stumps (higher pipermethystine content). Noble cultivar, water-extracted preparations (traditional Polynesian method) appear much safer. Sarris group advocates for use with standardized safer extracts.

Mechanism

Polynesian ceremonial drink; kavalactones (kavain, dihydrokavain, methysticin) act at GABA-A, TRPV1, NMDA, dopamine systems; anxiolytic without cognitive impairment of benzodiazepines

Dose & route

100-300 mg kavalactones/day

Common questions

Does Kava (Piper methysticum) work?
Read Off Label rates the evidence for Kava (Piper methysticum) as Moderate and the benefit magnitude as moderate, producing an overall grade of C+ (5.5/10). Hepatotoxicity reputation driven by pre-2002 use of acetone/ethanol extracts of stem peelings and basal stumps (higher pipermethystine content).
Is Kava (Piper methysticum) safe?
Kava (Piper methysticum) has a med risk profile in published human data. Legal status: Variable by country — OTC US; heavily regulated/banned in UK, Germany, Australia, Canada (though bans partially lifted). This is not medical advice — see the disclaimer.
What is the typical dose for Kava (Piper methysticum)?
100-300 mg kavalactones/day
How does Kava (Piper methysticum) work?
Polynesian ceremonial drink; kavalactones (kavain, dihydrokavain, methysticin) act at GABA-A, TRPV1, NMDA, dopamine systems; anxiolytic without cognitive impairment of benzodiazepines

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.