Rankings / Mood, Anxiety & Stress
Kava (Piper methysticum)
Mood, Anxiety & Stress · GABA-A modulator / TRPV1
Tier C+
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).
Studied, labeled, or reported-use context: 100-300 mg kavalactones/day — Variable by country — OTC US; heavily regulated/banned in UK, Germany, Australia, Canada; not individualized guidance.
What the evidence says
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
Studied, labeled, or reported dose & route
100-300 mg kavalactones/day
This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.
Citations
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Common questions
- What does the evidence show about Kava (Piper methysticum)'s effects?
- 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).
- What safety findings are reported for Kava (Piper methysticum)?
- Kava (Piper methysticum) has a med risk profile in the database. Med (hepatotoxicity — real but concentrated in certain extracts/cultivars; 2002 European regulatory action has been partially reversed; noble cultivars and water-extracted products much safer than acetone/ethanol extracts of root bark/peelings) Legal status: Variable by country — OTC US; heavily regulated/banned in UK, Germany, Australia, Canada (though bans partially lifted).
- What doses or routes are reported for Kava (Piper methysticum)?
- 100-300 mg kavalactones/day This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
- 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.