Kava: A Comprehensive Review of Efficacy, Safety, and Psychopharmacology
Australian & New Zealand Journal of Psychiatry November 15, 2010 Jerome Sarris, E. LaPorte, Isaac Schweitzer 157 citations
Kava, a South Pacific psychotropic plant, reduces anxiety by modulating GABA activity, altering lipid membrane structure and sodium channel function, inhibiting monoamine oxidase B, and blocking noradrenaline and dopamine reuptake. A review of six studies found significant anxiety reduction in four, with a mean Cohen's d of 1.1. Safety concerns include liver toxicity; traditional water-soluble extracts from the rhizome of appropriate cultivars are advised, along with avoiding alcohol and caution with other psychotropics. Routine liver function tests are recommended for regular users, and driving or operating heavy machinery should be avoided at high doses. More studies comparing kava's efficacy and safety with established pharmaceuticals are needed.