Kava-Kava is a powerful anxiolytic, which Pacific Islanders have used for more than 3000 years to induce a state of relaxation and tranquility. First mentioned in scientific records in 1886.Kava-Kava is a perennial shrub in the pepper family (Piper methysticum = "intoxicating Pepper") primarily cultivated in the South Pacific Islands. The thickened underground stem of the plant contains the active ingredients and is prepared by water or alcohol extraction from the root stock.

• About 15 resinous biochemical compounds called kava lactones or kava pyrones form the active ingredients.
• Fat-soluble kava lactones are postulated to demonstrate significant Gamma-aminobutyricacid (GABA) receptor binding activity but still disputed mode of action.

• Muscle-relaxant, anticonvulsant, analgesic activity.
• Unknown mechanisms of action but animal studies indicate direct influence on limbic system, with greatest effect on hippocampus and amygdala.

• Generalized anxiety disorder
• No published controlled clinical trials in the United States.
• German literature review shows five randomized, double blinded, and placebo controlled human trials of kava and anxiety.
• None of the trials enrolled more than 60 patients.
• Kava compared to oxazepam showed equal efficacy.
• Kava over four weeks showed significant improvement in anxiety scales used.
• Kava over four weeks relieved anxiety in peri- and postmenopausal women.

• Hypersensitivity to Kava-Kava preparations.

• Observational studies have shown a 1.5-2.3% incidence of side effects.

• Mild reversible gastrointestinal distress.
• Allergic skin reactions with scaly rash resembling ichthyosis in Kava drinkers in the Toga Islands.

• No known restrictions but do not recommend treatment if pregnant, nursing, diagnosed with depression.
• Persistent dizziness, yellow discoloration of hair, skin, and nails after consistent and heavy use of kava.

• Avoid concurrent kava use with anti-psychotic prescription medication.
• Avoid concurrent kava use with other supplements like St. John’s wort or valerian.

• Standard extracts contain 30% kava lactones available in liquid-filled gelcaps, powder- containing capsules, liquid, spray or root powder
• Commercial preparations refer to the total milligram content of kava lactones.
• German Commission E recommends a daily total dosage of 60 – 120 mg of kava lactones.
• American Herbal Product Association’s Kava Committee advises to limit consumption to 300 mg per day.

• Daily use should be restricted to 4-6 weeks.
• No safety data available for extended Kava use.

• Not known.
• Yellowish skin discoloration reported after heavy use of Kava.

• Avoid use in pregnant and nursing women.
• Avoid use when operating heavy equipment.