Research Therapies — 17 July 2013

An Australian national health survey (2011–12) identified that anxiety-related problems may affect about 4% of the population. 1

First-line treatment includes CBT, lifestyle advice (such as avoiding caffeine), daily exercise, stress management, reading self-help books and listening to calming music; all these strategies have evidence.

Kava (Piper methysticum) is a South Pacific plant of which the peeled root stock decocted in water is traditionally used for cultural, ceremonial, and medicinal purposes.

Studies suggest it may help generalised anxiety disorder (GAD).

A six-week RCT of 58 participants with GAD found an aqueous extract of kava was well tolerated and significantly reduced anxiety compared with placebo.2

A Cochrane review identified 12 double blind placebo RCTs (N = 700) and concluded kava extract was safe and effective for short-term use, although the effect was small.3

A recent systematic review of nutritional and herbal supplements for anxiety identified 24 studies (N = 2619) and found “strong evidence exists for the use of herbal supplements containing extracts of passionflower or kava and combinations of L-lysine and L-arginine as treatments for anxiety symptoms and disorders”.4

More studies are required to assess the benefits and safety of Kava especially with long-term use.

There are rare reported cases of hepatotoxicity especially when used with alcohol.


1. 364.0.55.001 Australian Health Survey: First Results, 2011-12; Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 29/10/2012[email protected]/Lookup/4D709A4E0614C546CA257AA30014BD06?opendocument

2.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 Apr 30. [Epub ahead of print]

3. Pittler MH, Ernst E. Kava extract versus placebo for treating anxiety. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD003383. DOI: 10.1002/14651858.CD003383

Assessed as up to date: January 12, 2005

4.Shaheen E Lakhan* and Karen F Vieira. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutrition Journal 2010, 9:42 doi:10.1186/1475-2891-9-42


As first appeared in Medical Observer, 16 July 2013


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