Social Anxiety Disorder Treatment and Therapy Why Kava Kava Shouldn't Be Used to Treat Social Anxiety By Arlin Cuncic Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." Learn about our editorial process Updated on May 11, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Joshua McCullough, PhytoPhoto/Stockbyte/Getty Images Kava kava (piper methysticum) is a plant native to the islands of the South Pacific. A member of the pepper family, the root and rhizome of the kava kava plant are used to prepare natural remedies for insomnia, anxiety, and menopausal symptoms. Kava Kava for Social Anxiety Disorder The use of kava kava in the treatment of social anxiety disorder is somewhat controversial, simply because there is not enough research about the supplement. The compounds in kava root believed to offer mood-altering properties are called kavalactones, however, little research has been done to pinpoint their exact mechanisms of action. While clinical trials have found evidence for the use of kava kava in reducing anxiety, reports of kava-induced hepatotoxicity (toxic liver injury) has led to the restriction of this supplement and bans on the sale of products containing kava kava in many countries. In 2002, the U.S. Food and Drug Administration (FDA) warned consumers and health professionals about the risk of liver damage associated with kava-containing dietary supplements. Case reports, which often included those with pre-existing liver toxicity, excessive kava kava doses, and heavy alcohol use, linked kava kava with hepatitis, cirrhosis, liver failure, and even death. These warnings are still in effect, and while kava in its traditional form poses an "acceptably low level of health risk," according to the World Health Organization (WHO), kava extracts and supplements may cause liver toxicity if overused or consumed on an ongoing basis. Who Shouldn’t Take Kava Kava Kava kava is not recommended for the following groups: Children under 18 People taking prescription monoamine oxidase inhibitors (MAOIs) People with liver disease, liver problems, or those taking drugs that affect the liver People taking drugs to treat Parkinson's disease Pregnant or nursing women Symptoms of Liver Problems Although the potential for liver problems is rare, if you experience signs of illness associated with the liver disease while taking kava kava you should consult with a medical professional immediately. Symptoms of liver problems may include: JaundiceBrown urineNauseaVomitingLight-colored stoolsUnusual tirednessWeaknessStomach or abdominal painLoss of appetite Medication Interactions You should not mix alcohol with kava kava. In addition, drowsiness may occur if combined with benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), or selective norepinephrine reuptake inhibitors (SNRIs). Side Effects Kava kava is available over-the-counter in the form of beverages, extracts, capsules, tablets, and topical solutions. Dosage guidelines recommend not exceeding 250 mg of the supplement within a 24-hour period. Side effects of kava kava are rare but may include the following: DizzinessDrowsinessHeadacheSensitivity to ultraviolet light sourcesStomach upset The 7 Best Online Anxiety Support Groups 4 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Chua HC, Christensen ETH, Hoestgaard-Jensen K, et al. Kavain, the major constituent of the anxiolytic kava extract, potentiates gabaa receptors: functional characteristics and molecular mechanism. Barnes S, ed. PLoS ONE. 2016;11(6):e0157700. doi:10.1371/journal.pone.0157700 Sarris J, LaPorte E, Schweitzer I. Kava: a comprehensive review of efficacy, safety, and psychopharmacology. Aus N Z J Psychiatry. 2011;4(1):27-35. doi:10.3109/00048674.2010.522554 National Center for Complementary and Integrative Health. Kava. World Health Organization. Food and Agriculture Organization of the United Nations. Kava: A review of the safety of traditional and recreational beverage consumption: Technical Report. Additional Reading National Center for Complementary and Alternative Medicine. Kava. Sarris J. Herbal medicines in the treatment of psychiatric disorders: 10-year updated review. Phytotherapy Research. 2018;32(7):1147-1162. doi: 10.1002/ptr.6055 National Center for Complementary and Alternative Medicine. Kava Linked to Liver Damage. Sarris J, Kavanagh DJ. Kava and St. John’s Wort: current evidence for use in mood and anxiety disorders. J Altern Complement Med. 2009;15(8):827-836. Singh YN, Singh NN. Therapeutic potential of kava in the treatment of anxiety disorders. CNS Drugs. 2002;16(11):731-743. By Arlin Cuncic Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Social Anxiety Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.