Why Kava Kava Shouldn't Be Used to Treat Social Anxiety

Hawaiian variety of 'Awa or kava kava, Piper methy
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:

  • Jaundice
  • Brown urine
  • Nausea
  • Vomiting
  • Light-colored stools
  • Unusual tiredness
  • Weakness
  • Stomach or abdominal pain
  • Loss 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:

  • Dizziness
  • Drowsiness
  • Headache
  • Sensitivity to ultraviolet light sources
  • Stomach upset
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.
  1. 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

  2. Sarris J, LaPorte E, Schweitzer I. Kava: a comprehensive review of efficacy, safety, and psychopharmacologyAus N Z J Psychiatry. 2011;4(1):27-35. doi:10.3109/00048674.2010.522554

  3. National Center for Complementary and Integrative Health. Kava.

  4. 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

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."