The efficacy and safety of Piper methysticum (kava) for anxiety and Generalised Anxiety Disorder: A critical narrative review

Purpose a critical narrative review of scientific literature regarding the efficacy of Piper methysticum (kava) for anxiety and Generalised Anxiety Disorder (GAD) Background 17% of Australian adults experience anxiety which includes GAD. Pharmaceutical treatments have side effects. Recent research has explored Piper methysticum (Kava) for GAD. Methods PubMed, EBSCO Host and the Cochrane library databases were searched focusing on RCTs, systematic reviews, and meta-analyses of peer-reviewed, full-text articles in English. 115 records were screened for which 98 were excluded; 17 full text articles were retrieved; ten were rejected and seven articles consisting of two systematic reviews and 5 RCTs were selected for critical analysis Results Kava, in commercial nutraceutical or ethanol form, is not effective for GAD. Of the two Systematic Reviews, one did not support Kava for GAD, while the other found that Kava is suitable for acute anxiety but not for long term symptoms of GAD. Three RCT studies had statistically significant results for anxiety but did not specifically address GAD. One RCT had moderate, non-significant results for GAD compared to a larger RCT showing Kava is only effective for short-term anxiety relief. Conclusion Kava, in commercial form, may help with short-term anxiety, but it is not proven effective for GAD. Further research on higher dosages and longer durations is needed to assess its efficacy and safety as a first-line treatment for GAD. Further research is needed in aqueous forms of extracts used as psychopharmacology in traditional cultural contexts.