Polynesian Valium

"Paradise on Earth!"

What images these words evoke! If you're like most people, you envision a tropical island somewhere in the South Pacific. Soft, warm breezes. Pristine sandy white beaches embraced on one side by a crescent of palm trees and on the other by the gentle and nurturing turquoise sea. Smiling, happy people, seemingly oblivious to the cares of life in the world of cable TV, drive-by shootings, and the IRS.

A fantasy? Probably. But if there is something a little more serene about the people of Polynesia, it may be due to a plant called kava. Long ago these people learned that when they ingested extracts of the kava, they soon felt better, more relaxed, at peace with the world. According to recent archeological discoveries, many Pacific societies have used kava as an integral part of the ceremonial culture.1 Fijians even use it to help them stop smoking.2 As one Polynesian islander recently told Dr. Ray Sahelian, "Kava is a healthy, natural way of relaxing. We don't need television. . . . Cares and worries disappear - carried away by the warm ocean wind."3

If there is something a little more serene
about the people of Polynesia,
it may be due to a plant called kava.

Kava is derived from the root of a shrub known as Piper methysticum, which grows in Polynesia, Malaysia, and Micronesia. Typically, the kava root is ground to a brownish powder, mixed with water and consumed as a beverage. As kava has found its way to the civilized world, the active ingredients have been extracted from the root and formulated into capsules and tinctures.

As with the natural antidepressant St. John's wort (hypericin), the Germans are far ahead of most other countries in the study and use of kava as a natural way to reduce anxiety. More than 30 years ago, a German pharmacologist was the first to isolate the active components of kava.3 And it was just last year that a multicenter, randomized, double-blind, placebo-controlled study conducted in Germany provided the best scientific support yet for its beneficial effects.4

In that study, 101 outpatients suffering from anxiety disorders, including certain phobias, took either a kava extract or a placebo for 25 weeks. Within 8 weeks, the patients taking kava were showing a significant reduction in anxiety. Kava was significantly superior to placebo over the long term and actually became even more effective with continued use. Specifically, the patients taking kava experienced less anxiety, tension, fear, and insomnia. After 24 weeks, 75% of the kava-treated patients were improved, compared with only 51% of the placebo group.

"Kava is a healthy, natural way of relaxing.
We don't need television. ...
Cares and worries disappear -
carried away by the warm ocean wind."

Adverse reactions to kava were rare. In fact, more patients in the placebo group dropped out of the study than kava patients. The authors concluded that kava should be considered as "a treatment alternative to tricyclic antidepressants (e.g., Elavil, Sinequan, Tofranil) and benzodiazepines (e.g., Valium, Xanax) in anxiety disorders, with proven long-term efficacy and none of the tolerance problems associated with tricyclics and benzodiazepines."4

Kava appears to be an effective, yet safe, means of reducing anxiety. There have been very few studies of humans using kava, and there is much to be learned about what this remarkable natural substance does and how it does it. At the present time, evidence suggests that kava may also provide relief from menopausal symptoms,5 pain,6 and insomnia.3

As with anything one ingests, users should observe certain dosing guidelines to be sure of achieving the maximal benefits with the minimal risks. Dr. Sahelian recommends starting with a daily dose of 40 to 80 mg of kavalactones (the active ingredient in kava) and increasing only as needed. Higher doses (100-250 mg kavalactones) may be needed to induce sleep.

Kava was significantly superior to placebo
in reducing anxiety, tension, fear, and insomnia.

The most common side effect of kava use in the South Pacific has been a skin rash that may be related to a disruption of cholesterol metabolism.7 This rash has not been reported outside of the Pacific, but that may be because it has been used there far longer than elsewhere.

Prolonged use of high doses should be avoided. Since the longest kava extract has been scientifically tested (with no serious side effects) has been 25 weeks, it is recommended that people limit their use of kava to 4 months at a time, at least until further studies demonstrate that it is safe to go longer. Kava is a potent compound and should never be combined with tranquilizing drugs, sedatives, or alcohol.

The best review of kava can be found in a new booklet by Dr. Ray Sahelian called Kava: Nature's Answer to Anxiety.3 In his usual, medically informed but understandable style, Dr. Sahelian reviews all the important research on kava and provides thoughtful guidelines for, and insights about, its use. Before you try kava, we recommend that you read this booklet.


  1. Hocart C, Frankhauser B, Buckle D. Chemical archaeology of kava, a potent brew. Rapid Commun Mass Spectrom. 1993;7:219-224.
  2. Groth-Marnat G, Renneker M, Leslie S. Tobacco control in a traditional Fijian village: indigenous methods of smoking cessation and relapse prevention. Soc Sci Med. 1996;43:473-477.
  3. Sahelian R. Kava: Nature's Answer to Anxiety. Green Bay, WI: IMPAKT Communications, Inc.; 1997.
  4. Volz H, Kieser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders - a randomized, placebo-controlled 25-week outpatient trial. Pharmacopsychiatry. 1997;30:1-5.
  5. Warnecke G. Psychosomatic dysfunctions in the female climacteric: clinical effectiveness and tolerance of kava extract. Fortschr Med. 1991;109:119-122.
  6. Jamieson D, Duffield P. The antinociceptive actions of kava components in mice. Clin Exp Pharmacol Physiol. 1990;17:495-507.
  7. Norton S, Ruze P. Kava dermopathy. J Am Acad Dermatol. 1994;31:89-97.

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