Kava

Kava (Piper methysticum) is a plant from the Western Pacific whose root has been used ceremonially for centuries. Its active compounds, kavalactones, modulate GABA-A receptors, voltage-gated sodium channels, and dopamine reuptake. Multiple meta-analyses have confirmed anxiolytic effects superior to placebo. Kava is studied for anxiety-related sleep disruption, where its anxiolytic properties may reduce pre-sleep hyperarousal. Important safety concern: rare but serious hepatotoxicity has been reported, leading to bans in some European countries (since lifted in Germany). The WHO recommends against combining kava with alcohol or hepatotoxic medications.