AI evidence summary · MVP
Kava for Anxiety
AI preliminary evidence assessment
CC 級｜AI 整體初步評級
This preliminary assessment is currently available in Traditional Chinese.
Exact question對有焦慮症診斷或焦慮症狀的成人，口服單方卡瓦，相較於安慰劑、一般照護或活性比較治療，是否改善經驗證的焦慮量表分數、治療反應或生活品質，以及有何肝傷害與其他不良反應？
已驗證評讀顯示研究結果方向不一致。主要限制包括：診斷型廣泛性焦慮症、混合焦慮診斷與僅有焦慮症狀的族群不可視為同質；水萃取物、WS 1490、LI 150及未充分描述製劑的劑量與結果不可直接合併。
Why this assessment was given
- 卡瓦在HAMA、主觀安適及次要指標優於安慰劑；此結果專屬苯二氮平漸停轉換情境。
Limitations affecting this assessment
- 多數療效報告僅有摘要，無法完整核對隨機化、盲法、失訪、停藥、不良事件、資助與利益衝突；不因摘要未記載而推定其不存在。
- 研究族群混雜確診廣泛性焦慮症、非精神病性焦慮、症狀升高者、睡眠伴焦慮及苯二氮平轉換患者，不能無條件合併。
- 卡瓦的水萃取、乙醇或丙酮等特殊萃取物、劑量及療程差異很大，療效與安全性不可視為同一製劑效果。
- PMID 16877894係三項既有試驗的次級合併分析，不增加獨立受試者；未將其另計為獨立支持單位。
- PMID 12119906僅能確認符合範圍的研究存在，完整結果及與其他報告的隊列連結不可得，未推論其效果。
- PMID 11159570是單一可能性高的嚴重肝損傷個案，只支持傷害訊號，不屬療效隊列，亦不能估算發生率。
- 自發通報與個案系列受漏報、選擇性通報、重複個案及分母未知限制，能提示嚴重肝毒性但不能可靠量化絕對風險。
- 至少一篇來源受限報告仍未解，全文擷取亦未完成，整體評估存在覆蓋限制。
- 監管措施僅作安全背景，未當作療效結果或正式GRADE判定。
- 此背景來源涵蓋多項研究，無法確認單一研究的人口或比較組，因此未列為讀者研究結果，也未納入評級。
Research results
Findings are currently provided in Traditional Chinese; source excerpts retain their original language.
Main result 1
5週卡瓦在HAMA、主觀安適及次要指標優於安慰劑；此結果專屬苯二氮平漸停轉換情境。
Applicability assessment: 研究對象在治療期間漸停先前使用的苯二氮平類藥物。
- Population
- 有非精神病性焦慮、緊張及不安狀態的患者
- Intervention
- 卡瓦特殊萃取物WS1490
- Comparator
- 安慰劑
- Outcome
- WS1490在HAMA及主觀安適感量表總分優於安慰劑。
- Follow-up
- 5週
- Formulation
- Not established
- Dose
- WS 1490由50 mg/日增至300 mg/日
Source excerpt: WS1490 was superior to placebo regarding the HAMA (P=0.01) and Bf-S (P=0.002) total scores and all secondary efficacy measures.View source
Main result 2
4週主要分析未見卡瓦優於安慰劑；依基線嚴重度進行的事後結果方向不一致。
Applicability assessment: 研究納入符合DSM-IV廣泛性焦慮症診斷的成人。
- Population
- 符合DSM-IV廣泛性焦慮症診斷的成人
- Intervention
- 卡瓦
- Comparator
- 相同外觀的安慰劑
- Outcome
- 主要分析中，兩組均有改善，但未見組間差異。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- 摘要未載明
Source excerpt: Improvement was observed with both treatments but no differences were found in the principal analysis.View source
Main result 3
8週三組療效與安全性無顯著差異，約75%反應、60%緩解；因無安慰劑且摘要未載非劣界值，不能確立等效。
Applicability assessment: 研究對象為廣泛性焦慮症門診患者，設有活性藥物比較組。
- Population
- 廣泛性焦慮症門診患者
- Intervention
- 卡瓦萃取物LI 150，每日400 mg
- Comparator
- 丁螺環酮或奧匹哌醇
- Outcome
- 各治療組約75%的患者達治療反應，約60%達完全緩解。
- Follow-up
- 8週
- Formulation
- Not established
- Dose
- LI 150 400 mg/日
Source excerpt: About 75% of patients were classified as responders (50% reduction of HAMA score) in each treatment group, about 60% achieved full remission.View source
Main result 4
4週治療後ASI直接組間比較不顯著，但探索性中心調整分析、安適感及CGI偏向卡瓦。
Applicability assessment: 納入多種DSM-III-R非精神病性焦慮診斷；所引結果包含探索性分析。
- Population
- 有神經症性焦慮的成人門診患者
- Intervention
- 卡瓦特殊萃取物WS 1490，每日150 mg
- Comparator
- 安慰劑
- Outcome
- 治療後ASI分數的直接組間比較未達顯著；探索性分析則顯示萃取物優於安慰劑。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- WS 1490 150 mg/日
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceMain result 5
4週睡眠主要終點及HAMA精神焦慮次量表均偏向卡瓦，安適與臨床整體評估亦較佳。
Applicability assessment: 研究以伴隨焦慮的睡眠障礙為核心，所引焦慮結果為HAMA精神焦慮次量表。
- Population
- 伴隨非精神病性焦慮、緊張及不安的睡眠障礙患者
- Intervention
- 卡瓦特殊萃取物WS 1490，每日200 mg
- Comparator
- 安慰劑
- Outcome
- HAMA精神焦慮次量表結果偏向卡瓦萃取物。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- WS 1490 200 mg/日
Source excerpt: Superior effects of kava extract were also present in the HAMA psychic anxiety sub-score (P=0.002).View source
Main result 6
4週HAMA相對安慰劑改善超過4分，次要指標呈偏向卡瓦的趨勢。
Applicability assessment: 研究對象為非精神病性焦慮患者。
- Population
- 非精神病性焦慮患者
- Intervention
- 卡瓦特殊萃取物WS 1490，每日150 mg
- Comparator
- 安慰劑
- Outcome
- HAMA總分相對安慰劑降低超過4分。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- WS 1490 150 mg/日
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceMain result 7
4週卡瓦在STAI焦慮改善不優於安慰劑，依從者分析結果相似。
Applicability assessment: 適用於同時具有升高焦慮與失眠症狀的網路招募成人，而非確診焦慮症。
- Population
- 同時有焦慮與失眠症狀的參與者
- Intervention
- 卡瓦
- Comparator
- 雙重安慰劑
- Outcome
- 卡瓦組STAI狀態焦慮分數的下降與安慰劑組相近。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- 28日供應量；摘要未載卡瓦劑量
Source excerpt: Those receiving kava had similar reductions in STAI-State score (2.7 point greater reduction in placebo compared with kava; 95% confidence interval [CI], -0.8 to +6.2).View source
Main result 8
4週HAMA於一週起即顯著偏向卡瓦，差距隨治療增加，次要指標一致。
Applicability assessment: 研究對象為非精神病性焦慮症候群患者。
- Population
- 非精神病性焦慮症候群患者
- Intervention
- 卡瓦萃取物WS 1490，每日300 mg
- Comparator
- 安慰劑
- Outcome
- HAMA焦慮症狀總分在治療一週後已顯著下降。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- WS 1490 300 mg/日
Source excerpt: The HAMA overall score of anxiety symptomatology revealed a significant reduction in the drug receiving group already after one week of treatment.View source
Main result 9
3週兩個受控期的HAMA變化及跨期合併分析均明顯偏向卡瓦。
Applicability assessment: 納入持續至少一個月、廣泛性焦慮症狀升高的成人，未限定須確診廣泛性焦慮症。
- Population
- 廣泛性焦慮症狀升高至少一個月的成人
- Intervention
- 卡瓦水萃取物，每日250 mg卡瓦內酯
- Comparator
- 安慰劑
- Outcome
- 跨期合併分析顯示卡瓦相對安慰劑的效果達統計顯著。
- Follow-up
- 3週
- Formulation
- Not established
- Dose
- 水萃取物，250 mg kavalactones/日
Source excerpt: The pooled effect of Kava vs. placebo across phases was highly significant (p < 0.0001), with a substantial effect size (d = 2.24, eta(2)(p)).View source
Main result 10
單次給藥卡瓦急性給藥後焦慮無變化；奧沙西泮降低焦慮，安慰劑則增加。
Applicability assessment: 研究只評估中度焦慮成人單次給藥後的急性效果。
- Population
- 18至65歲的中度焦慮成人
- Intervention
- 單次卡瓦，含180 mg卡瓦內酯
- Comparator
- 奧沙西泮及安慰劑
- Outcome
- 奧沙西泮條件下焦慮下降；卡瓦條件下焦慮沒有變化，安慰劑條件下焦慮增加。
- Follow-up
- 單次給藥
- Formulation
- Not established
- Dose
- 單次180 mg kavalactones
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceMain result 11
6週ITT分析顯示HAMA中度效應，緩解率26%對6%；較嚴重GAD次群效果較大。
Applicability assessment: 研究納入無共病情緒障礙的廣泛性焦慮症患者。
- Population
- 無共病情緒障礙的廣泛性焦慮症患者
- Intervention
- 卡瓦水萃取物，每日120或240 mg卡瓦內酯，依反應調整
- Comparator
- 安慰劑
- Outcome
- 卡瓦組的焦慮下降幅度大於安慰劑組。
- Follow-up
- 6週
- Formulation
- Not established
- Dose
- 水萃取物120 mg/日，無反應可增至240 mg/日
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceMain result 12
16週焦慮改善差異不顯著且數值偏向安慰劑，緩解率亦無顯著差異。
Applicability assessment: 研究納入目前未用藥且確診廣泛性焦慮症的參與者。
- Population
- 目前未用藥且確診廣泛性焦慮症的焦慮參與者
- Intervention
- 卡瓦乾燥根水萃取錠，每日兩次、每次120 mg卡瓦內酯
- Comparator
- 安慰劑
- Outcome
- 焦慮下降的組間差異未達統計顯著，數值上偏向安慰劑。
- Follow-up
- 16週
- Formulation
- Not established
- Dose
- 水萃乾燥根，120 mg kavalactones每日兩次
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceMain result 13
25週HAMA自第8週起顯著優於安慰劑，次要結果亦偏向卡瓦。
Applicability assessment: 研究納入多種非精神病性焦慮診斷的門診患者。
- Population
- 有非精神病性焦慮的門診患者
- Intervention
- 卡瓦特殊萃取物WS 1490
- Comparator
- 安慰劑
- Outcome
- 主要結果HAMA自第8週起顯示研究藥物顯著優於安慰劑。
- Follow-up
- 25週
- Formulation
- Not established
- Dose
- WS 1490；摘要未載劑量
Source excerpt: In the main outcome criterion, the Hamilton Anxiety Scale (HAMA), there was a significant superiority of the test drug starting from week 8 on.View source
Safety finding 14
服用約2個月後就醫單一個案出現嚴重肝細胞壞死、暴發性肝衰竭並接受肝移植，不能據此估算發生率。
Applicability assessment: 這是因輕度焦慮服用卡瓦的單一病例，只能提供傷害訊號。
- Population
- 因輕度焦慮服用卡瓦的一名50歲男性
- Intervention
- 卡瓦萃取物
- Comparator
- 無比較組
- Outcome
- 患者其後接受肝移植。
- Follow-up
- 服用約2個月後就醫
- Formulation
- Not established
- Dose
- 每日3至4粒，約210–280 mg lactones，持續2個月
Source excerpt: The patient received a liver transplant two days later.View source
Safety finding 15
5週摘要稱耐受性不劣於安慰劑，但未提供事件數。
Applicability assessment: 同一研究族群在漸停苯二氮平類藥物期間接受治療。
- Population
- 有非精神病性焦慮、緊張及不安狀態的患者
- Intervention
- 卡瓦（WS1490）
- Comparator
- 安慰劑
- Outcome
- 摘要稱WS1490的耐受性不劣於安慰劑。
- Follow-up
- 5週
- Formulation
- Not established
- Dose
- WS 1490由50 mg/日增至300 mg/日
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceSafety finding 16
4週兩組均稱耐受良好，但摘要未列事件數或肝功能細節。
Applicability assessment: 研究納入符合DSM-IV廣泛性焦慮症診斷的成人。
- Population
- 符合DSM-IV廣泛性焦慮症診斷的成人
- Intervention
- 卡瓦
- Comparator
- 安慰劑
- Outcome
- 摘要稱兩組均耐受良好。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- 摘要未載明
Source excerpt: Both treatments were well tolerated.View source
Safety finding 17
8週安全性未見組間顯著差異，但缺乏個別事件資料。
Applicability assessment: 研究對象為廣泛性焦慮症門診患者，設有活性藥物比較組。
- Population
- 廣泛性焦慮症門診患者
- Intervention
- 卡瓦萃取物LI 150
- Comparator
- 丁螺環酮或奧匹哌醇
- Outcome
- 意向治療分析中，安全性指標未見顯著組間差異。
- Follow-up
- 8週
- Formulation
- Not established
- Dose
- LI 150 400 mg/日
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceSafety finding 18
4週未見肝功能影響；有1件歸因於研究藥物的輕微疲倦。
Applicability assessment: 納入多種DSM-III-R非精神病性焦慮診斷的患者。
- Population
- 有神經症性焦慮的成人門診患者
- Intervention
- 卡瓦（WS 1490）
- Comparator
- 安慰劑
- Outcome
- 未見肝功能檢查受影響；有一件歸因於研究藥物的輕微疲倦事件。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- WS 1490 150 mg/日
Source excerpt: WS 1490 was well tolerated, with no influence on liver function tests and only one trivial adverse event (tiredness) attributable to the study drug.View source
Safety finding 19
4週未報告藥物相關不良事件或臨床、實驗室參數改變。
Applicability assessment: 研究以伴隨焦慮的睡眠障礙為核心。
- Population
- 伴隨非精神病性焦慮、緊張及不安的睡眠障礙患者
- Intervention
- 卡瓦（WS 1490）
- Comparator
- 安慰劑
- Outcome
- 未報告藥物相關不良事件或臨床及實驗室參數變化。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- WS 1490 200 mg/日
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceSafety finding 20
4週治療，後續2週安全性觀察未報告藥物相關不良事件或停藥症狀。
Applicability assessment: 研究對象為非精神病性焦慮患者。
- Population
- 非精神病性焦慮患者
- Intervention
- 卡瓦（WS 1490）
- Comparator
- 安慰劑
- Outcome
- 未報告藥物相關不良事件或研究結束後的停藥症狀。
- Follow-up
- 4週治療，後續2週安全性觀察
- Formulation
- Not established
- Dose
- WS 1490 150 mg/日
Source excerpt: WS 1490 was well tolerated and showed a safety profile with no drug-related adverse events or post-study withdrawal symptoms.View source
Safety finding 21
4週4週內未記錄歸因於藥物的不良經驗。
Applicability assessment: 研究對象為非精神病性焦慮症候群患者。
- Population
- 非精神病性焦慮症候群患者
- Intervention
- 卡瓦（WS 1490）
- Comparator
- 安慰劑
- Outcome
- 4週用藥期間未記錄歸因於藥物的不良經驗。
- Follow-up
- 4週
- Formulation
- Not established
- Dose
- WS 1490 300 mg/日
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceSafety finding 22
3週短期內未見嚴重不良反應或臨床肝毒性；未提供事件數。
Applicability assessment: 納入廣泛性焦慮症狀升高的成人；安全性觀察限於研究所用劑量及期間。
- Population
- 廣泛性焦慮症狀升高至少一個月的成人
- Intervention
- 卡瓦水萃取物
- Comparator
- 安慰劑
- Outcome
- 研究未發現嚴重不良反應或臨床肝毒性。
- Follow-up
- 3週
- Formulation
- Not established
- Dose
- 水萃取物，250 mg kavalactones/日
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceSafety finding 23
單次給藥卡瓦未見負面認知影響；奧沙西泮降低警覺性。
Applicability assessment: 研究只評估單次給藥後的急性效果。
- Population
- 18至65歲的中度焦慮成人
- Intervention
- 卡瓦
- Comparator
- 奧沙西泮
- Outcome
- 卡瓦未見負面認知影響；奧沙西泮條件下警覺性下降。
- Follow-up
- 單次給藥
- Formulation
- Not established
- Dose
- 單次180 mg kavalactones
Source excerpt: Kava was found to have no negative effect on cognition, whereas a reduction in alertness (p < 0.001) occurred in the oxazepam condition.View source
Safety finding 24
6週卡瓦組頭痛較多；其他不良反應及肝功能檢查無顯著組間差異。
Applicability assessment: 研究納入無共病情緒障礙的廣泛性焦慮症患者。
- Population
- 無共病情緒障礙的廣泛性焦慮症患者
- Intervention
- 卡瓦
- Comparator
- 安慰劑
- Outcome
- 卡瓦組頭痛較多；其他不良反應及肝功能檢查未見顯著組間差異。
- Follow-up
- 6週
- Formulation
- Not established
- Dose
- 水萃取物120 mg/日，無反應可增至240 mg/日
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceSafety finding 25
16週卡瓦組記憶較差與顫抖較常見；肝功能異常也較多，但無人符合草藥性肝損傷標準。
Applicability assessment: 研究納入目前未用藥且確診廣泛性焦慮症的參與者。
- Population
- 目前未用藥且確診廣泛性焦慮症的焦慮參與者
- Intervention
- 卡瓦
- Comparator
- 安慰劑
- Outcome
- 卡瓦組較常發生記憶變差及顫抖。
- Follow-up
- 16週
- Formulation
- Not established
- Dose
- 水萃乾燥根，120 mg kavalactones每日兩次
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceSafety finding 26
25週不良事件少見且兩組分佈相近，未提供事件數。
Applicability assessment: 研究納入多種非精神病性焦慮診斷的門診患者。
- Population
- 有非精神病性焦慮的門診患者
- Intervention
- 卡瓦（WS 1490）
- Comparator
- 安慰劑
- Outcome
- 不良事件少見，兩組分布相近。
- Follow-up
- 25週
- Formulation
- Not established
- Dose
- WS 1490；摘要未載劑量
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceAdditional finding 27
該合併分析報告卡瓦組未見效果；所分析試驗均未見顯著組間差異。
Applicability assessment: 來源彙整廣泛性焦慮症成人門診患者的多項試驗，部分參與者可能與個別試驗資料重疊。
- Population
- 符合DSM-IV廣泛性焦慮症診斷的成人門診患者
- Intervention
- 卡瓦
- Comparator
- 安慰劑；其中一項試驗另有文拉法辛比較組
- Outcome
- 廣泛性焦慮症的療效與安全性
- Follow-up
- Not established
- Formulation
- Not established
- Dose
- Not established
No additional short excerpt is shown for this finding. See the linked source to check the result.
View sourceSources consulted
- Hepatitis associated with Kava, a herbal remedy for anxiety. Context source; not counted as an included human-result report Full text · 2026-09-19T14:25:35.896345Z
- Efficacy of kava-kava in the treatment of non-psychotic anxiety, following pretreatment with benzodiazepines. Abstract only · 2026-09-19T14:25:35.896345Z
- A placebo-controlled study of Kava kava in generalized anxiety disorder. Abstract only · 2026-09-19T14:25:35.896345Z
- Kava-Kava extract LI 150 is as effective as Opipramol and Buspirone in Generalised Anxiety Disorder--an 8-week randomized, double-blind multi-centre clinical trial in 129 out-patients. Abstract only · 2026-09-19T14:25:35.896345Z
- Treatment of anxiety, tension and restlessness states with Kava special extract WS 1490 in general practice: a randomized placebo-controlled double-blind multicenter trial. Abstract only · 2026-09-19T14:25:35.896345Z
- Clinical efficacy of kava extract WS 1490 in sleep disturbances associated with anxiety disorders. Results of a multicenter, randomized, placebo-controlled, double-blind clinical trial. Abstract only · 2026-09-19T14:25:35.896345Z
- Kava treatment in patients with anxiety. Abstract only · 2026-09-19T14:25:35.896345Z
- An internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia. Abstract only · 2026-09-19T14:25:35.896345Z
- Kava in generalized anxiety disorder: three placebo-controlled trials. Context source; not counted as an included human-result report Abstract only · 2026-09-19T14:25:35.896345Z
- [Effect of a special kava extract in patients with anxiety-, tension-, and excitation states of non-psychotic genesis. Double blind study with placebos over 4 weeks]. Abstract only · 2026-09-19T14:25:35.896345Z
- The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum. Abstract only · 2026-09-19T14:25:35.896345Z
- The acute effects of kava and oxazepam on anxiety, mood, neurocognition; and genetic correlates: a randomized, placebo-controlled, double-blind study. Abstract only · 2026-09-19T14:25:35.896345Z
- Kava in the treatment of generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. Abstract only · 2026-09-19T14:25:35.896345Z
- Kava for generalised anxiety disorder: A 16-week double-blind, randomised, placebo-controlled study. Abstract only · 2026-09-19T14:25:35.896345Z
- Kava-kava extract WS 1490 versus placebo in anxiety disorders--a randomized placebo-controlled 25-week outpatient trial. Abstract only · 2026-09-19T14:25:35.896345Z
Reading and assessment notes
This is an AI preliminary assessment, not expert review or formal GRADE. Read the method and common limitations.
Absence of reported harms does not establish safety. This summary does not provide individual treatment or dosing advice.
Data and assessment record
Search coverage for this case
對有焦慮症診斷或焦慮症狀的成人，口服單方卡瓦，相較於安慰劑、一般照護或活性比較治療，是否改善經驗證的焦慮量表分數、治療反應或生活品質，以及有何肝傷害與其他不良反應？
Searched：2026-09-19T14:25:35.896345Z · Databases：PubMed
173 records identified; 173 screened; 13 reports from 13 unique study populations included.
Some included reports were assessed without full text.
- 部分候選文獻未取得全文，完整偏倚風險與次要結果評讀受限。
- 本次檢索限於 PubMed 與已取得全文，未進行所有資料庫與完整引文追查。
Processing record
Evidence summary available
Sources through：2026-09-19 · Generated：2026-09-24T10:08:07.278570+00:00
Retrieved 173 records · Screened 173 · Included 13 reports · Omitted 160
Run：reader-enrichment-rating-candidate-closure-v2
codex_cli / gpt-5.6-sol / problem-search-source-bound-l2+l11-v1
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