Here’s a review of the evidence by researchers at the University of Western Australia in Perth.


  • Effective in reducing anxiety symptoms.
  • The association of kava with liver toxicity is a significant concern.

St John’s wort

  • Effective in treating mild to moderate depression.

Omega-3 fatty acids

  • Promising data continue to emerge for managing depression.


  • Evidence supporting treatment of anxiety disorders is becoming stronger.

Aromatherapy or mindfulness-based meditation

  • Minimal evidence is available.

Cognitive interventions

  • Mindfulness-based stress reduction has little empirical basis.
  • Initial research of combined hypnotherapy plus cognitive-behavioral therapy is promising in depression.

The bottom line?
The authors would like to see more research. “Until a reasonable number of methodologically sound studies are completed,… it will remain difficult to draw any substantive conclusions regarding their usefulness to the clinician.”

More research is always nice, but based on this article and others on kava and St. John’s wort, these herbals can be used with confidence in appropriate patients who are under the care of a qualified healthcare professional.

The key is to use a brand with reliable manufacturing quality control. Here’s a ConsumerLab report on St Johns wort. I don’t see one for kava.

1/22/08 18:46 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.