Fifty-two outpatients suffering from anxiety of nonpsychotic origin were included in an observational study of a kava-kava preparation. Drug efficacy was evident on measures of a global improvement scale, with 42 patients (80.8%) rating treatment as "very good" or "good". Adverse events were rare. These results support kava-kava extract as an effective and safe alternative to antidepressants and tranquilizers in anxiety disorder without the tolerance problems associated with benzodiazepines.