Valerian (Valeriana officinalis)

Content provided by the Faculty of the Harvard Medical School

Valerian (Valeriana officinalis)

Be aware that the U. S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain valerian. Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with their pharmacists or health care providers before starting.

Evidence

Scientists have studied valerian for the following health problems:

Insomnia

Several studies suggest that taking valerian by mouth may reduce the time it takes for people to fall asleep and may improve sleep quality, especially in those who routinely suffer from insomnia or sleep difficulties. One study conducted in children with intellectual difficulties reports that valerian may be useful in the long-term treatment of sleep disruption. Valerian does not appear to cause a "hangover" effect the morning after use. Preliminary findings suggest that effects may be better with repeat use, rather than single-dose use. One study suggests a positive effect in insomniacs who are experiencing withdrawal symptoms from benzodiazepine. Another study showed that valerian extract may be comparable to the effects of the prescription benzodiazepine drug oxazepam (Serax) for insomnia. Further research is necessary to confirm these results.

Sedative

A few low-quality studies suggest that valerian does not possess significant sedative properties. A small double-blind, randomized, crossover, placebo-controlled study was performed in healthy elderly people to assess the effects of temazepam (Restoril), diphenhydramine (Benedryl) and valerian. The results confirmed that valerian was not different from placebo (sugar pill) on any measure of drowsiness (psychomotor function) or sedation.

Anxiety

Although early evidence suggests that valerian may possess some anti-anxiety properties, there are no clear answers in this area. Some of these studies have been done using combination products containing more than one herb. More research is needed before valerian can be recommended as a treatment for anxiety and related disorders.

Depression

A multicenter clinical trial was performed to assess the effectiveness of valerian extract and St. John’s wort in depression with comorbid anxiety. The studied determined that symptoms of depression and anxiety improved faster with valerian than with St. John’s wort alone. Valerian alone has not been proven to aid in depression or anxiety. More research is necessary before this therapy can be recommended.

Menopausal symptoms

Valerian has been studied along with other herbs to help with sleep disturbances and hot flashes present during peri- and postmenopause. Further research is needed to make a recommendation.

Stress

Valerian may be beneficial to health by reducing the physical reactions during stressful situations. A clinical trial studied the effects of valerian or kava on psychological stress induced in a laboratory. The study found that valerian or kava may reduce the physical reactions of stress and may therefore be beneficial to health. More studies are needed before any conclusions can be made.

Unproven Uses

Valerian has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care provider before using valerian for any unproven use.

Absence of menstrual period Aches Acne Anorexia Antiperspirant Antispasmotic Antiviral Arthritis Asthma Bloating Chest pain Colic Congestive heart failure Constipation Coughs Cramps Cyanosis Digestion problems Diuretic Epilepsy Fatigue Fever Gas Hangover

Heart disease Heartburn High blood pressure HIV Hypochondria Irritable bowel syndrome Liver disease Measles Memory Menstrual cramps Menstrual period stimulant Mood enhancement Muscle tension Nausea Nerve pain Seizures Skin disorders Urinary tract disorders Vaginal yeast infections Vertigo Viral gastroenteritis Vision enhancement Withdrawal from tranquilizers

Potential Dangers

Allergies

People with allergies to plants in the Valerianaceae family may be allergic to valerian.

Side Effects

Few side effects have been reported when valerian is used at recommended doses. Rare problems may include headaches, excitability, decreased ability to concentrate, inability to sleep, uneasiness, dizziness, shakiness, unsteady walking, lower-than-normal body temperature (hypothermia), stomach discomfort, nausea or vomiting. It is not clear if valerian causes drowsiness or sedation, although early studies suggest that this may not be a major problem. Nonetheless, you should avoid driving or operating heavy machinery, especially within a few hours of each dose.

Although not extensively studied, it is possible that valerian may cause adverse effects on the liver or heart, especially if high doses are used for long periods of time. If you have been diagnosed with a heart or liver disorder and are considering taking valerian, discuss this with your health care provider.

Pregnancy And Breast-Feeding

Valerian cannot be recommended during pregnancy or breast-feeding because there is not enough information available. In theory, valerian may cause birth defects. Pregnant women should avoid ethanol (alcohol) extracts.

Interactions

Interactions with drugs, supplements and other herbs have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with your health care provider or pharmacist before using herbs or dietary supplements.

Interactions With Drugs

In theory, valerian may increase the side effects, including the amount of drowsiness, caused by sedative drugs. Examples include benzodiazepines, such as lorazepam (Ativan); barbiturates, such as phenobarbital; narcotics, such as codeine; antidepressants, such as fluoxetine (Prozac); antihistamines, such as diphenhydramine (Benadryl); alcohol; and possibly some antiseizure or antidiarrheal drugs. Caution is advised while driving or operating machinery. The alcohol content in some valerian extracts may lead to vomiting if used with the drug disulfiram (Antabuse) or metronidazole (Flagyl).

Interactions With Herbs And Dietary Supplements

Very few interactions between valerian and herbs or supplements have been reported. Valerian may increase the side effects or the amount of drowsiness caused by some herbs or supplements, such as St. John's wort or melatonin. Caution is advised while driving or operating machinery. Valerian may have effects that counteract stimultation caused by caffeine.

Dosing

The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient and may not be effective. Appropriate dosing should be discussed with a health care provider before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas.

Valerian has only been studied for four to six weeks of use. It should not be used for longer without the supervision of a health care provider.

For Mild Insomnia

Adults (Aged 18 Or Older)

Capsules: 300-1800 milligrams of valerian have been taken my mouth.

Aqueous or aqueous-ethanol extract: A dose of 1.5 to three grams of herb has been taken by mouth 30 to 60 minutes before going to bed.

Tea: A dose of 1.5 to three grams of valerian root steeped in 150 milliliters of boiling water for five to 10 minutes has been taken by mouth 30 to 60 minutes before going to bed.

Children (Younger Than 18)

The dosing and safety of valerian have not been studied thoroughly in children, and valerian is therefore not recommended.

For Sedation Or Stress Reduction

Aqueous or aqueous-ethanol extract: A dose of 100 to 600 milligrams taken by mouth before or after stressful events has been used.

Tea: A dose of 1.5 to three grams of valerian root steeped in 150 milliliters of boiling water has been taken by mouth five to 10 minutes before or after stressful events.

Summary

Valerian has been suggested for several conditions but has been most studied as a treatment for insomnia. Valerian may reduce the length of time it takes to fall asleep and may improve sleep quality with fewer adverse effects than commonly used prescription drugs. Valerian is not recommended in pregnant or breast-feeding women or in children. Alcoholic extracts should always be avoided in pregnant women. Remember that alcohol in some liquid preparations or tinctures may cause nausea or vomiting if taken with the drugs disulfiram or metronidazole. Valerian has been studied for only four to six weeks, and safety has not been established for longer-term use. Consult your health care provider immediately if you experience side effects.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

Resources

Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Valerian

Natural Standard reviewed more than 355 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

Andreatini R, Sartori VA, Seabra ML, Leite JR. Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study. Phytother Res 2002;Nov, 16(7):650-654.
Chan TY. An assessment of the delayed effects associated with valerian overdose. Int J Clin Pharmacol Ther 1998;36(10):569.
Chen D, Klesmer J, Giovanniello A, Katz J. Mental status changes in an alcohol abuser taking valerian and gingko biloba. Am J Addict 2002;Winter, 11(1):75-77.
Coxeter, P. D., Schluter, P. J., Eastwood, H. L., Nikles, C. J., and Glasziou, P. P. Valerian does not appear to reduce symptoms for patients with chronic insomnia in general practice using a series of randomised n-of-1 trials. Complement Ther.Med 2003;11(4):215-222.
Cropley M, Cave Z, Ellis J, Middleton RW. Effect of kava and valerian on human physiological and psychological responses to mental stress assessed under laboratory conditions. Phytother Res 2002;Feb, 16(1):23-27.
Diaper, A. and Hindmarch, I. A double-blind, placebo-controlled investigation of the effects of two doses of a valerian preparation on the sleep, cognitive and psychomotor function of sleep-disturbed older adults. Phytother.Res 2004;18(10):831-836.
Donath F, Quispe S, Diefenbach K, et al. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry 2000;33(2):47-53.
Francis AJ, Dempster RJ. Effect of valerian, Valeriana edulis, on sleep difficulties in children with intellectual deficits: randomized trial. Phytomedicine 2002;May, 9(4):273-279.
Garges HP, Varia I, Doraiswamy PM. Cardiac complications and delirium associated with valerian root withdrawal. JAMA 1998;280(18):1566-1567.
Giedke H, Breyer-Pfaff U. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry 2000;33(6):239.
Glass JR, Sproule BA, Herrmann N, et al. Acute pharmacological effects of temazepam, diphenhydramine, and valerian in healthy elderly subjects. J Clin Psychopharmacol 2003;Jun, 23(3):260-268.
Gutierrez, S., Ang-Lee, M. K., Walker, D. J., and Zacny, J. P. Assessing subjective and psychomotor effects of the herbal medication valerian in healthy volunteers. Pharmacol.Biochem.Behav. 2004;78(1):57-64.
Hadley S, Petry JJ. Valerian. Am Fam Physician 2003;Apr 15, 67(8):1755-1758.
Hallam, K. T., Olver, J. S., McGrath, C., and Norman, T. R. Comparative cognitive and psychomotor effects of single doses of Valeriana officianalis and triazolam in healthy volunteers. Hum.Psychopharmacol. 2003;18(8):619-625.
Kuhlmann J, Berger W, Podzuweit H, et al. The influence of valerian treatment on "reaction time, alertness and concentration" in volunteers. Pharmacopsychiatry 1999;32(6):235-241.
Muller D, Pfeil T, von den Driesch V. Treating depression comorbid with anxiety: results of an open, practice-oriented study with St John's wort WS 5572 and valerian extract in high doses. Phytomedicine 2003;10(Suppl 4):25-30.
Poyares DR, Guilleminault C, Ohayon MM, Tufik S. Can valerian improve the sleep of insomniacs after benzodiazepine withdrawal? Prog Neuropsychopharmacol Biol Psychiatr 2002;Apr, 26(3):539-545.
Richards, K., Nagel, C., Markie, M., Elwell, J., and Barone, C. Use of complementary and alternative therapies to promote sleep in critically ill patients. Crit Care Nurs.Clin.North Am. 2003;15(3):329-340.
Stevinson C, Ernst E. Valerian for insomnia: systematic review of randomized clinical trials. Sleep Med 2000;1:91-99.
Sun J. Morning/evening menopausal formula relieves menopausal symptoms: a pilot study. J Altern Complement Med 2003;Jun, 9(3):403-409.
Taibi, D. M., Bourguignon, C., and Taylor, A. G. Valerian use for sleep disturbances related to rheumatoid arthritis.
Trevena, L. Sleepless in Sydney--is valerian an effective alternative to benzodiazepines in the treatment of insomnia? ACP J Club. 2004;141(1):A14-A16. View Abstract
Ziegler G, Ploch M, Miettinen-Baumann A, Collet W. Efficacy and tolerability of valerian extract LI 156 compared with oxazepam in the treatment of non-organic insomnia: a randomized, double-blind, comparative clinical study. Eur J Med Res 2002;Nov 25, 7(11):480-486.

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Last updated:	August 21, 2006

Medical content reviewed by the Faculty of the Harvard Medical School. Harvard Health Publications, Copyright © 2007 by President and Fellows of Harvard College. All rights reserved. Used with permission of StayWell.

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