Valerian

Updated | 2017-11-25


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Valerian


Overview

Botanical Name: Valeriana officinalis


Order: Dipsacales


Family: Caprifoliaceae


Valerian is commonly used to treat sleep disorders and insomnia.



Evidence

Strong:

-

Good:

  • Sleep Disorders/Insomnia (including menopausal and post-menopausal women, children, children with intellectual deficits, and people with restless leg syndrome; however, valerian may not work in cancer patients, people with arthritis, and with chronic insomnia), in one case the effectiveness of valerian was comparable to oxazepam [1-28]
    • Forms of valerian included: valerian acupressure; valerian / lemon balm; valerian / passionflower / hops (possible short-term alternative to zolpidem); valerian / hops (appears to be more superior than valerian alone); valerian / Valeriana edulis; and sesquiterpene extract from valerian
    • One study found that a homeopathic preparation might be more effective than valerian alone

Promising:

  • Anxiety/Stress, valerian / lemon balm may be more effective [29-34]
    • One study found that a homeopathic preparation might be more effective than valerian alone

Conflicting (Unclear):

-

Limited Evidence:

  • Benzodiazepine Withdrawal [35-36]
  • Calming and Anti-Depressive, valerian with passionflower / St. John’s wort; and St. John’s wort alone [37-38]
  • Nervous Agitation in Children, valerian with passionflower / St. John’s wort; and lemon balm seemed to work [39-40]
  • Obsessive Compulsive Disorder (OCD) [41]
  • Painful Menstruation [42]
  • Somatoform Disorder, a complex mixture with butterbur [43]

No Evidence:

-

No Clinical Research:

All other conditions.


Side Effects
Side effects may include:
  • Agitation
  • Allergic Reactions
  • Blurred Vision
  • Cardiac Disturbances
  • Drowsiness
  • Excitability
  • Gastrointestinal Complaints
  • Hangover-like Symptoms
  • Headache
  • Insomnia
  • Nausea
  • Paradoxical Stimulation (opposite effect)
  • Restlessness
  • Vomiting
Precautions and Adverse Events:
  • Avoid or contact a licensed healthcare practitioner, if you may be allergic to valerian, have liver disease, or psychiatric disorders.
  • Valerian appears to not affect motor skills, mood, and cognition when compared to other drugs with similar sedative properties (including Benzodiazepines, Diazepam, Diphenhydramine, and Temazepam).
  • Some cases of allergic reactions, including hives and respiratory distress, have been associated with valerian.
  • Abrupt discontinuation can potentially cause Benzodiazepine-like withdrawal syndrome.
  • Some people using valerian may have increased seizure threshold.
  • There was a case that valerian was toxic to the liver.
[44-53]


Pregnant or Nursing

There is not enough research on the use of supplements containing valerian during pregnancy and breast-feeding, so consult a licensed healthcare practitioner before use or avoid use.



Interactions

Major

  • Alprazolam
  • Lorazepam (interacted with a valerian/passionflower combination)
  • Phenobarbital
[54-61]

Moderate

  • Caffeine
  • Drugs Toxic to the Liver, valerian may increase the negative effects of these drugs
[54-61]

Potential

  • Alcohol
  • Antabuse
  • Barbiturates
  • Benzodiazepines
  • Iron
  • Loperamide
  • Opioid Analgesics
  • Valerian may NOT interact with drugs changed by Cytochrome P450s (CYPs) in the liver
[54-61]


Dosage

Valerian is not a "drug", the best doses have not been thoroughly established. Make sure to follow the specific product instructions and take as directed on the label, or consult a licensed healthcare practitioner before use. According to one report, overdose (20 times the recommended amount) produced mild symptoms. However, overdose of valerian may cause dilation of pupils, irregular heartbeat, and liver damage. [62]



Compounds
Valerian compounds


References

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Does valerian improve sleepiness and symptom severity in people with restless legs syndrome? Altern Ther Health Med. 2009 Mar-Apr;15(2):22-8. 6. Diaper A, 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 Oct;18(10):831-6. 7. Dimpfel W, Suter A. Sleep improving effects of a single dose administration of a valerian/hops fluid extract - a double blind, randomized, placebo-controlled sleep-EEG study in a parallel design using electrohypnograms. Eur J Med Res. 2008 May 26;13(5):200-4. 8. Dominguez RA, Bravo-Valverde RL, Kaplowitz BR, Cott JM. Valerian as a hypnotic for Hispanic patients. Cultur Divers Ethnic Minor Psychol. 2000 Feb;6(1):84-92. 9. Donath F, Quispe S, Diefenbach K, Maurer A, Fietze I, Roots I. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry. 2000 Mar;33(2):47-53. 10. Francis AJ, Dempster RJ. Effect of valerian, Valeriana edulis, on sleep difficulties in children with intellectual deficits: randomised trial. Phytomedicine. 2002 May;9(4):273-9. 11. Herrera-Arellano A, Luna-Villegas G, Cuevas-Uriostegui ML, Alvarez L, Vargas-Pineda G, Zamilpa-Alvarez A, Tortoriello J. Polysomnographic evaluation of the hypnotic effect of Valeriana edulis standardized extract in patients suffering from insomnia. Planta Med. 2001 Nov;67(8):695-9. 12. Jacobs BP, Bent S, Tice JA, Blackwell T, Cummings SR. An internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia. Medicine (Baltimore). 2005 Jul;84(4):197-207. 13. Koetter U, Schrader E, Käufeler R, Brattström A. A randomized, double blind, placebo-controlled, prospective clinical study to demonstrate clinical efficacy of a fixed valerian hops extract combination (Ze 91019) in patients suffering from non-organic sleep disorder. 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Oxman AD, Flottorp S, Håvelsrud K, Fretheim A, Odgaard-Jensen J, Austvoll-Dahlgren A, Carling C, Pallesen S, Bjorvatn B. A televised, web-based randomised trial of an herbal remedy (valerian) for insomnia. PLoS One. 2007 Oct 17;2(10):e1040. 20. Schulz H, Stolz C, Müller J. The effect of valerian extract on sleep polygraphy in poor sleepers: a pilot study. Pharmacopsychiatry. 1994 Jul;27(4):147-51. 21. Taavoni S, Ekbatani N, Kashaniyan M, Haghani H. Effect of valerian on sleep quality in postmenopausal women: a randomized placebo-controlled clinical trial. Menopause. 2011 Sep;18(9):951-5. 22. Taavoni S, Nazem Ekbatani N, Haghani H. Valerian/lemon balm use for sleep disorders during menopause. Complement Ther Clin Pract. 2013 Nov;19(4):193-6. 23. Taibi DM, Vitiello MV, Barsness S, Elmer GW, Anderson GD, Landis CA. A randomized clinical trial of valerian fails to improve self-reported, polysomnographic, and actigraphic sleep in older women with insomnia. Sleep Med. 2009 Mar;10(3):319-28. 24. Taibi DM, Bourguignon C, Gill Taylor A. A feasibility study of valerian extract for sleep disturbance in person with arthritis. Biol Res Nurs. 2009 Apr;10(4):409-17. 25. Waldschütz R, Klein P. The homeopathic preparation Neurexan vs. valerian for the treatment of insomnia: an observational study. ScientificWorldJournal. 2008 Apr 20;8:411-20. 26. Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol. 2001 Jun;16(4):353-356. 27. Wheatley D. Kava and valerian in the treatment of stress-induced insomnia. Phytother Res. 2001 Sep;15(6):549-51. 28. 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):480-6. 29. Andreatini R, Sartori VA, Seabra ML, Leite JR. 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Comparative cognitive and psychomotor effects of single doses of Valeriana officianalis and triazolam in healthy volunteers. Hum Psychopharmacol. 2003 Dec;18(8):619-25. 51. Kuhlmann J, Berger W, Podzuweit H, Schmidt U. The influence of valerian treatment on "reaction time, alertness and concentration" in volunteers. Pharmacopsychiatry. 1999 Nov;32(6):235-41. 52. Patra KK, Coffey CE. Implications of herbal alternative medicine for electroconvulsive therapy. J ECT. 2004 Sep;20(3):186-94. 53. Tsai HH, Lin HW, Simon Pickard A, Tsai HY, Mahady GB. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract. 2012 Nov;66(11):1056-78. 54. Carrasco MC, Vallejo JR, Pardo-de-Santayana M, Peral D, Martín MA, Altimiras J. Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam. Phytother Res. 2009 Dec;23(12):1795-6. 55. Donovan JL, DeVane CL, Chavin KD, Wang JS, Gibson BB, Gefroh HA, Markowitz JS. Multiple night-time doses of valerian (Valeriana officinalis) had minimal effects on CYP3A4 activity and no effect on CYP2D6 activity in healthy volunteers. Drug Metab Dispos. 2004 Dec;32(12):1333-6. 56. Fetrow CW, Avila JR. The complete guide to herbal medicines. Spring House, PA, USA: Springhouse Corporation; 2000. 57. Gruenwald J, Brendler T, Jaenicke C, editors. PDR for herbal medicines. 4th ed. Montvale, NJ, USA: Thomson Healthcare; 2007. 58. Gurley BJ, Gardner SF, Hubbard MA, Williams DK, Gentry WB, Khan IA, Shah A. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clin Pharmacol Ther. 2005 May;77(5):415-26. 59. Patra KK, Coffey CE. Implications of herbal alternative medicine for electroconvulsive therapy. J ECT. 2004 Sep;20(3):186-94. 60. Schellenberg R, Sauer S, Abourashed EA, Koetter U, Brattström A. The fixed combination of valerian and hops (Ze91019) acts via a central adenosine mechanism. Planta Med. 2004 Jul;70(7):594-7. 61. Tsai HH, Lin HW, Simon Pickard A, Tsai HY, Mahady GB. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract. 2012 Nov;66(11):1056-78. 62. Willey LB, Mady SP, Cobaugh DJ, Wax PM. Valerian overdose: a case report. Vet Hum Toxicol. 1995 Aug;37(4):364-5.

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