How It Works
Bottom Line: Valerian is no better than a placebo for relieving anxiety, and promoting sleep. It is uncertain whether it is safe to take for long periods of time.
Scientists are uncertain which compounds in valerian are responsible for its actions. In laboratory experiments, an extract of valerian prevents the breakdown of an important chemical in the nervous system called GABA. GABA is an inhibitory neurotransmitter, so increasing its availability will generally decrease the activity of the nervous system, causing sedation. The roots of valerian itself have been shown to contain considerable amounts of GABA.
Purported Uses
To calm muscle spasms
Laboratory studies support this use, but there is no proof from clinical trials that valerian can calm muscle spasms.
To treat anxiety
Large-scale clinical trials have found valerian is not more effective than a placebo for this use.
To treat insomnia
Large-scale clinical trials have found valerian is not more effective than a placebo for this use.
To ease menstrual cramps
No scientific evidence supports this use.
To relieve flatulence
No scientific evidence supports this use.
Research Evidence
Some studies suggest valerian can be used to treat sleeping disorders and anxiety. However, large-scale, well-designed clinical trials have found that valerian is no more effective than a placebo.
Warnings
This product is regulated by the FDA as a dietary supplement. Unlike approved drugs, supplements are not required to be manufactured under specific standardized conditions. This product may not contain the labeled amount or may be contaminated. In addition, it may not have been tested for safety or effectiveness.
Valerian should be stopped about one week before surgery, because it can interfere with general anesthesia.
Do Not Take If
You are taking barbiturates (Valerian lengthens the sedation time induced by barbiturates).
You are taking benzodiazepines (Valerian may have an additive sedative effect).
Side Effects
Headache
Uneasiness
Cardiac disturbances
Morning drowsiness when used at night for sleep promotion
Impaired alertness
Cases of liver toxicity and a withdrawal syndrome have been reported after long-term use.
Special Point
It is not yet known whether long-term use of valerian is safe. Cases of liver toxicity and a withdrawal syndrome have been reported after long-term use.
Scientific Name
Valeriana officinalis, Valerianae radix
Common Name
Garden valerian, Indian valerian, Pacific valerian, Mexican valerian, and garden heliotrope
Clinical Summary
Derived from the root of the plant. This supplement is frequently used as a sedative to improve sleep. Studies demonstrate that valerian extract is not more effective than placebo
(10) (11), however, it is unclear if the optimal doses have been used. Valerian may have an additive effect when combined with barbiturates (e.g., pentobarbital) and benzodiazepines (e.g., alprazolam or triazolam). Safety information regarding long-term use is not available, although cases of hepatotoxicity and withdrawal syndrome have been reported. Common adverse events include headaches and possible "hang-over" effect.
Purported uses
- Colic
- Insomnia
- Menstrual cramps
- Migraine treatment
- Sedation
- Spasms
- Stomach and intestinal gas
Constituents
Alkaloids: Pyridine type, actinidine, chatinine, skyanthine, valerianine, valerine
Iridoids: Valepotriates, valtrate and didrovaltrate
Volatile Oils: Monoterpenes (borneol), sesquiterpenes (b-bisabolene)
Other constituents: Caffeic and chlorogenic acids, B-sitosterol, tannins, choline
(1)
Mechanism of Action
The active ingredients are not known. However, researchers believe that a mixture of constituents (valepotriates and volatile oils) is responsible. Many researchers believe that the sedative effect is due to the valepotriates, and others believe it is due to the valepotriate decomposition products (baldrinal and homobaldrinal). In vitro, valerenic acid decreases degradation of Gamma-aminobutyric acid (GABA). Valerenic acid in animals appears to inhibit the enzyme system responsible for the central catabolism of GABA, increasing GABA concentration and decreasing CNS activity. More recent studies have shown that aqueous extracts of the roots contain appreciable amounts of GABA that could directly cause sedation, but there is some controversy surrounding the bioavailability of this compound.
(2) (3) (4)
Pharmacokinetics
One study demonstrated the onset of a sleep-promoting effect within 30 minutes of oral administration.
(8)
Warnings
Long-term use has been associated with hepatotoxicity. Patients should be warned not to drive or operate dangerous machinery if taking valerian.
Valerian should be stopped about one week before surgery because it may interact with anesthesia
(6) (9)
Adverse Reactions
Common: Headache, uneasiness, cardiac disturbances, morning drowsiness, impaired alertness
(5)
Herb-Drug Interactions
Barbiturates: Valerian lengthens the sedation time induced by barbiturates.
Benzodiazepines: Valerian may have an additive sedative effect.
(7)
Literature Summary and Critique
Jacobs B, et al. An Internet-Based Randomized, Placebo-Controlled Trial of Kava and Valerian for Anxiety and Insomnia. Medicine 2005 Jul;84(4):197-207.
An Internet-based double-blind study found that kava is no more effective than an placebo for anxiety. 391 patients were recruited through e-mail or advertisements on web sites. The participants were randomly assigned to 1 of 3 treatment groups that were given capsules containing either kava, valerian, or a placebo for 4 weeks. At the end of the study, patients who received valerian had similar improvements in anxiety symptoms and in sleep as compared to the placebo group.
References
- Newall C, et al. Herbal Medicines: A Guide for Health-Care Professionals, 2nd ed. London: Pharmaceutical Press; 1997.
- Schulz V, et al. Rational Phytotherapy: A Physicians Guide to the Use of Herbs and Related Remedies, 3rd ed. Berlin (Germany): Springer; 1998.
- De Smet PA, et al. Adverse Effects of Herbal Drugs. New York: Springer; 1997.
- Houghton PJ. The scientific basis for the reputed activity of Valerian. J Pharm Pharmacol 1999;51:505-12.
- Plushner SL. Valerian: Valerian officinalis. Am J Health Syst Pharm 2000;57:328-35.
- Upton R, et al. Valerian Root: Analytical, quality control, and therapeutic monograph. Soquel (CA): American Herbal Pharmacopoeia;1999.
- Brinker F. Herb Contraindications and Drug Interactions. Sandy (OR): Eclectic Medical Publications; 1998.
- Fachinformation: Sedalint® Baldrian, valerian extract. Sanofi Winthrop GmbH, Muenchen (Germany); 1996.
- Ang-Lee M, et al. Herbal medicines and perioperative care. JAMA 2001 Jul 11;286(2):208-16.
- Jacobs B, et al. An Internet-Based Randomized, Placebo-Controlled Trial of Kava and Valerian for Anxiety and Insomnia. Medicine 2005 Jul;84(4):197-207.
- 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.
