About Herbs

Bottom Line: Valerian has been shown in some studies to improve sleep.

Scientists are uncertain which compounds in valerian are responsible for its actions. In laboratory experiments, an extract of valerian prevented 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 a calming effect. The roots of valerian also contain considerable amounts of GABA.
Some studies have shown that valerian improves sleep and may help anxiety disorders. More research is needed.

Some studies suggest that valerian may help sleeping disorders and anxiety, but other research showed that valerian is no more effective than a placebo. A review of clinical trials found small improvements in sleep with valerian. Further study is needed to determine the correct dose.

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.

You are taking Barbiturates (Valerian lengthens the sedation time induced by barbiturates).

You are taking Benzodiazepines (Valerian may have additive effects).

You are taking Haloperidol (Valerian may have an additive effect causing hepatic damage).

Garden valerian, Indian valerian, Pacific valerian, Mexican valerian, and garden heliotrope

Valerina Forte®

Derived from the root of the plant, this supplement is frequently used as a sedative to improve sleep. Although the active ingredients are not known, a mixture of constituents (e.g., valepotriates and volatile oils) is thought to be responsible for its biological activity. Valerian exhibited antioxidant ⁽¹⁹⁾ and cytoprotective ⁽²⁰⁾ effects in vitro.
While some studies demonstrate that the sleep-inducing properties of valerian extract are not more effective than placebo ^{(1) (2)}, a meta-analysis concluded that modest improvements in sleep quality may be obtained with valerian. Additional research is necessary to determine the optimal dose ⁽³⁾.
Valerian may have an additive effect when combined with barbiturates (e.g., pentobarbital) and benzodiazepines (e.g., alprazolam or triazolam) ⁽¹⁸⁾. Safety information regarding long-term use is not available, although cases of hepatotoxicity ⁽⁴⁾ and withdrawal syndrome have been reported.

Colic

Insomnia

Menstrual cramps

Migraine treatment

Sedation

Spasms

Stomach and intestinal gas

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
⁽⁷⁾

Many researchers believe that the sedative effect of valerian 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, and direct binding of valerenic acid to GABA-receptors has been demonstrated ⁽⁸⁾. Aqueous extracts of the roots contain appreciable amounts of GABA that could directly cause sedation, but some controversy surrounds the bioavailability of this compound.
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One study demonstrated the onset of a sleep-promoting effect within 30 minutes of oral administration.
⁽¹²⁾

Long-term use has been associated with hepatotoxicity ⁽⁴⁾. 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.
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Common: Headache, uneasiness, cardiac disturbances, morning drowsiness, impaired alertness ⁽¹⁵⁾.
Case Report: Long-term use of valerian has been reported to cause hepatotoxicity in a 27-year-old woman. The symptoms improved following discontinuation of valerian use ⁽⁴⁾.

Barbiturates: Valerian lengthens the sedation time induced by barbiturates.
Benzodiazepines: Valerian may have synergistic effects ⁽¹⁸⁾.
Haloperidol: Valerian may have an additive effect causing hepatic damage ⁽¹⁷⁾.

Valerian inhibited cytochrome P450 (CYP) 2D6 ⁽⁵⁾ and to some extent CYP3A4 ⁽⁶⁾, and may interact with substances metabolized by these enzymes.

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.

Oxman AD, et al. A televised, web-based randomised trial of an herbal remedy (valerian) for insomnia. PLoS ONE. 2007;2(10):e1040.
In this randomized, double-blind, placebo-controlled study, 405 participants with insomnia were recruited via television and the internet. Participants were mailed valerian (200 mg tablets) or placebo tablets and took 3 tablets 1 hour before bed-time for 2 weeks. Although no differences in self-reported sleep quality were detected, participants in the intervention group reported better outcomes on the global self-assessment question and a trend toward improved sleep duration and reduced night awakening was observed. The authors concluded that valerian had modest effects on sleep quality compared to placebo. Because the optimal dose of valerian is unknown, the potential benefit of larger dosages awaits further study.

1. 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. Oct 2004;18(10):831-836.
2. Jacobs BP, Bent S, Tice JA, et al. An internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia. Medicine (Baltimore). Jul 2005;84(4):197-207.
3. Bent S, Padula A, Moore D, et al. Valerian for sleep: a systematic review and meta-analysis. Am J Med. Dec 2006;119(12):1005-1012.
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8. Benke D, Barberis A, Kopp S, et al. GABA(A) receptors as in vivo substrate for the anxiolytic action of valerenic acid, a major constituent of valerian root extracts. Neuropharmacology. Jun 17 2008.
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12. Fachinformation: Sedalint® Baldrian, valerian extract. Muenchen (Germany): Sanofi Winthrop GmbH; 1996.
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14. Upton R. Valerian Root: Analytical, quality control, and therapeutic monograph. Soquel (CA): American Herbal Pharmacopoeia; 1999.
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16. Brinker F. Herb Contraindications and Drug Interactions. 3rd ed. Sandy (OR): Eclectic Medical Publications; 2001.
17. Dalla Corte CL, Fachinetto R, Colle D, et al. Potentially adverse interactions between haloperidol and valerian. Food Chem Toxicol. 2008 Jul;46(7):2369-75.
18. Carrasco MC, Vallejo JR, Pardo-de-Santayana M, et al. Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam. Phytother Res. 2009 May 13. [Epub ahead of print].
19. Sudati JH, Fachinetto R, Pereira RP, et al. In vitro antioxidant activity of Valeriana officinalis against different neurotoxic agents. Neurochem Res. 2009 Aug;34(8):1372-9.
20. de Oliveria DM, Barreto G, De Andrade DV, et al. Cytoprotective effect of Valeriana officinalis extract on an in vitro experimental model of Parkinson disease. Neurochem Res. 2009 Feb;34(2):215-20.