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Valerian


What is it?

Valerian is an herb. Medicine is made from the root.

Valerian is most commonly used for sleep disorders, especially the inability to sleep (insomnia). It is frequently combined with hops, lemon balm, or other herbs that also cause drowsiness. Some people who are trying to withdraw from the use of “sleeping pills” use valerian to help them sleep after they have tapered the dose of the sleeping pill. There is some scientific evidence that valerian works for sleep disorders, although not all studies are positive.

Valerian is also used for conditions connected to anxiety and psychological stress including nervous asthma, hysterical states, excitability, fear of illness (hypochondria), headaches, migraine, and stomach upset.

Some people use valerian for depression, mild tremors, epilepsy, attention deficit-hyperactivity disorder (ADHD), and chronic fatigue syndrome (CFS).

Valerian is used for muscle and joint pain. Some women use valerian for menstrual cramps and symptoms associated with menopause, including hot flashes and anxiety.

Sometimes, valerian is added to bath water to help with restlessness and sleep disorders.

In manufacturing, the extracts and oil made from valerian are used as flavoring in foods and beverages.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for VALERIAN are as follows:

Possibly effective for...

  • Inability to sleep (insomnia). Some research suggests that valerian does not relieve insomnia as fast as “sleeping pills.” Continuous use for several days, even up to four weeks, may be needed before an effect is noticeable. Valerian seems to improve the sleep quality of people who are withdrawing from the use of sleeping pills. Not all evidence is positive, however. Some studies have found that valerian doesn’t improve insomnia any better than a “sugar pill” (placebo).

Insufficient evidence to rate effectiveness for...

  • Anxiety. There is contradictory evidence about the effectiveness of valerian for anxiety. Some people have reported that it seems to reduce stress in social situations. Yet, other studies have shown no effect.
  • Depression. Some early research suggests that taking valerian plus St. John’s wort improves symptoms of depression. Taking higher doses of valerian with St. John’s wort improves depression symptoms faster than low doses.
  • Restlessness. A specific combination product, providing valerian root extract 160 mg and lemon balm leaf extract 80 mg (Euvegal forte, Schwabe Pharmaceuticals), has been tried to reduce symptoms of serious restlessness (dyssomnia) in children under the age of 12. Early results show it might be effective, but more research is needed.
  • Menstrual disorders (dysmenorrhea). Early research suggests that taking valerian three times daily for two menstrual cycles reduces pain and the need for other pain relievers during menstruation.
  • Stress. Early research suggests that taking 600 mg of valerian for 7 days reduces blood pressure, heart rate and feelings of pressure when under stress. Other research found that taking 100 mg before speaking in front of an audience reduces feelings of anxiety. Another study found that taking a combination product containing valerian and lemon balm night lower anxiety caused by stress at low doses but increase anxiety when taken in larger doses.
  • Convulsions.
  • Mild tremors.
  • Epilepsy.
  • Attention-deficit hyperactivity disorder (ADHD).
  • Chronic fatigue syndrome (CFS).
  • Muscle and joint pain.
  • Headache.
  • Stomach upset.
  • Menopausal symptoms including hot flashes and anxiety.
  • Other conditions.
More evidence is needed to rate the effectiveness of valerian for these uses.

How does it work?

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Valerian seems to act like a sedative on the brain and nervous system.

Are there safety concerns?

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Valerian is LIKELY SAFE for most people when used in medicinal amounts short-term. Clinical studies have reported safe use of valerian for medicinal purposes in over 12,000 people in trials lasting up to 28 days. The safety of long-term use is unknown. Some information suggests that valerian might also be safe when taken by children for 4-8 weeks.

Valerian can cause some side effects such as headache, excitability, uneasiness, and even insomnia in some people. A few people feel sluggish in the morning after taking valerian, especially at higher doses. It’s best not to drive or operate dangerous machinery after taking valerian. The long-term safety of valerian is unknown. To avoid possible side effects when discontinuing valerian after long-term use, it's best to reduce the dose slowly over a week or two before stopping completely.

Special precautions & warnings:

Pregnancy or breast-feeding: There isn’t enough information about the safety of valerian during pregnancy or breast-feeding. Stay on the safe side and avoid use.

Surgery: Valerian slows down the central nervous system. Anesthesia and other medications used during surgery also affect the central nervous system. The combined effects might be harmful. Stop taking valerian at least two weeks before a scheduled surgery.

Are there interactions with medications?

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Major

Do not take this combination.

Alcohol
Alcohol can cause sleepiness and drowsiness. Valerian might also cause sleepiness and drowsiness. Taking large amounts of valerian along with alcohol might cause too much sleepiness. However, some research has found that combining valerian with alcohol does not increase sleepiness.

Moderate

Be cautious with this combination.

Alprazolam (Xanax)
Valerian can decrease how quickly the liver breaks down alprazolam (Xanax). Taking valerian with alprazolam (Xanax) might increase the effects and side effects of alprazolam (Xanax) such as drowsiness.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Some medications are changed and broken down by the liver. Valerian might decrease how quickly the liver breaks down some medications. Taking valerian along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking valerian, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

Sedative medications (Benzodiazepines)
Valerian might cause sleepiness and drowsiness. Drugs that cause sleepiness and drowsiness are called sedatives. Taking valerian along with sedative medications might cause too much sleepiness.

Some of these sedative medications include alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), triazolam (Halcion), and others.

Sedative medications (CNS depressants)
Valerian might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking valerian along with sedative medications might cause too much sleepiness. Taking valerian along with sedative medications used in surgery might cause prolonged sedation.

Some sedative medications include pentobarbital (Nembutal), phenobarbital (Luminal), secobarbital (Seconal), thiopental (Pentothal), fentanyl (Duragesic, Sublimaze), morphine, propofol (Diprivan), and others.

Minor

Be watchful with this combination.

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Some medications are changed and broken down by the liver. Valerian might decrease how quickly the liver breaks down some medications. Taking valerian along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking valerian, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

Are there interactions with herbs and supplements?

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Herbs and supplements with sedative (sleep-inducing) properties
Use of valerian with other herbs and supplements that act as sedatives might cause too much sleepiness in some people. This combination might also increase the side effects of valerian.

Some of the herbs and supplements with sedative effects include calamus, California poppy, catnip, hops, Jamaican dogwood, kava, L-tryptophan, melatonin, sage, SAMe, St. John's wort, sassafras, skullcap, and others.

Are there interactions with foods?

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Alcohol
When used with alcohol, valerian might cause too much sleepiness. However, some research has found that combining valerian with alcohol does not increase sleepiness.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For inability to sleep (insomnia):
    • 400-900 mg valerian extract up to 2 hours before bedtime for as long as 28 days, or
    • Valerian extract 120 mg, with lemon balm extract 80 mg 3 times daily for up to 30 days, or
    • A combination product containing valerian extract 187 mg plus hops extract 41.9 mg per tablet, 2 tablets at bedtime for 28 days.
Take valerian 30 minutes to 2 hours before bedtime.

Other names

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All-Heal, Amantilla, Baldrian, Baldrianwurzel, Belgium Valerian, Common Valerian, Fragrant Valerian, Garden Heliotrope, Garden Valerian, Grande Valériane, Guérit Tout, Herbe à la Femme Meurtrie, Herbe aux Chats, Herbe aux Coupures, Herbe de Notre-Dame, Herbe de Saint-Georges, Herbe du Loup, Indian Valerian, Mexican Valerian, Pacific Valerian, Rhizome de Valériane, Tagar, Tagar-Ganthoda, Tagara, Valeriana, Valeriana angustifolia, Valeriana edulis, Valeriana jatamansii, Valeriana officinalis, Valeriana Pseudofficinalis, Valeriana Rhizome, Valeriana sitchensis, Valeriana wallichii, Valerianae Radix, Valeriane, Valériane, Valériane à Petites Feuilles, Valériane Africaine, Valériane Celtique, Valériane Commune, Valériane de Belgique, Valériane des Collines, Valériane Dioïque, Valériane du Jardin, Valériane Indienne, Valériane Mexicaine, Valériane Officinale, Valériane Sauvage.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Valerian page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/870.html.

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