Валеріанка

Valerian is used as a sedative and sleep aid and is especially popular in Europe.

Some people take valerian for headaches, depression, menopausal symptoms, premenstrual syndrome, irregular heartbeat, and trembling. It is usually used for short periods of time (eg, 2 to 6 weeks), at dosages of 400 to 600 mg of dried root once a day 1 hour before bedtime.

In a 2006 meta-analysis of 16 randomized, placebo-controlled trials of valerian, the evidence suggested that valerian might improve sleep quality and shorten the time needed to fall asleep without producing adverse effects (1). However, there are still insufficient clinical data to confirm whether valerian is effective for insomnia (2-3). A 2011 randomized controlled trial in 100 women found that compared to placebo valerian improved sleep quality in women experiencing insomnia during menopause (4). A 2020 systematic review and meta-analysis of 60 studies (6,894 subjects) evaluated subjective sleep quality in 10 studies (1,065 subjects) and anxiety in 8 studies (535 subjects). The authors reported inconsistent outcomes possibly because of variable valerian extract quality (5). The 2017 American Academy of Sleep Medicine clinical practice guideline suggested that clinicians not use valerian as a treatment for sleep onset or sleep maintenance in adults with insomnia (6).

Two small randomized studies also reported a decrease in menopausal hot flashes with valerian compared to placebo after 4 and 8 weeks of use (7).

There is interest in using valerian to treat obsessive-compulsive disorder, and there is evidence of benefit per a pilot 8-week randomized controlled study (8). There is not enough scientific evidence to determine whether valerian works for headaches, depression, irregular heartbeat, and trembling.

Studies suggest that it is generally safe to give valerian at the usual doses. Adverse effects of valerian include headache, stomach upset, heart disturbances, and even insomnia in some people. A few people feel drowsy in the morning after taking valerian, especially at higher doses. Possible sedation from valerian may affect driving or other activities requiring alertness.

Valerian is not recommended for women who are pregnant or breastfeeding.

In vitro studies have suggested valerian to inhibit both CYP3A4 metabolism and p-glycoprotein activity (9), but no clinical studies have shown any drug metabolism interactions.

Valerian may prolong the effect of other sedatives (eg, barbiturates) and affect driving or other activities requiring alertness. Valerian should not be taken along with alcohol or sedatives.

(See also table Some Possible Dietary Supplement–Drug Interactions.)

1. 1. Bent S, Padula A, Moore D, et al: Valerian for sleep: a systematic review and meta-analysis. Am J Med 119(12):1005–1012, 2006. doi:  10.1016/j.amjmed.2006.02.026

2. 2. Fernández-San-Martín MI, Masa-Font R, Palacios-Soler L, et al: Effectiveness of valerian on insomnia: a meta-analysis of randomized placebo-controlled trials. Sleep Med 11(6):505-511, 2010. doi: 10.1016/j.sleep.2009.12.009

3. 3. Taibi D, Landis C, Petry H, et al: A systematic review of valerian as a sleep aid: safe but not effective. Sleep Med Rev 11(3):209–223, 2007. doi: 10.1016/j.smrv.2007.03.002

4. 4. Taavoni S, Ekbatani N, Kashaniyan M, et al: Effect of valerian on sleep quality in postmenopausal women: a randomized placebo-controlled clinical trial. Menopause 18(9):951-955, 2011. doi: 10.1097/gme.0b013e31820e9acf

5. 5. Shinjyo N, Waddell G, Green J: Valerian root in treating sleep problems and associated disorders-a systematic review and meta-analysis. J Evid Based Integr Med 25:2515690X20967323, 2020. doi:10.1177/2515690X20967323

6. 6. Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL: Clinical practice guideline for the tharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med 13(2):307-349, 2017. Published 2017 Feb 15. doi:10.5664/jcsm.6470

7. 7. Mirabi P, Mojab F: The effects of valerian root on hot flashes in menopausal women. Iran J Pharm Res 12(1):217-222, 2013. PMID: 24250592

8. 8. Pakseresht S, Boostani H, Sayyah M: Extract of valerian root (Valeriana officinalis L.) vs. placebo in treatment of obsessive-compulsive disorder: a randomized double-blind study. J Complement Integr Med 8, 2011. doi: 10.2202/1553-3840.1465

9. 9. Hellum BH, Nilsen OG: In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol 102(5):466-475, 2008. doi: 10.1111/j.1742-7843.2008.00227.x

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

1. National Institutes of Health (NIH): Valerian fact sheet for health professionals