Valerian

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

A 2020 systematic review and meta-analysis of 60 studies (6,894 subjects) evaluated subjective sleep quality in 10 studies (1065 subjects) and anxiety in 8 studies (535 subjects). The authors reported inconsistent outcomes possibly because of variable valerian extract quality (A 2020 systematic review and meta-analysis of 60 studies (6,894 subjects) evaluated subjective sleep quality in 10 studies (1065 subjects) and anxiety in 8 studies (535 subjects). The authors reported inconsistent outcomes possibly because of variable valerian extract quality (1). 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 (). 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 (2).

A 2024 umbrella review of 8 systematic reviews in 15,716 subjects reported that there was no evidence of benefit of valerian for objective measures of insomnia (A 2024 umbrella review of 8 systematic reviews in 15,716 subjects reported that there was no evidence of benefit of valerian for objective measures of insomnia (3).

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

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 (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 (5). There is not enough scientific evidence to determine whether valerian works for headaches, depression, irregular heartbeat, and trembling.). 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.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. Valerian is not recommended for women who are pregnant or breastfeeding.

In vitro studies have suggested that valerian inhibits both CYP3A4 metabolism and p-glycoprotein activity (In vitro studies have suggested that valerian inhibits both CYP3A4 metabolism and p-glycoprotein activity (6), 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.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–Medication Interactions.)

1. 1. Shinjyo N, Waddell G, Green J. Valerian root in treating sleep problems and associated disorders-a systematic review and meta-analysis. . 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

2. 2. Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic 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

3. 3. Valente V, Machado D, Jorge S, Drake CL, Marques DR. Does valerian work for insomnia? An umbrella review of the evidence. . Does valerian work for insomnia? An umbrella review of the evidence.Eur Neuropsychopharmacol. 2024 May;82:6-28. doi: 10.1016/j.euroneuro.2024.01.008

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

5. 5. 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.. 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

6. 6. 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 forHealth Professionals