VALERIAN (Valeriana Officinalis)

 

Valerian is a weed native to Europe and parts of Asia. The root (rhizome) of the plant is harvested to compound natural medicines.

Other names: All-heal, amantilla, balderbrackenwurzel, baldrian, baldrianwurzel, fragrant valerian, heliotrope, herbe aux chats, katzenwurzel, phu germanicum, phu parvum, valeriana, wild valerian.

 

We make no therapeutic claims for any product not listed with the TGA.  This information is to provide history for educational purposes only.  Only use on the advice of a registered health professional.  

 

Valerian was primarily used throughout history for insomnia and other sleep disorders.  Patients suffering withdrawal from conventional benzodiapine “sleeping pills” have been known to try Valerian to aid sleep as a natural alternative.  Valerian is frequently blended  with other sedating and calming herbal medicines such as Hops, Lemon Balm, Passionflower and others. There is some scientific evidence that Valerian may be effective, however not all studies confirm this.  (Ref 1)

 

 

Chemical components: The chemical composition of Valerian varies greatly depending on factors such as plant age and growing conditions.  Processing and storage of the herb also affects it's constituents such as iridoid esters, which are chemically unstable.  Components thought to contribute to therapeutic effect include Valerenic acid, Acetoxyvalerenic acid and Valepotriates. (Ref 5)

 

Duration of action:  Valerian has a short period of activity, with maximal Valerenic acid levels 1-2 hours post ingestion.  There is a marked decrease in levels within 4 hours and generally no detectable levels after 8 hours in the body.  Therefore Valerian does not produce residual morning sedation.  (Ref 5)

 

  

Insomnia:  Research suggests that Valerian improves the subjective quality of sleep and may reduce sleep latency, enabling people to fall asleep quicker.  A combination of Valerian with Lemon Balm or Hops is considered more effective than placebo.  Improvements are usually seen after 2 to 4 weeks of treatment.  Ethanolic Valerian extract did improve subjective sleep quality ratings in a manner similar to Benzodiazepines(Taibai et al 2007).  (Ref 5)

  

Benzodiazepine Alternative:  One double-blind trial found that subjects treated with either 600mg Valerian (ethanolic extract) or 10mg Oxazepam experienced significatly improved sleep, with no statistically significant differences detected between the treatments (Dorn 2000).   A 2002 double-blind randomised trial compared the effects of Valerian extract 600mg/day to Oxazepam 10mg for six weeks.  Subjectively, 83% of patients receiving Valerian rated it as 'very good' compared with 73% receiving Oxazepam.  (Ref 5)

 

Muscle Spasm, Cramping, Period Pain:  A double-blind randomised clinical trial involving 100 females experiencing moderate to severe period pain found Valerian provided some significant benefits compared to placebo.  (Mirabi et al 2011).  255mg of Valerian root was given three times per day for the first three days of the menstrual cycle, for two continuous cycles.  Active treatment reduced pain severity from 7.45 out of 10 at baseline to 1.99 by the second cycle.  This was compared with placebo which reduced pain from 7.06 at baseline to 4.41 in the second cycle.  Duration of pain was also shorter in the Valerian group.  (Ref 5)

 

 

Standardized extracts, tinctures, and solid formulations prepared by a health professional may provide more reliable dosage, however there is no guarantee of strength, purity, or safety of herbal medications, so effects can vary.  As with any medicinal preparation, to ensure the correct dose, patients have been encouraged to measure all liquid medications with an appropriate device such as a dropper, measuring spoon, or cup.

 

The appropriate dosage of Valerian depends on several factors such as the patient's age, health, and other medical conditions. Keep in mind that natural products are not always necessarily safe. Be sure to follow relevant directions on product labels and consult your pharmacist or physician before consuming.

 

 

The Australian Pharmaceutical Formulary 21st Edition lists the following as common dosage ranges:
Extracts are often standardised to 0.3% Valereic Acid, although other constituents may be responsible for the pharmacologic activity.  Preparations often combine Valerian with other complimentary medicines.
 
Tablets and Capsules: 
400-900mg dried root 30 to 60 minutes before bedtime for insomnia (Ref 2).
 
100-600mg dried root per day for anxiety (Ref 5)
 
Dried Root: 
1.5g-3g dry root in 150ml hot water as a decoction prior to bedtime for insomnia (Ref 2).
 
Maximum 3-9g dry root per day (Ref 5)
 
Tincture: 
1.2ml of 1:2 tincture mixed in water or juice 30 min before bed for Insomnia (equivalent to 600mg dry root) (Ref 5). 
 
or 0.2ml of 1:2 tincture prior to stressful activities.  (Ref 2, 4).
 
or 0.2ml of 1:2 tincture three times daily for benzodiazepine withdrawal (Ref 5).
 
Maximum 2-6ml 1:2 Valerian Tincture per day (Ref 5).
 
 
 
Qualified natural health practitioners may prescribe outside this dosage range.  Please do not increase dosage without professional advice.

 

As with many herbs, consuming regularly in smaller amounts has resulted in longer lasting benefits, while high doses are said to have a short lived but more intense effects. After a period of regular consumption of any herb, a pause of a few weeks is always recommended.

  

 

 
 
Valerian Tea
Tea is not the ideal method of Vallerian administration, although some literature suggests this is possible.  For best results consume at regular intervals over a period of 2-4 weeks.  Honey can be added for flavor and sweetness to mask the intense flavor and aroma of the Valerian root.
 
 
Valerian Vodka
Another common and effective way to extract and consume medicinal compounds is the use of vodka as a solvent.  Patients have been known to soak medicinal herbs such as Valerian in vodka for around 14 days to extract active compounds.
 
 
Valerian Tincture

 The most highly regarded method of administration for Herbalists and Naturopaths is via cold percolated 45% ethanol solvent tincture.  This extracts the highest percentage of water and alcohol soluble active ingredients resulting in a strong tincture which allows a patient to take a small amount of tincture for a very significant effect.  The most popular ratio of menstrum (solvent) to raw herb for Valerian is 2 parts menstrum to 1 part powdered Valerian root.  This is referred to as a 1:2 tincture. (Ref 3)

 

  

 

Valerian is LIKELY TO BE SAFE for most people when used in medicinal quantities for  short durations. The safety of long-term use is unknown. Some information suggests that Valerian might also be safe when taken by children for up to 4-8 weeks. (Ref 1)

 

 

Side effects -

Adverse effects are generally mild, transient and rare.  May cause stomach upset, headaches palpitations and insomnia.  (Ref 2)

 

It is best not to drive or operate machinery after taking Valerian and it's extracts.

 

Long term use of high doses may lead to withdrawal symptoms if ceased abruptly.  Delirium, and cardiac complications during withdrawal have been reported. To avoid possible withdrawal effects it is best to reduce the dose slowly over a week or two before ceasing. (Ref 2)

 

Other medical conditions -

Liver Problems - Use with caution in patients with hepatic impairment:  There is a theoretical risk of hepatotoxicity. (Ref 2)

Pregnancy and Breastfeeding -  Data is lacking on the safety of Valerian during pregnancy and breastfeeding.  Avoid use.

Surgery -  Valerian is a central nervous system depressant.  Anesthesia and some medications used during surgery also affect the central nervous system.  Combined effects may be harmful. Cease Valerian at least two weeks before any scheduled surgery.

 

Drug interactions -

Sedative medications are thought to interact with Valerian, possibly resulting in excessive drowsiness. .  Some sedative medications include Benzodianzepines , Zolpidem, Zoplicone, and drugs with a pharmacy warning label 1 in Australia (drowsiness as a side effect).  These medications are not totally contraindicated but should be used with caution, starting with very low doses until their combined effects in the individual patient can be established. 

 

Alcohol:  Randomised controlled trials have shown no potentiation effects with alcohol use (Ernst et al 2001).  (Ref 5)

 

Benzodiazepines:   Valerian can alter binding at Benzodiazepine receptors.  Theoretically, additive central nervous system depression may occur through enhanced GABA release and uptake inhibition.  Monitor for additive effects.  (Ref 1)

Alprazolam: Xanax, Alprax, Kalma.

Bromazepam: Lexotan.

Clobazam:  Frisium.

Clonazepam: Paxam, Rivotril.

Diazepam:  Valium, Antenex, Ranzepam.

Flunitrazepam: Hypnodorm.

Lorazepam:  Ativan.

Midazolam:

Nitrazepam:  Mogadon, Alodorm.

Oxazepam:  Serepax, Murelax, Alepam.

Temazepam: Temaze, Normison, Temtabs

Triazolam:  Halcion.

 

Common drugs with an Australian Ancillary Label 1: (CLICK FOR LINK)

 

Haloperidol:  Observe patients taking valerian concurrently with Haloperidol due to significant increase in lipid peroxidation levels in rat studies. (Ref 5)
 

 

Cytochrome P450 Substrate drugs - Studies to date have generally found minimal or no effect on CYP3A4, CYP2D6, CYP1A2, or CYP2A1 isoenzymes.  (Ref 2)

 

 

WARNING - 

Ask your Pharmacist before thinking about taking Valerian with any other medication.

 

     

    Although rare, allergic reactions to Valerian may occur. Stop taking Valerian and seek emergency medical attention if you experience symptoms of a serious allergic reaction including difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives.

     

     

    References:

    1)  http://www.webmd.com/vitamins-supplements/ingredientmono-870-valerian.aspx?activeingredientid=870&activeingredientname=valerian

     

    2) Australian Pharmaceutical Formulary 21st Edition 2009 p267.

     

    3)  Herbal Manufacture, Sharn Nulty, BHSc. DipHM. DipRM.  Byron Bay 2015

     

    4)  http://www.drugs.com/npp/valerian.html

     

    5)  Herbs and Natural supplements, an evidence based guide, volume 2, 4th edition.  Braun and Cohen 2015. p1030-1036.