17 February 2015

Alternatives || Valerian, aka "Nature's Valium" -- safe to use, effective? You be the judge

Many people suffering from insomnia turn to alternative medications to help them to either fall asleep or to stay asleep. Valerian is frequently touted as a useful treatment for insomnia, but does it work? Here is a breakdown of Valerian based on information that everyone should consider before taking any kind of over-the-counter supplement. Also, Dr. Timothy Morgenthaler for the Mayo Clinic offers this excellent general advice for people interested in using Valerian as a sleep aid: "Product claims may be misleading. Be a smart consumer and do a little homework. Don't just rely on a product's marketing. Look for objective, research-based information to evaluate a product's claims."

What Valerian is
Botanical illustration of  Valeriana officinalis


Valerian is a flowering plant found in grassland regions. Its root and leaves has been used for centuries to provide relief for insomniacs, often combined with hops or lemon balm to achieve a mild sedative effect. Germany's version of the FDA has approved of Valerian as an effective mild sedative; the USDA lists Valerian as "Generally Recognized As Safe" (GRAS).

How it works
Though the science is inconclusive on how Valerian works, some research shows that it can increase the amount of GABA in the brain much in the same way that some common anti-anxiety drugs work. Endogenous GABA is a chemical component of the brain which regulates nerve cells and promotes calm. Valerian may provide a similar, if lighter, effect on brain chemistry as Xanax or Valium. Some research points to using Valerian to help improve the sleep quality of people who are tapering their use of prescription sleeping pills. Other research points to the possibility that Valerian has no measurable efficacy except that it creates a placebo effect, meaning that the act of taking this medication (or others) is enough to convince the user the treatment is effective.

Research 
Dosage

According to research cited at WebMD, dosage to treat inability to sleep is "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." In all cases, it is recommended that you take Valerian 30 minutes to 2 hours before bedtime.

The University of Maryland Medical Center offers these dosage recommendations: "For insomnia, Valerian may be taken 1 - 2 hours before bedtime, or up to 3 times in the course of the day, with the last dose near bedtime. It may take a few weeks before the effects are felt.

  • Tea: Pour 1 cup boiling water over 1 teaspoonful (2 - 3 g) of dried root, steep 5 - 10 minutes.
  • Tincture (1:5): 1 - 1 1/2 tsp (4 - 6 mL)
  • Fluid extract (1:1): 1/2 - 1 tsp (1 - 2 mL)
  • Dry powdered extract (4:1): 250 - 600 mg
  • Once sleep improves, keep taking Valerian for 2 - 6 weeks.

Dr. Andrew Weil suggests using "products standardized to 1% valerenic acid."

Side effects

Use of Valerian may cause headache, excitability, uneasiness, insomnia, and next-day "hangover." It may impact performance, so users should not operate machinery or drive while taking Valerian. Pregnant women or women who are breast-feeding should be advised that there isn't enough information about the safety of taking Valerian during these situations to show that it is safe to use. Note that Valerian may depress the central nervous system and should be avoided prior to and during surgery as a safety precaution as it may dangerously impact the body's response to anesthesia.

Risk of addiction

Valerian has not been shown to be overly addictive physiologically, but Dr. Andrew Weil suggests it might become addictive psychologically.

Risk of overdose

Research has not shown evidence of Valerian overdose aside from one case which showed benign results.

Drug interactions

It is recommended that you avoid taking Valerian when drinking alcohol. Other drugs that may interact with Valerian include sedatives in the benzodiazepine and CNS depressant families. It is also important to note that Valerian may decrease the liver's ability to break down other medications, which can lead to unwanted increased effects or side effects from those medications. Dr. Andrew Weil advocates against using Valerian with kava. Other herbs and supplements which might have negative interactions with Valerian include these popular remedies: L-tryptophan, melatonin, St. John's wort, and skullcap (please note that this list is not exhaustive).



Sources consulted

Mayo Clinic/Timothy Morgenthaler, MD || Diseases and Conditions--Insomnia
Medline Plus || Valerian
National Institutes of Health/Office of Dietary Supplements || Valerian
University of Maryland Medical Center || Valerian
WebMD || Valerian
Dr. Andrew Weil || Valerian





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SleepyHeadCENTRAL strongly encourages people with ongoing sleep health problems to approach a medical professional to determine appropriate differential diagnoses and treatment. This post, like all other posts on SHC, is not intended to substitute for medical advice.