valerian root

Valerian (Valeriana officinalis) is a perennial plant native to Europe and Asia that has also naturalized in North America. Supplements are made from its roots and rhizomes (underground stems). In the United States it is sold as a dietary supplement and is a common ingredient in products promoted as mild sedatives and sleep aids, available in forms such as capsules, tablets, teas, and liquid extracts (tinctures).

According to NCCIH, the evidence on whether valerian helps with sleep problems is inconsistent, and the NIH Office of Dietary Supplements describes the clinical evidence for treating insomnia as inconclusive. In its 2017 clinical practice guidelines, the American Academy of Sleep Medicine recommended against using valerian for chronic insomnia in adults. NIH sources also state there is not enough evidence to draw conclusions about whether valerian helps with anxiety, depression, stress, PMS, menstrual cramps, or other conditions. Some valerian constituents have shown sedative effects in animals, but there is no scientific agreement on how it works.

There is no established standard dose. NCCIH notes that valerian has been used with apparent safety in doses of about 300 to 600 mg daily for up to 6 weeks, and clinical studies have generally used doses in or near this range taken before bedtime; the safety of longer-term use is unknown. Because the evidence is limited and supplements are not tightly regulated, talk to your doctor or pharmacist before taking valerian, especially if you are pregnant, breastfeeding, take other medicines, or have a health condition.

NIH sources indicate valerian has been used with apparent safety for short-term use by most adults, but long-term safety data are not available, so the safety of long-term use is unknown. NIH advises that people who are pregnant or nursing should not take valerian without medical advice because the possible risks to the fetus or infant have not been evaluated; children younger than 3 should also not take it for the same reason. Because valerian may cause drowsiness, use caution before driving or operating machinery.

Side effects reported with valerian include headache, stomach upset, dizziness, mental dullness, excitability, uneasiness, and vivid dreams; in one study, increased sleepiness was noted the morning after a 900 mg dose. Withdrawal symptoms have been reported after stopping long-term use. Overall, few adverse events have been documented in clinical studies, and the reported effects were often similar to those seen with placebo.

Valerian should not be combined with alcohol or with sedative medicines, because it may add to their drowsiness-causing or central nervous system depressant effects. NIH notes possible additive sedative effects with benzodiazepines (such as alprazolam, diazepam, or lorazepam), barbiturates and other CNS depressants, and sedative supplements such as kava, St. John's wort, and melatonin. Tell your doctor and pharmacist about all supplements you take so they can check for possible interactions with your medications.