People around the globe use valerian to combat insomnia, anxiety, stress, and more. Science has backed up its sleep-promoting effect, while the evidence for other benefits is less convincing. Read on to learn the benefits of valerian root, how to use it for optimal results, and what side effects to expect.
What is Valerian?
Valerian (Valeriana officinalis), also known as all-heal or garden heliotrope, is a flowering plant native to Europe and parts of Asia. Since ancient times, the root of this plant has been used to treat insomnia, nervousness, trembling, headaches, and heart palpitations [1].
In the US, valerian root is mainly sold as a sleep aid, while in Europe it is used to treat restlessness, tremors, and anxiety.
Valerian flowers have a delicate scent once used in perfumes. Valerian root, however, has a very strong, earthy smell. This is because of the volatile oils and other compounds responsible for its sedative effects [2, 3].
There are over 250 species of valerian, but V. officinalis is the species most used in the West [4].
Of the others, only two are commonly used for medicinal purposes (Himalayan V. wallichii and Mexican V. edulis) [5]. This article focuses on Valeriana officinalis.
Components
Valerian consists of many biologically active components that account for its wide-ranging effects [6, 7].
Valerian’s chemical composition varies greatly, depending on the species, season, geographical source, growing condition, processing method, and storage [8, 7].
Three main chemicals are thought to be the active components of valerian: The essential oils (valerenic acid and valenol), valepotriates, and a few alkaloids, (actinidine, chatinine, shyanthine, valerianine, and valerine) [9, 4, 10, 11].
Compounds Responsible for Sedating Effects Include:
- Valerenic acid increases levels of GABA, a neurotransmitter that reduces brain cell activity. It also has anti-inflammatory effects (by reducing NF-KappaB activity) [12, 13, 14].
- Iridoids (valepotriates and their derivatives) have sedative effects, but are unstable and break down during storage or in water, making their activity difficult to assess [10, 11, 15].
- Isovaleric acid prevents involuntary muscle contractions. Its action is similar to valproic acid, which is used to treat epilepsy [16].
- Hesperidin and linarin are antioxidant flavonoids with sleep-enhancing effects. Hesperidin also has anti-seizure effects (by blocking calcium channels) [17, 18, 19].
GABA is also found in valerian extracts in quantities sufficient to cause a sedative effect, although it is not known whether it crosses the blood-brain barrier. However, the glutamine present in water (but not alcohol) extracts of valerian root can cross the blood-brain barrier and be converted to GABA [20, 21].
Mechanisms of Action
Although its influence on the GABA system is well-documented, valerian has many other modes of action which may contribute to relaxation and other health benefits [22, 23, 24, 25, 26]:
- Activates adenosine and serotonin receptors [27, 28, 29]
- Inhibits prostaglandins (responsible for painful contractions) [1, 30]
- May relax blood vessels [31]
- May reduce the stress hormone, cortisol [32]
- Suppresses inflammation (NF-kappaB activity) [14]
Health Benefits of Valerian Root
Possibly Effective:
1) Insomnia
Valerian’s mild sedative effects have been used to promote relaxation and sleep for at least 2,000 years. Valerian may improve sleep by increasing GABA levels [33, 13, 34].
In fact, lower GABA levels are found in people with short and long-term stress and are linked to anxiety and poor sleep quality [35, 36, 37].
A meta-analysis of 16 studies and 1,093 people found that valerian improved the speed of falling asleep, depth, and overall quality of sleep [38].
In a 2-day study of 27 elderly patients with mental problems, 44% reported perfect sleep and 89% reported improved sleep using a valerian preparation (containing sesquiterpenes) [39].
Additionally, a one-month-long study of 16 people with insomnia found that a single dose of valerian improved the time to achieve deep sleep and its duration [40].
Valerian may also help reduce sleep disturbances in a variety of health conditions:
- Rheumatoid arthritis [41]
- Menopause [42]
- Hypothyroidism [38]
- PTSD [43]
- HIV [44]
- Fibromyalgia [45]
- Benzodiazepine withdrawal [46]
A more recent meta-analysis (18 trials and over 1,000 patients) found that valerian’s improvement of insomnia was mainly subjective [47, 38].
While some research shows that valerian may be useful for treating short-term insomnia, there is a lack of well-designed clinical trials that support its effectiveness and safety beyond 4 to 6 weeks [48, 47, 37, 46, 49].
Rather, its main benefit seems to be promoting natural sleep after several weeks of use, without the risk of dependence or negative health effects. When used properly, it can serve as a more gentle alternative to common insomnia drugs [50, 40, 51].
2) Menopausal Symptoms
In a study of 100 menopausal women with sleep disturbances, valerian root significantly improved sleep quality after 4 weeks [42].
A 3-month study of 60 postmenopausal women found that valerian significantly improved the severity and frequency of hot flashes [52].
Insufficient Evidence:
No valid clinical evidence supports the use of valerian root for any of the conditions in this section. Below is a summary of up-to-date animal studies, cell-based research, or low-quality clinical trials which should spark further investigation. However, you shouldn’t interpret them as supportive of any health benefit.
3) Anxiety
Valerian is known as ‘nature’s valium’ because it supposedly has a similar effect on reducing anxiety as the benzodiazepines Valium and Xanax. These bind to GABA receptors in the brain (amygdala) [53, 54, 55].
One study of 2,462 adults with major depressive disorder and anxiety found that high doses of valerian (1000 mg/day) taken in combination with St John’s Wort (600 mg/ day) for 6 weeks reduced the symptoms of anxiety and depression by 66% [56].
Some researchers noticed that mice treated with valerian and valerenic acid exhibited a decrease in anxious behaviors [57].
However, one 4-week pilot study of 36 people with anxiety showed no significant differences between the valerian-treated group and placebo group [58].
Further studies should clarify the potential benefits of valerian for anxiety.
4) Stress Management
In a study of 27 patients regularly kept awake at night by stress-inducing thoughts, 89% of those patients had better sleep after one month of valerian treatment [39].
Valerian may also reduce physical reactions during stressful situations. It slowed heart rate and reduced blood pressure in response to stress in a 2-week study of 56 healthy people [59].
A 4-day study of 24 healthy volunteers found that the combination of lemon balm and valerian improved laboratory-induced stress scores at 600 mg compared to placebo, but increased anxiety at a higher dose (1800 mg) [60].
Valerian reduced physical and psychological stress in rats by maintaining serotonin and norepinephrine levels in brain regions associated with fear and anxiety (hippocampus and amygdala) [61, 62, 63, 64, 65].
In mice, valerian reduced blood levels of a hormone involved in the stress response [32].
5) ADHD
Valerian increases GABA levels in the brain. Deficiencies in GABA play a role in anxiety, restlessness, and obsessive behavior, which are symptoms often seen in ADHD [66].
In a study of 30 children aged 5 to 11, valerian (3 times a day for 2 weeks) improved ADHD symptoms (sustained inattention and impulsivity and/or hyperactivity). These positive effects disappeared one week after discontinuing valerian treatment [67].
In a 7-week study of 169 children with hyperactivity and concentration difficulties (but not meeting ADHD criteria), the combination of valerian and lemon balm decreased symptoms of restlessness, concentration difficulties, and impulsiveness [68].
Similarly, in another study of 918 children under 12 with difficulty falling asleep and restlessness, a combination of valerian and lemon balm improved symptoms in 81% of the patients with insomnia and 70.4% of the patients with restlessness without any negative effects [69].
The preliminary results are promising, but more research is needed before proclaiming valerian safe and effective for ADHD, restlessness, and similar disorders in children.
6) Menstrual Cramps
Because of this, it is commonly used to treat uterine cramping associated with painful menstrual cramps (dysmenorrhea) [30].
A 3-day study of 100 female students found that valerian was effective in relieving menstrual cramp pain compared to placebo [70].
7) Wellbeing During Cancer and HIV Treatment
An 8-week study of 227 patients undergoing cancer therapy did not support the use of valerian for insomnia, although fatigue was reduced [71].
Additionally, in a review, valerian improved insomnia and wellbeing in people undergoing treatment for cancer due to its calming effects. Contrary to popular belief, it did not interact with cancer drugs [72].
The drug efavirenz used in HIV patients is known to impair mental health and cause psychiatric disorders. In a 4-week pilot study of 51 HIV-positive patients, valerian root reduced insomnia and anxiety but failed to reduce psychosis and suicidal thoughts [44].
8) Memory and Cognitive Function
In a study of 61 patients, valerian reduced the risk of cognitive decline a month after heart surgery compared to placebo [73].
Scientists observed the potential of valerenic acid to significantly improve memory by reducing oxidative stress in the memory center of the brain (hippocampus) in mice [32].
9) Fibromyalgia
A valerian bath (3 times a week for 3 weeks) significantly improved wellbeing and sleep and decreased pain in 30 people with fibromyalgia [45].
Further research is warranted.
10) OCD
In an 8-week trial of 31 adults with OCD, valerian root reduced OCD symptoms compared to placebo [74].
There’s insufficient evidence to rate its effectiveness for OCD based on a single small trial.
11) Digestive Problems
Valerian is used as a home remedy for stomach cramps. Although it can reduce muscle spasms, current evidence does not support the use of valerian as a digestive aid [70].
In a study on guinea pigs, valepotriates and the essential oil present in valerian reduced contractions in the small intestine [75].
12) Restless Leg Syndrome (RLS)
An 8-week study of 37 people with restless leg syndrome (RLS) found that valerian significantly improved RLS symptoms and decreased daytime sleepiness [76].
However, two reviews found insufficient evidence to confirm valerian’s effectiveness in treating RLS [77, 78].
Animal and Cellular Research (Lacking Evidence)
No clinical evidence supports the use of valerian root for any of the conditions listed in this section. Below is a summary of the existing animal and cell-based research, which should guide further investigational efforts. However, the studies listed below should not be interpreted as supportive of any health benefit.
Heart Health
In test tubes, valerian strengthened blood vessels and improved their elasticity [4, 79, 31].
in animal studies, researchers examined its potential to lower blood pressure (hypertension) by relaxing blood vessels [31, 59, 4].
Seizures
Valerian reduced the frequency of seizures in one study on rats (possibly by activating adenosine receptors) [80].
Kidney Damage
In rats with high cholesterol, valerian protected against kidney damage caused by a high-fat diet [81].
Other
Although there is a popular opinion that valerian may benefit these conditions, there is no scientific evidence backing its use in:
- Shin Splints: Valerian is used as a home remedy for shin splints (medial tibial stress syndrome). Anecdotal evidence suggests that drinking valerian tea relaxes the muscles and reduces pain [82].
- Migraines and Headaches: Despite its traditional use, the evidence is lacking for valerian reducing the severity of migraines and headaches [83].
- Joint Pain in Arthritis: Despite the historical use of valerian to relieve joint pain, there are no studies to support this. Anecdotal reports of its effectiveness may be due to its general calming effects [84].
- Sciatica Pain: People with sciatica taking valerian report some pain relief. This may be due to its muscle relaxant effects [85].
- Hand Tremors: Valerian may reduce hand tremors through its anti-anxiety effects. However, the evidence is anecdotal [86].
- Heart Palpitations: Valerian is traditionally known to decrease heart palpitations. It may do this by its relaxing effects on smooth muscle, but the evidence is lacking [87].
- Depression in Bipolar Disorder: The sedative effects of valerian may improve depression in bipolar disorder. However, there is no clinical evidence available to support this, although valerian did improve depression in rats [88].
Limitations and Caveats
Valerian illustrates both the negative and positive aspects of herbal drugs. The variability in its composition and the instability of some of its chemicals make standardization difficult [21].
The composition of any valerian product may vary considerably between manufacturing lots, as dietary supplements are not always tested for consistency and seasonal variations in valerian’s many active compounds are known [8].
No information is available about the long-term safety of valerian or its safety in children younger than age 3, pregnant women, or nursing mothers. Studies on rats indicate caution [89, 2, 90].
A great volume of research exists, although a lot of information is anecdotal. Human studies to date have not been based on sound practices [51, 91, 92, 51, 93].
Valerian Root Risks and Side Effects
This list does not cover all possible side effects. Contact your doctor or pharmacist if you notice any other side effects. In the US, you may report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada, you may report side effects to Health Canada at 1-866-234-2345.
Valerian is likely safe when taken for 4 to 8 weeks by healthy adults at recommended doses. Long-term safety data are not available. In rare cases, it can cause mild side effects, such as [94, 49]:
- Headaches
- Digestive upset
- Excitability
- Dry mouth
- Thinking problems
- Strange dreams
Valerian has been classified as “generally recognized as safe” in the US [95].
Other Risks and Precautions
- Allergic Reaction: People with allergies to plants in the Valerianaceae family may be allergic to valerian [90].
- Addiction: Medical reports link overuse of valerian to liver toxicity and addictiveness [96, 97].
- Drowsiness: At high doses, daytime drowsiness can occur and caution is advised while driving or operating machinery [90, 98, 99].
- Increased Effects of Anesthetics: If you need surgery, stop taking valerian at least 2 weeks ahead of time. Valerian may increase the effects of anesthetics that act on GABA receptors [13].
- Withdrawal Symptoms: Heart problems and delirium might occur if valerian is stopped suddenly [100].
- Overstimulation: At high doses, excitation may occur in some people [60].
- Suicide: Researchers report 1 case of attempted suicide after a massive overdose on valerian [101].
Drug Interactions
Herb-drug interactions can be dangerous and, in rare cases, even life-threatening. Always consult your doctor before supplementing and let them know about all drugs and supplements you are using or considering.
Animal studies and anecdotal reports suggest that valerian may increase both beneficial and side effects caused by sedative drugs. Examples include [90, 102]:
- Benzodiazepines, such as lorazepam (Ativan)
- Barbiturates, such as phenobarbital
- Narcotics, such as codeine
- Antidepressants, such as fluoxetine (Prozac)
- Antihistamines, such as diphenhydramine (Benadryl)
- Alcohol
- Anti-seizure drugs
However, there is little evidence for clinically relevant interactions in humans [103].
Valerian may increase levels of drugs metabolized by CYP450 by inhibiting these enzymes (e.g. lovastatin, triazolam, chemotherapeutic agents) in animals [90].
However, clinical studies show minimal effects on CYP3A4 activity and no effect on CYP2D6 activity in healthy volunteers [104].
Valerian tinctures may have high alcohol content (15 to 90%) and theoretically may cause side effects if taken with drugs like metronidazole (Flagyl) or disulfiram (Antabuse) [90].
Valerian may affect the response to anesthetics by prolonging the time until wakefulness [105, 13].
Valerian Sources and Supplements
Valerian-based supplements have not been approved by the FDA for medical use. In general, regulatory bodies aren’t assuring the quality, safety, and efficacy of supplements. Speak with your doctor before supplementing.
The roots and rhizomes (underground stems) and stolons (horizontal stems) of valerian are used to make supplements, including capsules, tablets, and liquid extracts, as well as teas [7, 106].
Even in standardized plant extracts, there is some variation in the number of different chemicals, which may account for different reports of efficiency. However, the clinical effects are remarkably consistent across different preparations [7].
Valerian is sometimes combined with other herbs such as lemon balm, passion flower, and hops [49].
Dosage
The below doses may not apply to you personally. If your doctor suggests using valerian root, work with them to find the optimal dosage according to your health condition and other factors.
Doses range from 400-450 mg in insomnia clinical trials. Doses were taken 1-2 hours before bed, or up to 3 times in one day. Once sleep improved, treatment continued for 2 to 6 weeks [107, 98, 108, 39].
Recommended doses range from 400-900 mg at bedtime [21].
Valerian is most effective if taken regularly for 2 or more weeks. It may take a few weeks before the effects of valerian root supplementation are felt [90].
Higher dosages may have a stimulating effect, so it is best to start with a minimal dose and use the lowest dose needed to achieve the desired effect [21].
User Experiences
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Valerian root is often combined with other sedating herbs, such as hops (Humulus lupulus), St. John’s Wort, kava, and lemon balm (Melissa officinalis) to treat insomnia.
Insomnia:
“…when I drink a valerian tea before going to sleep when I wake up in the morning, I feel like I had a heavy sleep but a good one, you know, like the nights you got in holidays when all your stress goes away and you sleep like a baby.”
“I work nights and from time to time have difficulty staying asleep once I fall asleep. Taking valerian root has really helped with that problem. I started taking valerian when I was traveling a lot to help prevent jet lag and it really helped with that problem as well.”
“I take 3 to 4 valerian root capsules as a sleep aid. I also find myself dreaming more, or at least remembering more dreams.”
Anxiety:
“Helps me more compared to Lexapro, Celexa, Xanax, Vistaril, etc. without negative side effects. The only side effect experienced is tiredness, which is manageable compared to suicidal tendencies caused by other medications.”
“When I am feeling anxious or nervous, I take one capsule and it helps to take the edge off my nervousness without making me drowsy. I have had no side effects from the drug.”
Fibromyalgia:
“I was recently diagnosed with fibromyalgia. I actually could feel my entire body relax. I’ve just finished my Extra Sleepy Time Tea – I used 4 bags for 100 mg. The first time I did this I woke up feeling well-rested and refreshed. I can’t remember the last time I woke up feeling “good” vs. my joints cracking and moaning when I first get moving!”
Menopause:
“It works! It also seems to help reduce my hot flashes due to menopause.”
“I have been having a hard time getting to sleep (hot flashes, anxiety, etc.). I am so happy that I found valerian. Not only has it made me sleep well, but it is also helping with my anxiety and ADD… an added effect I did not know would happen. I am so happy!”
Asperger’s Syndrome:
“Valerian root has been very beneficial for symptoms of my Asperger’s syndrome. Anxiety in social situations and overstimulation cause the inability to sleep well and that will cause problems at school and work. I started taking 2 of the 450 mg Valerian root every night after a week I noticed I could function better during the day and less anxious in a college setting. Warning, do not drink alcohol before bedtime when taking valerian. They don’t mix.”
Valerian Root vs. Melatonin
Both valerian and melatonin are sleep aids, although their mechanisms are different.
Sometimes they are combined together but caution is warranted, as the sedative effect may be too high [109].
Melatonin is a hormone produced by the pineal gland. It is affected by light and dark and controls the body’s sleep-wake cycle or circadian rhythm. Low melatonin levels are linked to insomnia [110].
Studies have shown lower doses of melatonin are more effective in promoting sleep [110].
As with valerian, too high a dose can have the reverse effect, making it more difficult to fall and stay asleep. Even melatonin is only a short-term solution as it loses effectiveness with long-term use [111].
