Valerian root relieves anxiety and nervousness-related chronic and periodic insomnia. Herbalists have understood the mildly sedating, sleep-enhancing properties of valerian for centuries, and also recommend its use for mild stomach pains, headaches, and menstrual pain. Currently, the FDA is considering the approval of valerian root as an OTC sleep aid.

This three-to-five-foot herbaceous perennial has erect grooved, hollow stems that are hairy at the base and branch out toward the top. Dark green leaves grow in four to eight pairs from each stem; simple, pinnately lobed, and opposite, with hairy leaf veins on underside. Small fragrant flowers are white, lavender, or pink with three stamens and bloom in June in four-inch-wide panicles. Ornamental and medicinal, this perennial grows wild in damp, elevated locations.

Rhizomes, roots, and occasional stolons are sources of the crude drug. Superior preparations are light brown with a faint scent; darker, more pungent scents are considered inferior. The rhizome is one to two inches tall, ovoid, cylindrical, and light grayish-brown; with a "dirty sock" smell when dried. Darker offshoots of multiple joints with coarse longitudinal wrinkles grow from the rhizome. Stolons are gnarled and also light grayish-brown. Fresh root tastes sweet, spicy, and bitter. Soils rich in minerals grow healthier roots and provide stronger tinctures. These roots have sweeter taste and reduced "dirty sock" smell.

• Roots

The rhizome contains 0.8% to 1% iridoid valepotriates, 80% to 90% of which occur as valtrates (didrovaltrate, isovaltrate) and other iridoids. Many of these preparations no longer contain all of these constituents.

Rhizome hypodermis contains 0.3% to 0.8% volatile oil, which consists of monoterpenes and sesquiterpenes, which occur mostly as esters, including 0.1% to .03% valerenic (sometimes called valeric) as well as acetoxyvalerenic acids in medicinal valerian, as well as bornyl isovalerate, bornyl acetate, and bornyl formate. Valerian also contains alkaloids—including actinidine, valerine, and valerianine—and polyphenolic acids (caffeic and chlorogenic acids), tannins, gum, and resin.

Aqueous, aqueous-alcohol, and glycerite extracts, which are standardized to contain 0.8% valerenic acid content, are available in liquid, tablet, or capsule form. Nonstandardized dried-root material is available cut and sifted (for tea) or in capsules. Valeriana officinalis is the species most frequently used in the United States, often compounded with other sedative herbs (passionflower, hops, lemon balm, kava) to enhance relaxation and provide mild sedation.

Traditional: sedative, mild hypnotic, carminative, antispasmodic, bactericide, anodyne (pain relief), nervine

Conditions: insomnia, nervousness, stress-related anxiety, migraine, stomach or intestinal cramps, hysteria, exhaustion, and abdominal, pelvic, or menstrual cramps

Clinical applications: insomnia, anxiety, stress, fever, convulsions, neuralgia, spastic muscles, night leg cramps

The whole root drug is mildly sedating and reduces smooth muscle spasms. Actions may be due to increased concentrations of GABA (gamma-aminobutyric acid) in the synaptic cleft; increased GABA concentrations may decrease CNS activity, result in sedation, and reduce anxiety. Components in valerian extracts apparently decrease GABA catabolism, inhibit GABA uptake and release (secondary to a reversal of the Na⁺ and Ca²⁺-independent GABA carrier release of [3H]GABA), and trigger peripheral nervous system spasmolytic effects.

Individual components of volatile oil and iridoids depress the central nervous system, reduce smooth muscle spasms in laboratory animals, with positive inotropic/negative chronotropic effects on coronary smooth muscle, and reduce arrhythmia and convulsion.

In human studies, valerian enhances sleep, reduces nighttime sleep disturbances, and improves overall sleep quality (in geriatric sleep-disturbed patients, nonelderly chronic insomniacs, and periodic insomniacs) and mood.

Although clinical trials are not yet conclusive, early results suggest that valerian can be as effective as benzodiazepines for sleep disorders, without benzodiazepine "hangover" or addiction risk.

To reduce nervousness, anxiety, or headache or menstrual pain, any of the following forms and dosages may be used. Dosages repeated three times a day will also reduce sleeplessness. To relieve insomnia, patients must take a dosage at least 30 to 45 minutes before bedtime. For chronic insomnia, allow two weeks of continued use to achieve optimum therapeutic effect, then continue use for another two to four weeks.

• 2 to 3 g dried root in tea, up to several times daily
• ¹/4 to ¹/2 tsp. (1 to 3 ml) tincture, up to several times daily
• ¹/4 tsp. (1 to 2 ml) fluid extract (1:1)
• 150 to 300 mg valerian extract, dried or liquid, standardized to contain 0.8% valerenic acid, 1% to 1.5% valtrates

Valerian is a safe, mild, herbal medicine. The German Commission E lists no side effects. The American Herbal Products Association (AHPA) rates valerian class 1 (safe when used appropriately). Mild gastrointestinal upset infrequently reported. Reports that chronic use (longer than two to four months) causes insomnia are controversial. Some individuals develop a "paradoxical reaction" of nervousness and excitability with valerian (rare).

Valerian has not posed risks to fetuses or breast-fed newborns, but all pregnant and lactating women should consult with a professional when considering taking any herb.

Valepotriates, valtrate, didrovaltrate, dihydrovaltrate, and isovaltrate have cytotoxic and mutagenic properties in vitro on specific cultured tumor cells and strains of bacteria. In humans, the degradation of these substances into baldrinals and possible polymers are believed to form nonmutagenic metabolites. Although the specific risks to human stomach, liver, and intestines have not been proven, species with high valepotriate content (e.g., Mexican and Indian valerian) are not recommended, and valerenic acid preparations, such as V. officinalis, are advised.

While no clinically significant interactions between this herb and conventional medications are known to have been reported in the literature to date, including the German Commission E monograph (Blumenthal 1998), valerian does possess sedative properties; therefore, it should be used with caution, if at all, in patients taking benzodiazepines, barbiturates, or other medications with sedative potential.

Valerian is considered a dietary supplement and generally recognized as a safe food additive in the United States. It is awaiting FDA approval as an over-the-counter sleep aid. Valerian is approved in Germany by the German Commission E to treat nervous restlessness and sleeping disorders and in Canada as a sedative and spasmolytic.

Balderer G, Borbely AA. Effect of valerian on human sleep. Psychopharmacol. 1985;87:406-409.

Blumenthal M, ed. The Complete German Commission E Monographs Therapeutic Guide to Herbal Medicines. Boston: Integrative Medicine Communications; 1998:226-227.

Blumenthal M, Riggins C. Popular Herbs in the U.S. Market: Therapeutic Monographs. Austin, Tex: The American Botanical Council; 1997.

Brown D. Herbal Prescriptions for Better Health. Rocklin, Calif: Prima Publishing; 1996.

De Smet PAGM, Keller K, Hänsel R, Chandler R, eds. Adverse Effects of Herbal Drugs. Berlin: Springer; 1997:3.

Diefenbach K, et al. Valerian effects on microstructure of sleep in insomniacs. (2nd Congress of the European Assoc. for Clinical Pharmacology and Therapeutics, Berlin, Germany, Sept. 17–20, 1997) Eur J Clin Pharmacol. 1997;52(suppl):A169.

Hobbs C. The Herbal Prescriber. Santa Cruz, Calif. Botanica Press; 1995.

Kowalchik C, Hylton W, eds. Rodale's Illustrated Encyclopedia of Herbs. Emmaus, Pa: Rodale Press; 1998:495-496.

Leathwood PD. Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacol Biochem Behav. 1982;17:65-71.

Leung A, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics. 2nd ed. New York, NY: John Wiley and Sons; 1996.

Lindahl O, Lindwall L. Double-blind study of a valerian preparation. Pharmacol Biochem Behav. 1989;32:1065-1066.

Lindahl O, Lindwall L. Double-blind study of valepotriates by hairy root cultures of Valeriana officinalis var. sambucifolia. Planta Med. 1992;58:A614.

McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, Fla: CRC Press; 1997:120.

Murray MT. The Healing Power of Herbs: The Enlightened Person's Guide to the Wonders of Medicinal Plants. Rocklin, Calif: Prima Publishing; 1995.

Newall CA, Phillipson JD. Interactions of Herbs with Other Medicines. Kings Centre for Pharmacognosy, the School of Pharmacy, University of London. The European Phytojournal. 1998; 1. Available at: www.ex.ac.uk/phytonet/phytojournal.

Petkov V. Plants with hypotensive, antiatheromatous and coronarodilating actions. Am J Chin Med. 1979;7:197-236.

Samuelsson G. Drugs of Natural Origin: A Textbook of Pharmacognosy. Stockholm, Sweden: The Swedish Pharmaceutical Press; 1992.

Santos MS. Synaptosomal GABA release as influenced by valerian root extract—involvement of the GABA carrier. Arch Int Pharmacodyn Ther. 1994; 327:220-231.

Schulz V, Hänsel R, Tyler V. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin: Springer; 1998.

Seifert T. Therapeutic effects of valerian in nervous disorders: a field study. Therapeutikon. 1988;2(94).

Schultz H, Stolz C, Muller J. The effect of valerian extract on sleep polygraph in poor sleepers: a pilot study. Pharmacopsychiatry. 1994;27:147-151.

Wagner et al. Comparative studies on the sedative action of valeriana extracts, valepotriates, and their degradation products. Planta Med. 1980;39:358-365.