Valerian, native to the Americas, Asia, and Europe has been used to ease insomnia, stress-related anxiety, and nervous restlessness for thousands of years, with particular popularity in Europe starting in the 17th century. Now, modern day research, mainly over the last decade, has begun to confirm the scientific validity of these historic uses. It may also ease menstrual and stomach cramps, irritable bowel syndrome, some of the restlessness that accompanies attention deficit/hyperactivity disorder (ADHD) and migraine symptoms. There have also been rare reports for use to treat convulsions from a seizure disorder. Its most well-researched use, however, is as a calmant to help people sleep.

Insomnia
Valerian is a popular treatment alternative to benzodiazepines (such as diazepam and alprazolam) and other commonly prescribed medications for sleep problems because it is considered to be both safe and gentle. In studies of animals and people, valerian has demonstrated mild sedative and tranquilizing activity, as well as the ability to relieve anxiety. Generally, studies have shown that valerian reduces the time it takes to fall asleep and improves the quality of sleep itself. Plus, unlike many prescription sleep aids, valerian may have fewer after effects the next day, such as morning drowsiness. In addition, although not studied scientifically, some experts use valerian for sleep disturbances related to feelings of depression.

Valerian products are made from the root of a tall, wispy plant, which is grown to decorate gardens but also grows wild in damp grasslands. Its umbrella-like heads top grooved, erect, and hollow stems. Its dark green leaves are pointed at the tip and hairy underneath. Small, sweet-smelling white, light purple, or pink flowers bloom in June. The root is light grayish brown and has a pungent odor.

The manufacture of medicinal valerian products begins with pressed fresh root or powdered freeze-dried root (frozen below 400°C). Valerian pressed-root juice added to alcohol or glycerite (sweet, nonalcohol liquid) bases become fluid extracts or tinctures; powdered root goes into capsules and tablets.

Valerian fluid extracts and tinctures are sold in alcohol or alcohol-free (glycerite) bases. Powdered valerian is available in capsule or tablet form, and also as a tea.

Valerian products are commonly added to formulas that contain other calming herbs, such as passionflower (Passiflora incarnata), hops (Humulus lupulus), lemon balm (Melissa officinalis), skullcap (Scutellaria lateriflora), and kava (Piper methysticum). (Note: reports linking kava with severe liver damage has prompted regulatory agencies in Europe and Canada to warn consumers of the potential risks associated with this herb and even remove kava-containing products from the market. Based on these and other reports in the United States, the Food and Drug Administration (FDA) also issued a consumer advisory in March of 2002 regarding the "rare," but potential risk of liver failure associated with kava-containing products.)

Valerian products should be standardized to contain 0.8% valerenic or valeric acid; standardization helps to assure quality control in herbal products.

Pediatric

Adjust the recommended adult dose to account for the child's weight. Most herbal dosages for adults are calculated on the basis of a 150 lb (70 kg) adult. Therefore, if the child weighs 50 lb (20 to 25 kg), the appropriate dose of valerian for this child would be 1/3 of the adult dosage.

Adult

To help bring on sleep, reduce nervousness and anxiety, valerian may be taken in the following doses an hour or so before retiring, or up to three 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 C boiling water over 1 teaspoonful (2 to 3 g) of dried root, steep 5 to 10 minutes.
• Tincture (1:5): 1 to 1 1/2 tsp (4 to 6 mL)
• Fluid extract (1:1): 1/2 to 1 tsp (1 to 2 mL)
• Dry powdered extract (4:1): 250 to 500 mg
• Valerian extract, standardized to contain 0.8% valerenic acid: 150 to 300 mg.

Once sleep improves, valerian should be continued for two to four weeks. A total of four to six weeks is usually the length of treatment advised by herbalists. After six weeks, a two-week break is recommended to see if sleep has improved. (Note, however, that abruptly stopping valerian has, on very rare occasions, caused withdrawal symptoms; see Precautions. Therefore, it is important to follow the directions of a qualified practitioner when weaning off of valerian.) If there has been no improvement, another four-to-six week course of treatment may be started.

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.

The American Herbal Products Association (AHPA) gives valerian a class 1 safety rating, which indicates that it is a safe herb with a wide dosage range.

Nevertheless, some people have a "paradoxical reaction" to valerian. This means that instead of feeling calm or sleepy, they suddenly feel nervous, anxious, and restless after they take valerian and may experience palpitations (a feeling of a racing heart).

There is also some evidence that in cases where valerian has been used over a long period of time, serious withdrawal symptoms may occur when it is stopped abruptly.

Women who are pregnant or breastfeeding are advised against using valerian and, because of its tranquilizing effects, valerian should not be used while driving, operating heavy machinery, or engaging in other activities that require alertness. Also, some warn against use if you have liver disease because of a few reports of liver damage when valerian was used in combination with skullcap, another herb used for anxiety.

If you are currently being treated with any of the following medications, you should not use valerian without first talking to your healthcare provider.

Anesthesia
For those facing surgery, it is important to note that valerian may increase the effects of anesthesia and, thus, it is important to discuss the use of valerian with your healthcare providers (particularly the surgeon and anesthesiologist) well in advance of your planned operation. The doctors may advise you on how to taper use of valerian prior to the surgery. Or, they may allow you to continue use up to the time of surgery, making any necessary adjustments to the anesthesia and giving you medication to avoid possible withdrawal symptoms from the valerian while in the hospital.

Sedatives and Anti-anxiety Medications
There are no reports in the scientific literature to suggest that valerian interacts with any conventional medications. However, valerian is a sedative herb that may increase the effects of alcohol and medications for anxiety and insomnia. Valerian should not be combined with barbiturates (medications, such as pentobarbital, prescribed for sleep disorders or seizures), and should be used with caution, if at all, by people taking benzodiazepines (anti-anxiety and sleep inducing medications including alprazolam, diazepam, and lorazepam) or other sedative medications (such as antihistamines).

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