Natural Products

Valerian

Valeriana officinalis

Efficacy

• Indications with proven efficacy:
  Nervous states
• Also used for these other indications, but with no proof of efficacy:
  Fatigue
  Hypochondria
  Intestinal cramps
  Migraine
  Rheumatic pain
  Sleeping disorders

Security

• Risk of Drug Interactions: Low
• Adverse Effects: Not Frequent

What is it?

Valerian is a perennial plant indigenous to Europe and North America. It contains valepotriate and valerenic acid, substances exclusive to valerian, which are thought to be responsible for its medicinal properties. The applicable part of the plant are the roots. Because the safety of valepotriate is not well established (some studies suggest that they might be mutagenic), most standardized products contain only valerenic acid (0.8% extracts), but products vary widely and are not uniform in content.

Valerian preparations are marketed in capsules, tea and tincture.

It seems that valerian's active principles are capable of binding to benzodiazepine receptors in the brain. Benzodiazepines are a well known family of anti-anxiety agents, of which Valium and Ativan are the most commonly known. However, valerian's effect is not similar to that of the benzodiazepines, since it does not cause altered mental capacity, residual effect the following day or dependence with long-term use.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) or homeopathic medicine number (DIN-HM) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plants content varies naturally from plant to plant – just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

Does it work?

Valerian has been shown effective to treat nervous states. It appears to improve the quality of sleep by decreasing the onset and increasing the duration of sleep. Its effects appear to be dose-related. Two to four weeks of used may be necessary to reach its full effect.

• Nervous states:
  To relieve nervousness and anxiety:
  Extract – 600 to 1800 mg per day in 3 or 4 divided doses
  Tea – 2 to 3 grams root per cup, one or several times a day
  Tincture – 1 to 3 mL, one or several times a day
• Insomnia:
  To treat insomnia:
  Extract – 150 to 900 mg ½ to 2 hours before bedtime
  Tea – 2 to 3 grams root per cup, in the evening
  Tincture – 4 to 6 mL, in the evening

Is it safe?

• Valerian is not associated with any specific toxicity. Adverse effects are not frequent, but some users may experience residual drowsiness, headaches, excitation, discomfort, mild gastrointestinal discomfort, and cardiac disturbances. Intoxication is associated with the following symptoms: coordination problems, decreased body temperature and muscle relaxation. Intake of valerian before driving a car is not recommended.
• Since there is no safety data available concerning its use during pregnancy and breast-feeding, pregnant and lactating women should not use valerian.
• In theory, valerian may increase the sedative effect of alcohol, barbiturates, benzodiazepines and other sedatives. Before taking valerian, check with your pharmacist to make sure that there are no interactions with your regular medication.

Clinical notes

• Valerian appears to be a mild and safe sedative. To reach its full effect, it may be necessary to use it over at least 2 to 4 weeks.

References

1. Blumethal M et al. The Complete German Commission E monographs, 1998
2. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2007
3. Lininger S. et Al. The Natural Pharmacy, Prima Health, 1998
4. Barnes J. et Al. Herbal Medicines, 2nd edition, Pharmaceutical Press, 2002
5. Pierce Andrea, Practical Guide to Natural Medicines, 1999
6. Passeportsanté.net. Valériane. http://www.passeportsante.net
7. Taylor J. CE: Phytomedicinals: Uses, precautions, and drug interactions. Drug Topics 2003;1:79
8. Rotblatt M. et Ziment I. Evidence-Based Herbal Medicine, Hanley & Belfus, 2002