Ingredient review —Valeriana officinalis
What is it?
Description
Valeriana officinalis, commonly referred to as Valerian root, is a medicinal herb found in North America, Asia, and Europe that has been traditionally used to treat sleep and anxiety disorders. Valerian contains more than 150 phytochemicals, and valerian extracts are most often standardized by their valeric acid content. However, it is not fully known which constituents are primarily responsible for its effects. (26)(31)(54) Valerian’s mechanism of action is not completely understood but may be due to its stimulation of GABA transmission via positive modulation of GABA-A receptors, (7)(33) similarly to benzodiazepines (a class of sedatives). (31) However, valerian may possess certain advantages over benzodiazepines and other conventional sedatives, including lower rates of adverse events. (18)(27)(59) For example, valerian may not impair alertness, concentration, or reaction time upon awakening, (35) impair machine operation and driving ability, (22)(57) or exhibit the same extent of clinically relevant interactions with other pharmaceuticals. It is important to note, however, that valerian may theoretically have additive effects if administered in combination with other sedatives. (26)(31)
Main uses
Anxiety and stress
Behavioral and nervous system regulation
Insomnia and sleep disturbance
Premenstrual, menstrual, and postmenopausal symptoms
Formulations
Formulation
Characteristics
Dormeasan ®
Tincture containing 460 mg valerian root at a drug extract ratio (DER) of 1:10 and 460 mg of Humulus lupulus at a DER of 1:12, both of which are dissolved in 61% ethanol (15)
LI 156 (Sedonium®)
Contains 300 mg dry root extract of at a DER of 3-6:1 (14)
NSF-3
Contains 300 mg valerian standardized to 0.8% valerenic acid, 30 mg Humulus lupulus standardized to 0.35% rutin, and 80 mg Passiflora incarnata standardized to 4% isovitexin in a 410 mg tablet (38)
Songha Night™
Contains 120 mg of valerian extract at a DER of 4.5:1 and 80 mg of Melissa officinalis extract at a DER of 5:1 (32)
Valdispert ® forte
Contains 135 mg of aqueous alkaline dried valerian root extract with DER of 5-6:1 (52)
Ze 185 (Relaxane®)
Contains 90 mg of a 55% methanolic valerian root extract at a DER of 5-8:1, 90 mg of a 90% ethanolic Petasites hybridus root extract at a DER of 7-14:1, 90 mg of a 50% ethanolic Passiflora incarnata herbal extract at a DER of 3-6:1, and 60 mg of a 20% ethanolic Melissa officinalis leaf extract at a DER of 3.5-5.5:1 (40)
Dosing & administration
Anxiety & stress
General outcomes from A-level evidence
Note: evidence does not consistently report benefit in the treatment of anxiety (44)
Dosing & administration
90 mg (in Ze 185) per day for four days or 600 mg (as LI 156, Sedonium®) per day for seven days prior to a stressful event to healthy adults
Outcomes
Class of evidence
b
Dosing & administration
530 mg per day one hour before sleep for four weeks to Px with HIV using efavirenz
Outcomes
Improves anxiety score (reduced Hamilton Anxiety Rating Scale) and sleep score (reduced Pittsburgh Sleep Quality Index) (1)
Class of evidence
b
Dosing & administration
1,500 mg single dose with mefenamic acid therapy to infertile women undergoing hysterosalpingography
Outcomes
anxiety score compared with mefenamic therapy alone (23)
Class of evidence
b
Dosing & administration
100 mg (standardized to 0.8% valeric acid; 70% ethanolic extract) or 50 mg (valepotriates) three times per day for four weeks to adults with psychological stress or generalized anxiety disorder (GAD)
Outcomes
psychic factor subscale on the Hamilton Anxiety scale to a similar extent to diazepam in Px with GAD
alpha coherence (negatively correlated with improvement in anxiety scores) and theta coherence in Px with psychological stress
Class of evidence
c
Dosing & administration
100 mg valerian extract single administration one hour prior to mandibular molar extraction to Px with anxiety
Outcomes
anxiety to a similar extent as midazolam without sedation or somnolence (19)
Class of evidence
c
Dosing & administration
360 mg (as Songha Night™) with 240 mg lemon balm extract single administration prior to lab-induced stress
Outcomes
Attenuates negative effects of stressor test on anxiety
Note: higher doses increased anxiety (32)
Class of evidence
c
Cognitive function
General outcomes from A-level evidence
No data currently available.
Dosing & administration
530 mg valerian root extract twice per day for eight weeks in patients who underwent coronary artery bypass graft surgery
Outcomes
Prevents disturbance of mini-mental state examination scores by 10 days of use and reduced odds of cognitive dysfunction by ~11% (28)
Class of evidence
b
Dosing & administration
530 mg per day one hour before bed for one month to Px on hemodialysis
Outcomes
mini-mental state examination total score (50)
Class of evidence
c
Insomnia/sleep disturbances
General outcomes from A-level evidence
sleep latency and wake time after sleep onset to improve sleep duration (24)
Note: evidence does not consistently report improvement in objective measures of sleep quality such as sleep onset latency, sleep duration, sleep efficiency, or wake times. (8)(20)(36)(51)(53)(56) Inconsistency in the formulation of the valerian extract (e.g., ethanolic, aqueous, etc.) and the presence of additional ingredients such as hops may partially explain inconsistent effects (8)(12)
Dosing & administration
400-1,060 mg extract per day one hour before bed for 1-4 weeks to healthy adults or adults with insomnia
Outcomes
Class of evidence
b
Dosing & administration
120-375 mg (45% methanolic standardized extract, or Hova®) with 60-84 mg hops per night for 1-4 weeks to healthy adults or adults with mild insomnia
Outcomes
Class of evidence
b
Dosing & administration
90 mg (in Ze 185) three times per day for two weeks to adults diagnosed with somatoform disorder
Outcomes
anxiety score (measured by visual analog scale) & depression score (Beck’s Depression inventory)
Improves the Clinician’s Global Impression score (40)
Class of evidence
b
Dosing & administration
450 mg (standardized to 0.8% valerenic acid) per day one hour before bedtime for eight weeks to Px undergoing cancer therapy
Outcomes
fatigue, reports of sleep disturbance, & drowsiness (5)
Class of evidence
b
Dosing & administration
600 mg (as LI 156, Sedonium®) once or twice for 2-6 weeks to adults with primary or non-organic/non-psychiatric insomnia
Outcomes
Class of evidence
c
Dosing & administration
300 mg (in NSF-3) per day at bedtime for two weeks to adults with insomnia
Outcomes
Improves total sleep time, sleep latency, number of nightly awakenings, & insomnia severity scores to a similar extent as zolpidem (38)
Class of evidence
c
Dosing & administration
500 mg (in Ze 91019) per day for four weeks to adults with primary insomnia
Outcomes
sleep latency (34)
Class of evidence
c
Dosing & administration
800 mg dry root (containing 106 mg valeric acid) per day one hour before bed for eight weeks to adults with restless leg syndrome
Outcomes
sleepiness and restless leg syndrome symptom severity in Px with higher Epworth sleepiness scale scores (11)
Class of evidence
c
Dosing & administration
500 mg (as Valeriana edulis containing 5.52 mg valtrate/isovaltrate) one hour before bed for two weeks to children aged 7-14 with intellectual deficits and sleep difficulty
Outcomes
sleep latency & nocturnal wake times
duration of sleep & sleep quality (21)
Class of evidence
c
Dosing & administration
405 mg (as Valdispert ® Forte) three times per day for one week to healthy elderly adults
Outcomes
sleep stage 1
slow-wave sleep & density of K-complexes (52)
Class of evidence
c
Dosing & administration
460 mg (as Dormeasan® tincture) single dose to healthy adults with self-reported poor sleep
Outcomes
sleep duration and time spent in deep sleep (15)
Class of evidence
c
Dosing & administration
100 mg (as Valeriana wallichii root combination with 80% didrovaltrate, 15% valerate, and 5% acelvaltrate) three times per day for two weeks to Px with insomnia previously using chronic benzodiazepines
Outcomes
subjective sleep quality
wake time after sleep onset
May also increase sleep latency and alpha counts in slow-wave sleep (48)
Class of evidence
c
Obsessive-compulsive disorder
General outcomes from A-level evidence
No data currently available.
Dosing & administration
765 mg extract per day for eight weeks to adults
Outcomes
obsessive-compulsive behavior (47)
Class of evidence
c
Premenstrual, menstrual or postmenopausal symptoms
General outcomes from A-level evidence
No data currently available.
Dosing & administration
530 mg valerian extract twice per day for the last seven days of the menstrual cycle for three consecutive cycles, or every day for two months to women with premenstrual syndrome
Class of evidence
b
Dosing & administration
765-1,060 mg in two or three divided doses, respectively, for two months to postmenopausal women
Class of evidence
b
Dosing & administration
255 mg three times per day for three days at the start of menstruation for two consecutive cycles to women with dysmenorrhea
Outcomes
severity of menstrual pain & syncope score (41)
Class of evidence
b
Adverse effects
Reported side effects may include headaches, gastrointestinal distress, nausea, diarrhea, sweating, dizziness, drowsiness, or other psychological effects such as feelings of isolation, brain fog, depression, or irritability. Valerian does not appear to have an increased risk of any severe side effects compared to other pharmaceutical treatments or placebo groups. (8)(56) However, the likelihood of experiencing multiple adverse events per patient may be greater than placebo. (36)
Pharmacokinetics
Absorption
Distribution
- Valerenic acid in serum measurable for at least five hours in healthy adults (2)
Metabolism
Excretion
- Valerenic acid’s half-life was approximately one hour in healthy adults (2)(3)
- Similar elimination rate occurs with single- or multiple-doses, but elimination rate may be positively correlated with body weight indicating that higher range doses may be required for individuals with increased body weight (3)
Last updated: September 14th, 2020
References
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