valerian (generic name)
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Interactions with Drugs
Based on animal and human studies, valerian may increase the amount of drowsiness caused by some drugs, although this is an area of controversy. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery. In one human study, a combination of valerian and the beta-blocker drug propranolol (Inderal®) reduced concentration levels more than valerian alone. A brief episode of confusion was reported in one patient using valerian with loperamide (Imodium®) and St. John's wort (Hypericum perforatum L.).
An episode of agitation, anxiety, and self-injury was reported in a patient after taking valerian with fluoxetine (Prozac®) for a mood disorder (the person was also drinking alcohol). In theory, valerian may interact with anti-seizure medications, although human data is lacking. Valerian tinctures may contain high alcohol content (15-90%) and theoretically may cause vomiting if taken with metronidazole (Flagyl®) or disulfiram (Antabuse®). Valerian may interact with certain drugs metabolized by the liver or vasopressin.
Interactions with Herbs & Dietary Supplements
Based on theoretical concerns, valerian may increase the amount of drowsiness caused by some herbs or supplements.
A brief episode of confusion was reported in one patient during use of valerian with loperamide (Imodium®) and St. John's wort (Hypericum perforatum L.). Nausea, sweating, muscle cramping, weakness, elevated pulse, and high blood pressure were reported after a single dose of a combination product with St. John's wort, kava, and valerian. Valerian may interact with certain herbs and supplements that are metabolized by the liver.
This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Samuel Basch, MD (Mt. Sinai Medical Center); Steven Bratman, MD; Cathi Dennehy, PharmD (University of California, San Francisco); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Gerald Gianutsos, PhD (University of Connecticut School of Pharmacy); Taras Hollyer, BSc, MSc (Canadian College of Naturopathic Medicine); Charles Holmes, MD (Harvard Medical School); Adrianne Rogers, MD (Boston University Medical Center); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration).
BibliographyDISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Andreatini R, Sartori VA, Seabra ML, et al. Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study. Phytother Res 2002;16(7):650-654.
Diaper A, Hindmarch I. A double-blind, placebo-controlled investigation of the effects of two doses of a valerian preparation on the sleep, cognitive and psychomotor function of sleep-disturbed older adults. Phytother.Res 2004;18(10):831-836.
Dominguez RA, Bravo-Valverde RL, Kaplowitz BR, et al. Valerian as a hypnotic for Hispanic patients. Cultur Divers Ethni Minor Psychol 2000;6(1):84-92.
Francis AJ, Dempster RJ. Effect of valerian, Valeriana edulis, on sleep difficulties in children with intellectual deficits: randomized trial. Phytomedicine 2002;9(4):273-279.
Eadie MJ. Could valerian have been the first anticonvulsant? Epilepsia 2004;45(11):1338-1343.
Garges HP, Varia I, Doraiswamy PM. Cardiac complications and delirium associated with valerian root withdrawal. JAMA 1998;280(18):1566-1567.
Garrard J, Harms S, Eberly LE, et al. Variations in product choices of frequently purchased herbs: caveat emptor. Arch Intern.Med 10-27-2003;163(19):2290-2295.
Giedke H, Breyer-Pfaff U. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry 2000;33(6):239.
Gutierrez S, Ang-Lee MK, Walker DJ, et al. Assessing subjective and psychomotor effects of the herbal medication valerian in healthy volunteers. Pharmacol Biochem Behav 2004;78(1):57-64.
Kuhlmann J, Berger W, Podzuweit H, et al. The influence of valerian treatment on "reaction time, alertness and concentration" in volunteers. Pharmacopsychiatry 1999;32(6):235-241.
Muller D, Pfeil T, von den Driesch V. Treating depression comorbid with anxiety--results of an open, practice-oriented study with St John's wort WS 5572 and valerian extract in high doses. Phytomedicine 2003;10 Suppl 4:25-30.
Stevinson C, Ernst E. Valerian for insomnia: systematic review of randomized clinical trials. Sleep Med 2000;1:91-99.
Sun J. Morning/Evening menopausal formula relieves menopausal symptoms: a pilot study. J Altern Complement Med 2003;9(3):403-409.
Taibi DM, Bourguignon C, Taylor AG. Valerian use for sleep disturbances related to rheumatoid arthritis. Holist Nurs Pract 2004;18(3):120-126.
Ziegler G, Ploch M, Miettinen-Baumann A, et al. Efficacy and tolerability of valerian extract LI 156 compared with oxazepam in the treatment of non-organic insomnia--a randomized, double-blind, comparative clinical study. Eur J Med Res 2002;7(11):480-486.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.