Valerian: Benefits, Dosage, Contraindications

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Valerian is a perennial herbaceous plant measuring 1 to 1.5 meters in height. Originally from Europe and Asia, acclimatized in the Northeast of America, valerian grows preferentially on clay-siliceous soils. It is found in shaded and moist places. Valerian has been used since ancient times for various properties, particularly for its sedative virtues. This property is the origin of its name: valeriana comes from the Latin valere, which means "to be well". The roots are the parts used in therapy. The pharmacological effects of valerian have been mainly attributed to valepotriates (iridoid esters such as valtrate), essential oils, monoterpenes, and sesquiterpene constituents. The primary monoterpene is borneol and the primary sesquiterpenes are valerenic acid and valeranone. Other potentially active constituents are flavonoids 6-methylapigenin, hesperidin, and linarin. The valepotriates decompose into other potentially active compounds, including baldrinal and homobaldrinal. The characteristic unpleasant odor of valerian has been attributed to isovaleric acid. Valerian is widely used for sleep disorders, including insomnia, and also for anxiety and stress.

Other name(s) 

Hill Valerian, Small-Leaved Valerian, Saint George's Herb

Scientific name(s)

Valeriana officinalis

Family or group: 

Plants

Active ingredients:

Flavonoids

Valepotriates

Glutamine

GABA

Valerenic Acid

Valtrate


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Sleep Disorders
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Most research shows that oral valerian modestly reduces sleep onset latency and improves subjective sleep quality. The greatest benefit is generally observed in patients who take 400-900 mg of valerian extract up to 2 hours before bedtime. Meta-analyses show that taking valerian significantly increases the chances of having improved sleep quality by 37% to 80% compared to placebo.

Posologie

posologieOral route: root

posologie400 - 900 mg

formulationdry extract


Synergies


Menopause
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Some clinical research shows that taking 225 mg of ground valerian root three times daily for 8 weeks reduces the severity of hot flashes by 47% and their frequency by 39% compared to baseline in postmenopausal women. Other clinical research shows that taking a valerian root extract at a dose of 530 mg twice daily for two months reduces the severity of hot flashes in 80% of patients and lowers their frequency by 49% compared to baseline in postmenopausal women. In both studies, these improvements were significant compared to placebo treatment, which did not improve these results.

Posologie

posologieOral route: root

posologie675 - 1060 mg

duration8 - weeks

formulationdry extract


Anxiety
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There is conflicting evidence on the efficacy of valerian for anxiety. A preliminary study shows that taking 100 mg of valerian three times daily for 21 days reduces anxiety in patients with mild anxiety. Preliminary clinical research has also reported that taking 1 to 2 capsules of valerian root 50 mg and St. John's wort 100 mg twice daily for 2 weeks improves symptoms of moderately severe anxiety more effectively than diazepam 2 mg twice daily. However, other preliminary research seems to suggest that valerian extract titrated in valepotriates or valerenic acid has no beneficial effect on generalized anxiety disorder. These inconsistencies may be due to doses or concentration of valepotriates or valerenic acids contained in the valerian preparation.

Posologie

posologieOral route: root

posologie100 - 300 mg

duration21 - days

formulationdry extract


Synergies


Stress
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Preliminary research suggests that taking 600 mg of valerian for 7 days before participating in a mental stress session significantly mitigates the corresponding increase in systolic blood pressure, heart rate, or the sensation of pressure. Other research suggests that taking 100 mg of valerian before a verbal test in front of an audience reduces subjective feelings of anxiety compared to placebo. However, this study did not determine if the difference between groups was statistically significant.

Posologie

posologieOral route: root

posologie100 - 600 mg

formulationdry extract


Nervousness
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The EMA recognizes as established, the efficacy of valerian in relieving mild nervous tension and sleep disorders.

Posologie

posologieOral route: root

posologie576 - 1350 mg

formulationdry extract


Dysmenorrhea
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Preliminary clinical research suggests that taking 255 mg of powdered valerian root three times a day for two menstrual cycles significantly reduces the duration of intense pain associated with menstruation and the need for additional analgesics.

Posologie

posologieOrally: root

posologie765 mg

formulationdry extract


Properties


Sedative

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Valerenic acid and its derivatives cause a mild sedative effect when administered orally in animals. The sedative and hypnotic action is gradual (the effect may appear only after 14 days) and would be enhanced by a lignan (hydroxypinoresinol), which binds to benzodiazepine receptors and acts synergistically with valerenic acid and valepotriates. Two flavonoids, hesperidin and linarin, would also contribute to the sedative and hypnotic effects of valerian, acting synergistically with 6-methylapigenin and valerenic acid. Several clinical trials have shown that valerian improves sleep quality and decreases the time to fall asleep.

Usages associés

Sleep Disorders, Nervousness

Anxiolytic

full-leaffull-leaffull-leafempty-leaf

The anxiolytic, anticonvulsant, and sedative effects of valerian are likely due to the action of its constituents on several receptors, including those of gamma-aminobutyric acid (GABA), adenosine A1, and serotonin (5-HT1). Valerenic acid, one of its components, acts as a GABA agonist. Valerian can increase GABA concentrations, thereby reducing the activity of the central nervous system, and bind to GABA-A receptors. It could also influence sleep regulation via adenosine and serotonin receptors. Studies suggest that valerian could also have antidepressant effects, possibly related to GABAergic mechanisms or binding to serotonin receptors (5HT1A).

Usages associés

Anxiety, Sleep Disorders, Stress, Nervousness

Antispasmodic

full-leaffull-leafempty-leafempty-leaf

This antispasmodic action is mainly due to valepotriates. These compounds act on the central nervous system centers and cause the relaxation of smooth muscles, by modulating calcium entry into the cells or binding directly to smooth muscles.

Usages associés

Dysmenorrhea


Safety dosage

Adult from 12 years: 400 mg - 600 mg

- Single dose: 400-600 mg of dry extract for relief of mild nervous tension up to 3 times per day. - Dry extract (DER 4-6:1), extraction solvent: water, single dose of 420 mg for relief of mild symptoms of mental stress up to 3 times per day. - Dry extract (DER 4-7:1), extraction solvent: methanol 45% (V/V), single dose of 144-288 mg for relief of mild symptoms of mental stress up to 4 times per day. To promote sleep, a single dose 1 hour before bedtime, with an earlier dose in the evening if necessary. - Dry extract (DER 5.3-6.6:1), extraction solvent: methanol 45% (m/m), single dose of 450 mg for relief of mild symptoms of mental stress up to 3 times per day. To promote sleep, a single dose 1 hour before bedtime, with an earlier dose in the evening if necessary.


Interactions

Médicaments

Benzodiazepines: moderate interaction

Theoretically, concomitant use with benzodiazepines may result in additive therapeutic and adverse effects. Some benzodiazepines include alprazolam (Xanax), clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), triazolam (Halcion), and others.

Alprazolam: moderate interaction

Taking a valerian extract at a dose of 1000 mg per day (providing 10 mg of valerenic acid) appears to increase levels of alprazolam by about 19%. This is very likely due to valerian's inhibitory effects on cytochrome P450 3A4 (CYP3A4) (13014). While this increase is statistically significant, it may not be clinically significant.

Cytochrome 450 3A4: moderate interaction

There is in vitro evidence that valerian may increase the metabolism of testosterone, a substrate of the cytochrome P450 3A4 (CYP3A4) enzyme, in human hepatocytes. However, other in vitro evidence shows that valerian inhibits the metabolism of dibenzylfluorescein and 7-benzyloxyresorufin induced in solution by CYP3A4. Clinical research suggests that valerian does not significantly inhibit CYP3A4 at relatively low doses of 375 mg per day, but has modest effects at higher doses of 1000 mg per day. Medications metabolized by CYP3A4 include lovastatin, ketoconazole, itraconazole, fexofenadine, triazolam, chemotherapeutic agents, and many others. Use valerian with caution or avoid in patients taking these medications.

Plantes ou autres actifs

Sedative: weak interaction

Using valerian with other herbs and supplements with sedative properties could enhance therapeutic and adverse effects. These products include calamus, California poppy, catnip, hops, kava, L-tryptophan, melatonin, sage, SAMe, St. John's wort, and others.


Precautions

Child up to 12 years: avoid

Insufficient data.

Pregnant women: avoid

Safety during pregnancy and breastfeeding has not been established. In the absence of sufficient data, use during pregnancy and breastfeeding is not recommended.

Breastfeeding women: avoid

Safety during pregnancy and breastfeeding has not been established. In the absence of sufficient data, use during pregnancy and breastfeeding is not recommended.

Surgical intervention: avoid

Valerian has depressant effects on the central nervous system (CNS). Valerian may cause additive CNS depression when used together with anesthesia and other medications during and after surgical procedures. It is advised to stop taking valerian at least two weeks before non-urgent surgical operations.