Valerian, a pink or white flowering plant that is native to Europe, is used as a treatment for sleeplessness and anxiety. In herbal remedies, the plant’s root is made into a tea or extract to be used primarily as a sedative. Valerian may be comparable in efficacy compared to diphenhydramine (the anti-histamine otherwise known as Benadryl, marketed as a sleep aide and allergy medication found over-the-counter).
Valerian-hops vs. diphenhydramine for insomnia:
In a randomized, placebo-controlled, parallel-group study over 28 days, 184 people with mild insomnia were randomized to either (a) standardized combination of valerian (187-mg native extracts; 5-8:1, methanol 45% m/m) and hops (41.9-mg native extracts; 7-10:1, methanol 45% m/m) or (b) placebo for 28 days (n = 65), or (c) 2 tablets of diphenhydramine (25 mg) for 14 days followed by placebo for 14 days (n = 60). Researchers tested quite a few aspects of sleep (such as time to fall asleep, length of sleep, number of awakenings) and found evidence of benefit in only a few. Compared to placebo and diphenhydramine, valerian-hops reduced the time to fall asleep. In the first 14 days of treatment, diphenhydramine significantly increased sleep efficiency and total sleep time compared to placebo. Individuals in the groups taking valerian-hops or diphenhydramine reported lower insomnia severity compared to placebo at 14 days. Additionally, quality of life was significantly better for those on valerian-hops at the end of the study period. (1)
Valerian adverse effects and interactions:
Valerian may have additive effects of sedation to alcohol, antihistamines, muscle relaxants, sedatives, anti-seizure drugs, narcotics, and drugs used in treatment of mental illnesses. In some patients, valerian has made anxiety or insomnia worse or has led to am sluggishness. One should not operate machinery after taking this herb. High doses should be avoided. Valerian may lead to additive sedation and central nervous system depression effects when taken with opioid or narcotic analgesics (2). Use of central nervous system depressant drugs should be avoided when also taking valerian. (3)
Assessment and Plan: Valerian root, valerian extract
- Individuals in the groups taking valerian-hops standardized combination of valerian (187-mg native extracts and hops (41.9-mg native extracts) or diphenhydramine reported lower insomnia severity compared to placebo at 14 days. (1)
- Valerian may have additive effects of sedation to alcohol, antihistamines, muscle relaxants, sedatives, anti-seizure drugs, narcotics, and drugs used in treatment of mental illnesses. In some patients, valerian has made anxiety or insomnia worse or lead to am sluggishness. One should not operate machinery after taking this herb. High doses should be avoided. Valerian may lead to additive sedation and central nervous system depression effects when taken with opioid or narcotic analgesics (2). Use of central nervous system depressant drugs should be avoided when also taking valerian. (3)
References:
1.Morin CM, Koetter U, Bastien C, Ware JC, Wooten V. Valerian-hops combination and diphenhydramine for treating insomnia: a randomized placebo-controlled clinical trial. Sleep. 2005 Nov;28(11):1465-71. http://www.ncbi.nlm.nih.gov/pubmed/16335333
2.Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. Journal of Clinical Pharmacology and Therapeutics 2002 Dec; 27(6): 391-401. http://www.ncbi.nlm.nih.gov/pubmed/12472978
3.Abebe W. An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations. J Dent Hyg. 2003 Winter;77(1):37-46. http://www.ncbi.nlm.nih.gov/pubmed/12704968