Valerian (Valeriana officinalis) is used in herbal medicines for mild nervous tension and sleep problems. The roots and rhizomes are used. Benefits, dosage and risks differ according to the preparation; a plant origin guarantees neither effectiveness nor safety. This overview explains which statements are supported by evidence and when medical advice is needed.
Common valerian, botanically Valeriana officinalis, is a flowering plant native to Europe and parts of Asia that also grows in North America. The wider Valeriana genus includes many different species. Valerian has a long history of medicinal use dating to ancient Greece and Rome. Preparations include teas, tablets, drops and other oral liquids.
Certain valerian-root preparations are used for mild nervous tension and sleep disorders. Results for sleep problems are inconsistent, however; not every tea, extract or combination product has been studied equally well. An effect may develop gradually, but it is neither guaranteed after exactly 14 days nor a reason to increase the dose. Valerian does not replace treatment for high blood pressure. Tiredness, slower reactions and other side effects are possible. Source: NCCIH, Valerian.
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The European Medicines Agency distinguishes between certain dry ethanolic extracts whose use is supported by clinical studies and other preparations whose use rests on a long tradition. This does not establish effectiveness for arbitrary dietary supplements or every form of insomnia. The exact contribution of individual constituents to effects in humans is not fully understood. Laboratory findings alone do not establish a treatment for mental or physical illnesses. Source: EMA, Valerianae radix.
Side effects are possible with herbal medicines too. Their frequency and nature depend on the particular preparation. Follow the package leaflet and have symptoms assessed.
Reported effects include headaches, stomach upset, nausea, abdominal cramps, drowsiness, restlessness and vivid dreams. Not everyone experiences these symptoms; their frequency is not reliably known for every preparation. Avoid driving when your attention is impaired. Kidney problems or other new symptoms should not be self-diagnosed from a general list of side effects. Source: NCCIH.
Do not combine valerian with alcohol or other sedating substances on your own. Have a pharmacist or clinician check possible interactions; do not stop prescribed medicines yourself to do so. Long-term safety is insufficiently understood. Study durations of several weeks are not a general maximum duration for every preparation. The package leaflet and your individual treatment plan matter. Persistent or worsening sleep problems warrant a medical assessment. Source: NCCIH.
Symptoms after an overdose or signs of an allergic reaction must be taken seriously. Call emergency services for breathing difficulties or impaired consciousness: 112 in Europe or your local emergency number. Contact a poison information service or a medical professional for advice about a possible overdose.
Valerian and Liver Side Effects
Liver injury has very rarely been reported in connection with valerian, often involving products containing several herbal ingredients. This does not establish inevitable liver damage or a fixed rise in liver blood-test results. Long-term effects on the liver are insufficiently known. If your skin or eyes turn yellow, your urine becomes dark or other new symptoms develop, do not continue taking the preparation without advice; seek medical guidance promptly. Source: NCCIH, Valerian Safety.
Valerian should not be described categorically as free of dependence or withdrawal risks. Restlessness, irritability and sleep problems have been reported after prolonged use followed by abrupt stopping. This does not mean its risks are the same as those of benzodiazepines; reliable evidence about long-term use remains limited. Discuss longer-term use and stopping with a medical professional. Self-treatment is unsuitable for children and during pregnancy or breastfeeding. Source: NCCIH.
Availability without a prescription does not mean longer-term use without assessment is advisable. Record which product you use and whether it actually improves your sleep. Lack of benefit, daytime tiredness or symptoms when stopping warrant a review with a clinician or pharmacist. Increasing the dose yourself is not an appropriate solution.
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Even with a herbal preparation, do not increase the dose without advice. A diminishing effect, wanting to take it more often or symptoms when stopping are reasons to review its use. These observations alone do not establish an addiction disorder. Persistent insomnia calls for assessment of possible causes and suitable treatment options rather than continually increasing intake.
A higher dose is not automatically harmless. The European Medicines Agency describes symptoms after an overdose. Seek medical advice if an overdose is suspected. Possible symptoms include:
- Gastrointestinal problems such as diarrhea, vomiting and nausea
- Do not drive if taking the preparation makes you drowsy
An effect may develop gradually. A delayed effect is not a reason to exceed the recommended dose. If symptoms persist or worsen, speak to a doctor or pharmacist.
Avoid combining valerian with alcohol. Additional tiredness and slower reactions are possible; having no symptoms on a previous occasion does not establish safe tolerance. Other sedating substances also need consideration when checking interactions. Do not drive if drowsy or your attention is impaired. Call emergency services immediately for breathing difficulties, unconsciousness or seizures: 112 in Europe or your local emergency number. Source: NCCIH.
