If you feel highly anxious, cannot sleep, have a child with hyperactivity attention deficit issues or are a woman experiencing discomforting symptoms of PMS, menstrual syndrome or menopause, valerian may be the answer

Valerian is an ancient herb that has been used for thousands of years as a medical treatment. Current scientific research is confirming through animal and human studies that valerian is one of the most effective natural medicines to remedy insomnia and sleep disorders, hyperactivity attention deficit issues, hot flashes or night sweats during menopause, pain from premenstrual syndrome (PMS) or menstruation, anxiety and anxiety disorders, as well as anxiety before dental surgery.

1. Insomnia and Sleep Disorders

Insomnia -- the most common sleep disorder -- affects approximately one-third of U.S. adults and can increase absenteeism, health care use and social disability.^[i] Extracts of the roots of valerian have been a widely used herbal medicine for inducing sleep and improving sleep quality.^[ii]

In a systematic review of 16 studies encompassing a total of 1,093 patients, six studies showed valerian extract at doses from 300 to 500 milligrams (mg) daily clearly improved sleep quality without any side effects.^[iii]

Kava and valerian are both herbal remedies with anxiety-relieving and sedative properties without dependence potential or any appreciable side effects. In a pilot study, 24 patients suffering from stress-induced insomnia were treated for six weeks with 120 mg of kava daily followed by two weeks off treatment, and then, for another six weeks, received 600 mg of valerian daily. Total stress severity and insomnia issues were significantly relieved by both compounds with no significant differences between them.^[iv]

Sleep disturbances often reduce quality of life. About 50% of postmenopausal women experience sleep disturbances such as insomnia, which can be intensified with hot flashes.

In a clinical study of 100 postmenopausal women aged 50 to 60 years who were experiencing insomnia, subjects received either the valerian extract dose of 500 mg or a placebo twice a day for four weeks. Quality of sleep during menopause significantly improved in the valerian group compared to the placebo group.^[v]

In a similar study of 100 menopausal women aged 50 to 60 years old with sleep disorders, half received valerian with lemon balm and the other half a placebo. Valerian/lemon balm effectively reduced symptoms of sleep disorders during menopause compared to the placebo.^[vi]

Valerian in doses of 100, 200 and 300 milligrams per kilograms (mg/kg) of body weight was given in a sleep and brain activity study of rats. Sleep latency -- the time it takes to fall asleep^[vii] -- was decreased and duration of non-rapid eye movement (NREM) sleep was increased in a dose dependent manner.

The most significant changes occurred at doses of 200 and 300 mg/kg and included decreases in sleep latency and wakefulness time as well as increases of NREM sleep, total sleep durations and EEG slow wave activity during NREM sleep.

Levels of norepinephrine (NE), dopamine (DA), dihydroxyphenylacetic acid (DOPAC) -- a major dopamine metabolite -- serotonin (5-HT) and hydroxy indole acetic acid (HIAA) -- a biomarker of serotonin level -- were measured in frontal cortex and brain stem after valerian treatment at the dose of 200 mg/kg.

NE and 5HT levels decreased significantly in both frontal cortex and the brain stem. DA and HIAA levels significantly decreased only in the cortex. DOPAC level was not changed in any brain region. Valerian had a sleep quality improving effect, which may be linked to levels of monoamines -- single amino neurotransmitters such as serotonin, dopamine and norepinephrine^[viii] -- in the cortex and brain stem.^[ix]

In a study of 918 children younger than 12 years suffering from restlessness, nervous dyskoimesis -- abnormal movements or issues related to dyssomnia -- and interrupted sleep,^[x] patients were individually prescribed a valerian/lemon balm treatment. In total, 80.9% experienced improvement in dyssomnia symptoms, 70.4% decreased restlessness and the other listed symptoms, such as dyskoimesis, improved by 37.8% on average. No treatment-related adverse events occurred.^[xi]

2. Hyperactivity, Impulsivity and Concentration

In an observational study, 169 primary school children suffering from hyperactivity and concentration difficulties but not meeting attention deficit hyperactivity disorder (ADHD) criteria were treated with a daily dose of 640 mg valerian root extract and 320 mg lemon balm extract.

In those children having strong to very strong symptoms, poor ability to focus decreased from 75% to 14%, hyperactivity from 61% to 13% and impulsiveness from 59% to 22%. Parents reported highly significant improvements in social behavior, sleep and ADHD symptoms.^[xii]

Systematically reviewing the natural alternatives to ADHD drugs, a researcher recommended a combination of valerian root and lemon balm extracts to improve hyperactivity, impulsive behaviors and attention deficits in children.^[xiii]

3. Hot Flashes or Night Sweats

Hot flashes or night sweats -- caused by changes in hormone levels^[xiv] -- often are the most common and disruptive symptoms of menopausal syndrome, affecting up to 80% of middle-aged women. As a widely used herbal supplement, researchers have shown valerian possesses phytoestrogenic properties that may make it a safe and effective natural substitute for hormone replacement therapy, which is burdened by potentially serious side effects.^[xv]

In a three-month clinical trial of 60 menopausal women aged 45 to 55 years, subjects took either a placebo or valerian in a 530 mg capsule twice daily for two months. The severity of hot flashes in the valerian group was significantly lower than the placebo group at one, two and three months after the intervention.^[xvi]

Researchers studied 68 menopausal women with hot flashes assigning half to take 255 mg valerian capsules and the other half a starch capsule placebo, both taken three times a week for eight weeks. The valerian group had significant decreases in hot flash severity compared to the placebo group and a substantial reduction in hot flash frequency four (29%) and eight (39%) weeks after treatment. ^[xvii]

4. Menstrual Pain and PMS

Dysmenorrhea is the medical term for moderate to severe pain caused by menstrual periods.^[xviii] Approximately 60% of women have menstrual pain during their periods. The typical treatment for menstrual pain is a prescribed drug called mefenamic acid -- a non-steroidal anti-inflammatory drug (NSAID) with known side effects such as bloody urine or stools, vomiting, back pain, ulcers or bleeding stomach, allergic reactions and higher risk of a fatal heart attack. It's also not recommended for those who are pregnant or breastfeeding.^{[xix],[xx],[xxi]}

Naturally, due to the side effects and contraindications of this popular drug treatment for menstrual pain, many women are looking for safer options such as herbal medicines to help them. After a systematic review of the alternative medicine literature, researchers recommended a fixed dose combination of 300 mg of valerian, 80 mg of passionflower and 30 mg of humulus lupulus -- hops -- extracts to effectively reduce pain, anxiety and the associated psychological stress due to dysmenorrhea.^[xxii]

For 39 female subjects aged 16 to 42 who suffered from primary dysmenorrhea, 18 were given 300 mg of valerian and 21 took 250 mg of mefenamic acid three times a day for three days starting from the onset of bleeding or pain for three cycles. Valerian was just as effective in reducing pain and much safer than mefenamic acid. ^[xxiii]

In a trial of 100 female students, 49 received valerian at a dose of 255 mg three times daily and 51 a placebo beginning at the onset of menstruation, for two consecutive menstrual cycles. After the intervention, the pain severity from dysmenorrhea was more significantly reduced in the valerian group compared to the placebo, due to its antispasmodic effect.^[xxiv]

In a clinical trial, 100 female students with premenstrual syndrome (PMS)-- one to two weeks before a woman's menstrual period they might experience symptoms of fatigue, bloating, backaches, headaches, irritability, depression, poor sleep and anxiety^[xxv] -- were randomly divided into groups receiving valerian and placebo.

The participants received two pills daily in the last seven days of their menstrual cycle for three cycles and recorded their symptoms. A significant difference was seen in mean emotional, behavioral and physical premenstrual symptom severity in the herbal intervention group.^[xxvi]

5. Anxiety and Anxiety Disorders

Valerian is not only used as an effective treatment of insomnia, but is also used as an anxiolytic -- an anxiety-reducing agent -- due to the content of valerenic acid in valerian extracts.^[xxvii]

In a four-week clinical trial, 64 volunteers suffering from psychological stress took either valerian extract of 100 mg or a placebo three times a day. Compared with the placebo, valerian positively altered functional brain connectivity in relation to anxiety and anxiety disorders.^[xxviii]

Fifteen healthy volunteers participated in a cross-over study where subjects were required to take either 900 mg of valerian extract or placebo -- 900 mg of vitamin E. Valerian significantly reduced intracortical facilitation -- a measure of motor cortex excitability -- indicating a positive neuropsychiatric effect for anxiety.^[xxix]

In another cross-over experiment, 24 healthy volunteers received three separate single doses of 600 mg, 1200 mg or 1800 mg of combined valerian and lemon balm or a placebo, on separate days separated by a seven-day washout period.

The results showed that the 600 mg and 1200 mg doses of the combination ameliorated the negative effects of the Defined Intensity Stressor Simulation on ratings of anxiety, but the highest dose of 1800 mg showed an increase in anxiety.^[xxx]

From a mouse and rat model of nervous tension and mild sleep disorders, valerian was shown to have an anxiolytic effect in the 45% methanolic and 35% ethanolic extracts as well as in the phyotofin Valerian 368 in a dose range of 100 to 500 mg/kg per body weight.

Additionally, the phytofin Valerian 368 showed antidepressant activity in the forced swimming test after subacute treatment. Although valerian did not perform as a sedative or muscle relaxant, it was an effective anxiolytic and antidepressant agent.^[xxxi]

6. Anxiety Relief for Molar Extraction

Patients who are scheduled for dental surgery are often highly anxious. Herbal compounds are being investigated to eliminate side effects of typical drugs used to sedate patients for dental procedures. A single 100 mg dose of either valerian or a placebo was randomly administered one hour before a molar extraction procedure to 20 volunteers between 17 and 31 years of age.

Patients treated with valerian were calmer and more relaxed during surgery as observed by the majority -- 70% or more -- of researcher's and surgeon's evaluations. Valerian also had a greater effect on two markers of anxiety -- maintenance of systolic blood pressure and heart rate after surgery compared to the placebo.^[xxxii]

Twenty anxious patients undergoing third molar extractions were selected and received capsules containing 100 mg of valerian or 15 mg of the drug midazolam orally 60 minutes before the dental procedures. Although midazolam was more effective in reducing the physiological parameters studied, valerian seemed to provide the comfort and relaxation required to address stress and anxiety, with no sedation and less somnolence than midazolam, during a molar extraction.^[xxxiii]

Valerian, A Natural and Safe Herb With Powerful Properties

Valerian is one of the safest herbal medicines, which dates to ancient Greek and Roman times, to relieve sleep problems and stress/anxiety issues.^[xxxiv] More recently, it's been found to improve attention deficit/hyperactivity symptoms in children and women's health problems in PMS, menstruation and menopause such as cramping and hot flashes. If you would like to learn more, see GreenMedInfo.com's website for research on valerian.

References

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[xxiii] Kazemian A, Parvin N, et al. Comparison of Analgesic Effect of Valeriana officinalis and Mefenamic Acid on Primary Dysmenorrhea. J Med Plants 2017;4(64):153–159.

[xxiv] Mirabi P, Dolatian M, Mojab F, Majd HA. Effects of valerian on the severity and systemic manifestations of dysmenorrhea. Int J Gynaecol Obstet. 2011 Dec;115(3):285-8. doi: 10.1016/j.ijgo.2011.06.022. Epub 2011 Sep 28. PMID: 21959068.

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[xxxii] Pinheiro ML, Alcântara CE, de Moraes M, de Andrade ED. Valeriana officinalis L. for conscious sedation of patients submitted to impacted lower third molar surgery: A randomized, double-blind, placebo-controlled split-mouth study. J Pharm Bioallied Sci. 2014 Apr;6(2):109-14. doi: 10.4103/0975-7406.129176. PMID: 24741279; PMCID: PMC3983740.

[xxxiii] Farah GJ, Ferreira GZ, Danieletto-Zanna CF, Luppi CR, Jacomacci WP. Assessment of Valeriana officinalis l. (Valerian) for Conscious Sedation of Patients During the Extraction of Impacted Mandibular Third Molars: A Randomized, Split-Mouth, Double-Blind, Crossover Study. J Oral Maxillofac Surg. 2019 Sep;77(9):1796.e1-1796.e8. doi: 10.1016/j.joms.2019.05.003. Epub 2019 May 9. PMID: 31158346.

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