Valerian trials by Jill Hoppe, Certified Herbalist Medical Herbalism 12(1):16-18 A controlled and double-blind German study evaluated whether valerian root extract impaired reaction time, alertness and concentration the morning after administration, in 102 people. A computer-assisted application measured reaction time, alertness, two-handed coordination, sleep quality, and visual discrimination tasks. One group took 600 mg. valerian root extract (LI 156), another took 1 mg. of the benzodiazepine flunitrazepam (Rohypnol), and a third group took placebo. The next morning, valerian did not impair reaction abilities, concentration or coordination in any patient. After fourteen days of nightly administration, a second evaluation took place. Patients taking valerian or placebo did not experience significant negative impact. The researchers concluded that single or repeated use of 600 mg. valerian root extract does not have a negative effect on reaction time, alertness and concentration the morning after intake. (Kuhlmann). In a recent Gallup survey, 36% of American respondents reported insomnia complaints. The benzodiazepine tranquilizers (valium, xanax, etc.) are the most widely used substances for the treatment of sleep disorders. Benzodiazepines effectively induce sleep, but they are addictive and have other side effects including impaired coordination, negative effects on memory, confusion, lethargy, weakness and rebound insomnia after withdrawal. Valerian may be a useful alternative for people with sleep problems or anxiety. Traditional Use Valerian has been traditionally employed as a nervine, carminative, and sedative. Galen (130–200 CE) prescribed valerian for insomnia and numerous ailments. Felter (1922) recorded the use of valerian for cerebral and spinal stimulating effects, hysteria, hypochondria, headache, hemicrania, chorea, mental depression, carminative effects, and nervine actions, particularly when “the brain circulation is feeble and there is mental depression and despondency.” Recent Trials Clinical
research shows that valerian improves overall
sleep quality, shortens the
time it takes to fall asleep and decreases the
number of perceived awakenings
during sleep. One double-blind,
placebo-controlled valerian study of 128
people measured subjective sleep parameters.
Each person received 3 samples
containing placebo, 3 samples containing 400 mg.
valerian extract, and
3 samples containing an over-the-counter
preparation with 400 mg. valerian
and hops strobiles.
The
samples were administerd on non-consecutive
nights. Compared to the placebo,
valerian reduced the fall asleep time and
increased sleep quality—particularly
among those who considered themselves poor or
irregular sleepers. The commercial
preparation with valerian and hops was not as
effective as the experimental
valerian extract (Leatherwood).
In-vitro and in-vivo experiments have identified antispasmodic effects on smooth muscles, hypotensive effects, and dilating effects on coronary arteries. Anti-depressant activity has also been investigated. A randomized, investigator-blinded study with 39 fibromyalgia patients examined the effects on pain, disturbed sleep and tender point count using plain water, pine oil or valerian whirlpool baths. The baths were carried out 10 times, three times per week. General pain, daytime change of pain intensity, well-being and occurrence of disturbed sleep were recorded before and after therapy. The number of tender points were identified by digital palpitation. Pain threshold on the shinbone and middle part of the deltoid muscle, and pain threshold and pain tolerance of both trapezius muscles were measured by an instrument used to asses pain. After the valerian baths, well-being and sleep significantly improved and tender point count decreased significantly. Pine oil baths resulted in significant improvement in well-being, but a significant decrease of pain threshold in the shinbone and the right deltoid muscle. Plain water baths significantly reduced general pain intensity. (Ammer) Mode of Action Valerian contains an extensive array of active constituents. Most valerian studies, however, have focused upon the valepotriates, volatile oils and valerenic acid. Despite extensive investigation, the exact constituents responsible for valerian’s sedative effect, and the mode of action, remain unknown. Like many medicinal plants, the therapeutic effect depends upon the interaction of the plant’s constituents as a whole, rather than its isolated parts. Valerian contains amino acids, alkaloids, phenolic acids, flavonoids, caffeic acid, choline, B-sitosterol, fatty acids plus numerous additional constituents and minerals. A nutritional analysis identified valerian as the best herbal source of calcium examined (Pedersen). A root analysis identified 42,000 parts per million (Duke). Valerian’s sedative effects may involve the inhibition of the breakdown of the amino acid gamma-aminobutyric acid (GABA). A study using aqueous valerian root and rhizome extract exhibited an increase in GABA at the synaptic cleft (space between the junction of two neurons) by inhibiting re-uptake and/or stimulation of GABA release from nerve terminals on isolated rat brain synaptosomes. The release was Na+ dependent and Ca2+ independent. GABA is a major inhibitory neurotransmitter that induces relaxation by blocking the arousal of brain centers (benzodiazepines are thought to potentiate the activity of GABA). Since GABA does not readily cross the blood-brain barrier, however, the authors of this study were not convinced that valerian binds to GABA receptor sites in the brain (Santos). The amino acids of valerian root and rhizome extracts were evaluated in another study to identify whether an exchange mechanism is involved in the GABA release, induced by valerian extract. Arginine and glutamine were the highest amino acid concentrations found, followed by alanine and GABA. The authors comment that the high glutamine concentration could contribute to valerian’s sedative effects since glutamine crosses the blood-brain barrier, where it can be taken up by the nerve terminals and metabolized to GABA. The actual GABA present in the valerian preparation may also contribute to valerian’s sedative properties (Santos). Authors
of a 1999 double-blind study with 16 insomniac
patients theorized that
slow distribution and slow increase in
concentration of valerian to the
effector site may produce the mild sedative
effect, but only after prolonged
use. No effect on sleep was noted by insomniacs
with short-term valerian
treatment, but after two weeks of treatment,
sleep and subjective sleep
perception improved. An unexpected outcome in
this study was a significant
reduction in headaches and gastrointestinal
complaints while patients were
taking valerian (Donath). This finding is
consistent with the traditional
use of valerian.
Indications Like many medicinal plants, valerian has numerous medicinal uses but its main indications are for tension and anxiety. Valerian may be used during anxiety, nervous insomnia, tension-induced indigestion or muscle cramping. The eclectic specific indications of pale face and deficient cerebral circulation may help predict the patients most likely to benefit, and patient without those indications may be most likely to experience adverse effects of overstimulation and insomnia. Dose The fresh or recently dried root is believed to be the highest quality herb. Tincture (fresh, whole plant 1:2; dry root 1:5, 70% alcohol): 30 – 90 drops, to 3 times daily Capsules (root - #00): 2 – 3 daily Hot Tea: Two teaspoons dried root per 1 cup boiling water, 2-3 times daily, one before bed Cold Infusion: Pour a glass of water over 2 teaspoons dried root, let stand 8 hours Plant juice: Adults = 1 tablespoon 3 times daily. Children = 1 teaspoon 3 times daily External use: Brew a strong valerian tea, strain and add to bathwater Standardized extract (1.0 to 1.5 valtrate or 0.8 valeric acid): 300 – 400 mg. daily Cautions Energetically, valerian is acrid, slightly bitter, and warm. Culpepper (1649) stated that valerian is “under the influence of mercury, and therefore hath a warming faculty.” Sauer (1777) wrote “Valerian possesses the virtues of warming and drying; of dissolving thick humors trapped in small glands; of strengthening the eyesight, head, and liver; of forcing urine and sweat; and of withstanding all poisons.” The warming effects of valerian may be why some people find valerian stimulating. Valerian may aggravate tiredness the morning following administration in some people. If this occurs, herbal traditions suggest reducing the dose in half. The valepotriates have been found to be toxic in-vitro; however, this has not been demonstrated in-vivo. (Chan) Empirical
evidence suggests that valerian may alleviate
symptoms when attempting
to withdraw from benzodiazepine drugs
(Andreatini). Valerian was implicated
in a serious withdrawal effect, however, which
included cardiac complications
and delirium in a 58-year-old man with a history
of coronary artery disease,
hypertension, and congestive heart failure. The
patient was admitted to
a hospital for a lung biopsy and upon admission
he was taking multiple
medications
(isosorbide, dinitrate, digoxin,
furosemide, benazepril, aspirin, lovastatin,
ibuprofen),
potassium, zinc, vitamins and 530 mg. – 2 g. per
dose of valerian extract
daily. This dose is perhaps five times the dose
used in traditional herbalism.
Herbal remedies are usually discontinued in
hospitalized patients and this
patient began exhibiting symptoms within 24
hours after valerian discontinuation.
Since the patient’s symptoms were reversed with
administration of the benzodiazepine
midazolam (1 mg every hour, total dose of 11 mg
in 17 hours), the authors
hypothesized that valerian withdrawal produced a
benzodiazepine-like withdrawal
syndrome. The authors considered that the
medications increased the potential
for a valerian withdrawal reaction. (Garges).
References Ammer K, Melnizky P. Medicinal Baths for treatment of generalized fibromyalgia. Forsch Komplementarmed 1999;6(2):80-85 [Article in German] Andreatini R, Leite JR. Effect of valepotriates on the behavior of rats in the elevated plus-maze during diazepam withdrawal. European Journal of Pharmacology 1994;260(2-3):233-5 Blumenthal M. Herbal Medicine Explanded Commission E Monographs. Boston, Massachusetts: Integrative Medicine Communications, 2000 Chan TYK, Tang CH, Critchely AJH. Poisoning Due to an Over-the-counter Hypnotic, Sleep-Qik (Hyoscine, Cyproheptadine, Valerian). Postgrad.Med. J. 1995;71:227-228 Culpepper’s Complete Herbal. Great Britain: Wordsworth Editions Limited, 1995 Donath F, Quispe S, Diefenbach K, Maurer A, Fietze I, Roots I. Critical Evaluation of the Effect of Valerian Extract on Sleep Structure and Sleep Quality. Pharmacopsychiatry 2000;33:47-53 Ellingwood F. American Materia Medica, therapeutics and Pharmacognosy. Portland, Oregon: Eclectic Medical Publications, 1983 Felter HW. The Eclectic Materia Medica, Phamacology and Therapeutics. Cincinnati, Ohio: 1922 Foster S, Tyler V. Tyler’s Honest Herbal. Binghamton, New York Haworth: Herbal Press, 1999 Garges HP, Varia I, Doraiswamy PM. Cardiac Complications and Delirium Associated with Valerian Root Withdrawal. JAMA. 1998;280(18):1566-1567 Grieve M. A Modern Herbal. Great Britain: Tiger Books International, 1998 Kuhlmann J, Berger W, Podzuweit H, Schmidt U. The influence of valerian treatment on “reaction time, alertness and concentration” in volunteers. Pharmacopsychiatry 1999;32(6):235-41 Leatherwood PD, Chauffard F, Heck E, Munoz-Box R. Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacol Biochem Behavior 1982;7(1):65-71 McCaleb R, Leigh E, Morien K. The Encyclopedia of Popular Herbs. Rocklin, California: Prima Publishing, 2000 Pedersen
M. Nutritional Herbology. Warsaw, Indiana:
Wendell W. Whitman Company,
1994
Santos M, Ferreira F, Cunha A, Carvalho A, Macedo T. An Aqueous Extract of Valerian Influences Trasport of GABA in Synaptosomes. Planta Medica 1994;60:278-279 Santos M, Ferreira F, Faro C, Pires E, Carvalho A, Cunha A, Macedo T. The Amount of GABA Present in Aqueous Extracts of Valerian is Sufficient to Account for [3H]GABA Release in Synaptosomes. Planta Medica 1994;60:475-476 United States. Department of Agriculture. Dr. Duke’s Phytochemical and Ethnobotanical Databases. Agricultural Research Service – NGRL, Beltsville Agricultural Research Center, Beltsville, Maryland Webach M. & Murray M. Botanical Influences on Illness A Sourcebook of Clinical Research. California: Third Line Press, Inc., 2000 |
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