Valerian

CAM (GABA agonist; serotonin 5-HT5A agonist)

Hypnotic (safe in elderly)³
Non-specific anxiety³

OCD³

Features

Generic, Sedating, Elderly-Safe, Natural, Tolerable, Weight-Free, Non-controlled, Sexual-free, Bipolar-Safe, Elderly-Preferred

Handout

Dosing

Insomnia: 450-600 mg 1-2 hr before bedtime.

Anxiety: 500-1000 mg daily, divided bid or all at night

OCD: 765 mg, divided bid or tid.

Many products do not contain the active ingredient (≥ 2 mg valerenic acids) or are contaminated with lead.
Best price: GNC Herbal Plus Valerian Extract
Other options: Nature’s Way Standardized Valerian (no longer made)
These propriety extracts have positive trials for sleep but are difficult to find in the US: Sleeproot (by OmniActive) and ReDormin Forte ZE91019 (by SFI Health, a product combined with hops).

Management

TOLERABILITY: Headaches, menopausal symptoms, premenstrual syndrome, tremor.

RISKS: Rare reports of hepatotoxicity, possibly due to contaminated products.

EMR Text

Insomnia

Valerian use based on multiple randomized controlled trials in insomnia (Shinjyo N et al, J Evid Based Integr Med. 2020;25:2515690X20967323).

Valerian side effects, including liver risks, reviewed with patient.

Anxiety

Valerian use based on multiple randomized controlled trials in anxiety, some of which were negative but tend to have positive results when a standardized, quality extract was used (Chandra Shekhar H et al, Adv Ther. 2024;41(1):246-261).

Valerian side effects, including liver risks, reviewed with patient.

OCD

Valerian use based on a small randomized controlled trial in OCD (Pakseresht S et al, J Complement Integr Med. 2011;8).

Valerian side effects, including liver risks, reviewed with patient.

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