Insomnia is a common sleep problem throughout the world. Many available prescription medications for insomnia are associated with significant side effects including daytime somnolence and dependence. The search for a more natural and safer hypnotic has stimulated many patients to turn to herbal products such as valerian root. Although it has been used for centuries, its mechanism of action, as well as the constituents of the plant responsible for its activity, is not well defined.
As with a number of other herbs, comparison of clinical studies is difficult owing to differences in product content, preparations, and sample size. One randomized, double-blind, study of 4-week duration suggested significant improvements in sleep efficacy in patients with insomnia (112). Similar beneficial effects were found in another small study using a different com pound. Sleep latency and quality were noted to be significantly improved with valerian compared to placebo (113). A more recent study suggested that valerian is equivalent to oxazepam for the treatment of insomnia (114). Definitive conclusions regarding the use of valerian for insomnia are difficult to make, however, owing to study limitations (115).
Side effects of valerian are usually mild and include headaches, nausea, nervousness, palpitations, and drowsiness. Case reports of idiosyncratic hepatotoxicity have also been reported (116). Concomitant use of valerian with alcohol or other hypnotics should be avoided to guard against excessive sedation.
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