Valerian Root

Plant and early records

Valerian in this article means Valeriana officinalis L., a plant whose root and rhizome are used medicinally. The National Center for Complementary and Integrative Health (NCCIH) describes it as native to Europe and Asia, also growing in North America, and says it was historically used for insomnia, migraine, fatigue and stomach cramps. A 2020 systematic review states that recorded medicinal use dates to the first century AD, with its historical value lying mainly in stimulant-type uses such as diuretic, carminative and menstrual-stimulant effects.

The same review states that use of valerian for nervous disorders and insomnia is recorded from the Middle Ages, and that extracts were used as a sedative and sleep aid from the 18th century. The sources reviewed for this page do not document attributions of valerian to specific classical authors such as Hippocrates or Galen, so this page does not repeat them.

European regulatory listing

The 2020 review cites the European Medicines Agency as listing relief of mild nervous tension and sleep disorders as well-established uses of Valeriana officinalis root. The sources reviewed do not describe the German Commission E monograph, and this page does not summarize it. A herbal-medicine listing of this kind is a separate question from the clinical trial findings described under Research and Evidence.

Names and parts used

Valerian is the common name for Valeriana officinalis, and the parts used in the products discussed here are the root and rhizome. A related species, Valeriana jatamansi (often called Indian valerian), is a different plant with its own traditional use in Chinese medicine and Ayurveda and a literature that is mostly laboratory and animal research. Findings on one species should not be carried over to the other.

Preparations named in the research

A 2006 systematic review of 16 placebo-controlled trials noted that valerian doses, preparations and length of treatment varied considerably between studies. A 2020 review distinguishes whole root or rhizome material from extracts and from combination products that pair valerian with other herbs such as lemon balm. Trials of such combinations cannot be read as trials of valerian alone, and this page flags combination studies where they are discussed.

Forms and how the products are described

The sources reviewed describe whole root or rhizome material, extracts, and combination products containing valerian. They do not describe tea preparation, so this page does not cover it. NCCIH notes that dietary supplements are not approved by the US Food and Drug Administration before sale and that manufacturers are responsible for evaluating the safety and labeling of their products. The Dietary Supplements page covers that category in general, and valerian belongs to the wider Herbal Medicine family on Machipedia. This page gives no doses and no product advice.

Quality and variability

The authors of a 2020 systematic review suggest that inconsistent trial results may be partly due to the variable quality of herbal extracts. They report that the effect for sleep quality appeared larger in the few trials of whole root than in extract trials, and they state that this is a small subgroup comparison. They also note that valerian contains multiple active constituents, some relatively unstable, and say quality-control methods such as standardization and shelf-life testing may need revision.

An earlier meta-analysis reached a similar practical point, recommending that future studies assess a range of doses of standardized preparations. No source reviewed for this page tests how much a given retail product matches its label.

Traditional and promoted uses

NCCIH states that valerian is promoted today for insomnia, anxiety, stress and depression, and was historically used for insomnia, migraine, fatigue and stomach cramps. The 2020 review lists nervous tension and sleep disorders among the European regulatory listings, and notes that earlier recorded uses were mainly stimulant-type uses. Promotion for a use is not evidence that the use is supported by trials; the next section reports what the trials and reviews found.

Menopause-related sleep and hot flashes

NCCIH notes that three small studies suggest possible benefit for menopause symptoms but that the evidence is not conclusive. Trials in postmenopausal women have examined sleep quality with valerian extract alone and sleep and hot flashes with a fennel and valerian combination, as described under Research and Evidence.

Systematic reviews on insomnia and sleep quality

A 2006 systematic review and meta-analysis identified 16 randomized, placebo-controlled trials with 1,093 patients. Most had significant methodological problems. For a dichotomous outcome of improved sleep quality, reported by 6 studies, the relative risk of improved sleep was 1.8 (95% confidence interval 1.2 to 2.9), but the authors found evidence of publication bias in that summary measure.

A 2020 review and meta-analysis included 60 studies with 6,894 participants, including a meta-analysis of subjective sleep quality (10 studies). Its authors concluded that valerian could promote sleep and attributed inconsistent trial results to variable extract quality. Two later umbrella reviews were more cautious. A 2024 umbrella review of 8 systematic reviews found no evidence of efficacy for insomnia. A 2023 umbrella review of alternative insomnia treatments found that valerian did not significantly improve sleep outcomes and rated overall study quality as low; the same review reported that melatonin (see the Melatonin page) reduced both self-reported and objectively assessed sleep onset latency.

Guidelines and older adults

A 2023 systematic review of 17 clinical practice guidelines that include complementary approaches for insomnia found that none endorsed valerian and that the shared position was not to recommend valerian for insomnia, citing risk profile or limited benefit. NCCIH reports that the American Academy of Sleep Medicine 2017 guideline recommends against valerian for chronic insomnia in adults and that overall results for sleep are inconsistent.

A 2021 systematic review of over-the-counter sleep aids in people aged 65 and older included five studies and reported that valerian showed no effect on subjective or objective sleep outcomes.

Anxiety

A 2022 network meta-analysis of 29 randomized trials comparing 12 medicinal herbs for anxiety reported insufficient evidence to confirm the effectiveness of valerian against standard treatment. The 2020 review reported a pooled analysis of 8 studies on anxiety, and its authors noted high variability among extracts. NCCIH states that the evidence for anxiety is insufficient to draw conclusions. The same network meta-analysis reported an anxiolytic effect for kava in its pooled estimate (see the Kava page), a finding that does not carry over to valerian.

Menopause-related sleep trials

A randomized, triple-blind trial of 100 postmenopausal women aged 50 to 60 with insomnia compared a valerian extract with placebo for 4 weeks and reported a statistically significant difference in Pittsburgh Sleep Quality Index scores, with 30 percent of the valerian group and 4 percent of the placebo group showing improvement. A randomized trial of 76 postmenopausal women in Iran tested a fennel and valerian combination against placebo for 8 weeks and reported lower sleep-quality scores and fewer hot flashes in the combination group. Because the second trial tested a combination, its result cannot be attributed to valerian alone.

Reported side effects

NCCIH lists possible headache, stomach upset, mental dullness, excitability, uneasiness and vivid dreams, and says stopping abruptly after chronic use may cause withdrawal symptoms. In the 2020 review, no serious adverse events were reported across the included studies, which covered participants aged 7 to 80. The review reports paradoxical agitation or restlessness in a minority of participants, and mild effects in individual trials such as dizziness, sleepiness, drowsiness and vivid dreams, which its authors say lacked a clear link to treatment.

Liver injury reports

NCCIH states that liver injury has been reported in very rare cases, mostly when valerian was combined with other herbal products, and that long-term effects on the liver are unknown. One published case report describes a 53-year-old woman who developed cholestatic jaundice after about a month of a combination liver-cleansing product and a nightly sleep aid listing valerian among several constituents; biopsy was consistent with drug-induced liver injury, and her tests improved after both products were stopped and a course of corticosteroids was given. The report cannot show that valerian alone caused the injury. The NIH LiverTox entry could not be opened for this page and is not cited.

Interactions, pregnancy, children and clinician advice

NCCIH advises that, because valerian may have a sleep-inducing effect, it should not be combined with alcohol or sedatives, and that people taking any medicine should consult a health care provider first. It states that little is known about safety in pregnancy and breastfeeding, and its page does not address use in children. The 2020 review describes a few pediatric trials and an observational study, including paradoxical reactions such as restlessness in a small number of children, and its authors judge valerian to be well tolerated across ages; that view rests on small studies and is not a recommendation.

Anyone with persistent insomnia or anxiety, a liver condition, or a medication regimen, and anyone who is pregnant or breastfeeding, should ask a clinician before using valerian. This page is information only and does not replace or delay necessary care.