Valerian

What valerian is

Valerian is a plant native to Europe and Asia that also grows in North America. The part used in supplements comes from its roots and underground stems, and it is sold as capsules, tablets, teas, and liquid extracts. People have used it as a traditional remedy for a long time, most often for sleep and for nerves. Like other supplements, it is not reviewed by the FDA the way prescription medicines are, so the actual content can vary from one product to the next.

This page is general education about valerian as a supplement. It is not a recommendation that you should or should not take it; that is a conversation to have with your clinician about your own situation.

What it is used for

The most common reason people reach for valerian is sleep, and it is also promoted for anxiety, stress, low mood, and menopause symptoms. Here it is important to be straight about the evidence: research on whether valerian actually helps with sleep is inconsistent, and one of the main sleep guidelines recommends against using it for ongoing insomnia in adults. For menopause symptoms a few small studies hint it might help, but there is not enough to be sure, and for anxiety, depression, and the other promoted uses the evidence is not strong enough to draw conclusions either. The honest summary is that there is not enough evidence to say valerian is useful for any particular condition.

In a psychiatric setting, valerian is something we might talk through as a small, optional piece, not as a stand-in for the treatment that actually addresses what you are working on. Whether it makes sense for you depends on your history, what else you take, and what you are hoping it will do. That is decided case by case, and it is reasonable to bring it up alongside guides like sleep and anxiety.

How it might work

Honestly, the way valerian might affect sleep or mood is not established. It is considered possible, though not proven, that it has a mild sleep-inducing effect, which is part of why it gets used the way it does and why it is not meant to be mixed with other things that make you drowsy. Possible is not the same as proven, and how much it helps a given person, if at all, is individual. Two people taking the same product can have very different experiences.

How people take it

There is no single right way to take valerian, and the details are worth talking over with your clinician or pharmacist rather than copying a number from a label or a website. A few general points apply:

• Think short term. What has actually been studied is short-term use over a few weeks; the safety of taking it long term is not known, so it is not meant to run indefinitely on its own.
• Do not mix it with alcohol or sedatives. Because it may have a sleep-inducing effect, combining it with alcohol or with sedative medicines can stack up in a way you do not want.
• Do not stop abruptly after long use. If you have taken it regularly for a while, stopping suddenly can bring on withdrawal-type symptoms; it is better to taper with guidance.
• Products are not all the same. Strength and content vary between brands, so two bottles labeled the same way are not necessarily equivalent.

What to expect

This varies from person to person, and the inconsistent evidence is part of why. If valerian helps at all, the effect tends to be subtle rather than dramatic. Give any honest trial a fair, time-limited stretch and pay attention to how you actually feel rather than to what it is supposed to do. If you notice nothing, that is useful information, not a failure, and it is fine to stop and look at other options together. As always, this is case by case.

Possible side effects

Many people who take valerian short term tolerate it, and the everyday side effects are usually mild. The lists below are possibilities, not certainties.

Possible more common side effects:

• Headache
• Stomach upset
• Mental dullness or feeling foggy
• Excitability or uneasiness
• Vivid dreams

One thing worth knowing is that stopping valerian abruptly after taking it regularly for a long time can bring on withdrawal-type symptoms, such as anxiety, irritability, heart-rhythm sensations, trouble sleeping, and, in rare cases, hallucinations. That is a reason to taper rather than quit cold.

Less common, but concerning signs that could need urgent care:

• Signs of an allergic reaction: rash, hives, or swelling of the face, lips, tongue, or throat
• Signs of a liver problem, which has been reported only in very rare cases and most often when valerian was combined with other herbal products: yellowing of the skin or eyes, dark urine, severe stomach pain, or unusual tiredness

For any of these, use the help options at the bottom of this page: call 911 or go to the nearest emergency department for a medical emergency or severe reaction, or call or text 988 for a mental health crisis.

Interactions and safety

This is the part most worth reading. Valerian is generally low-risk for short-term use in most adults, but a few things matter:

• It should not be combined with alcohol or with sedatives. Because valerian may have a sleep-inducing effect, putting it together with other things that make you drowsy can add up more than you expect.
• Its specific drug interactions are not well mapped. That is actually a reason for more caution, not less: if you take any prescription medicine, it is worth checking before adding valerian, because some herbs and medicines interact in ways that are hard to predict.
• Liver problems have been reported, though only in very rare cases and most often alongside other herbal products. Long-term effects on the liver are not known.
• Little is known about using valerian during pregnancy or while breastfeeding, so that is a conversation to have first rather than after.

The simplest safeguard is to tell your clinician and pharmacist everything you take, including supplements and over-the-counter products. Knowing the full picture lets us catch a problem before it happens and decide together whether valerian fits your plan.

When to contact your clinician

For routine questions, mild side effects, or whether valerian fits with the rest of your plan, send a message through the patient portal or bring it to your next visit. These are part of your ongoing care and are answered in the normal course of a few business days, so they are best for things that are not urgent.

If something feels urgent, you do not need to wait for a reply. The fastest way to get care is 911 or the nearest emergency department for a medical emergency or severe reaction, or 988 any time for a mental health crisis or thoughts of self-harm.

Questions to ask your clinician

• Is valerian a reasonable thing to try in my situation, and what would we be hoping it does?
• Does it interact with any of the medicines I already take, including anything sedating?
• How long should I try it before we decide whether it is worth continuing?
• If I have been taking it for a while, how should I stop it safely?
• If sleep is the real issue, what else should we be looking at?