Akar Dari 148
Akar Dari 148
This fact sheet provides an overview of the apply of valerian for insomnia and other sleep disorders and contains the post-obit key data:
- Valerian is an herb sold as a dietary supplement in the U.s.a..
- Valerian is a mutual ingredient in products promoted every bit mild sedatives and sleep aids for nervous tension and insomnia.
- Prove from clinical studies of the efficacy of valerian in treating slumber disorders such as insomnia is inconclusive.
- Constituents of valerian take been shown to take sedative effects in animals, but there is no scientific agreement on valerian’s mechanisms of action.
- Although few agin events have been reported, long-term safety data are not available.
What is valerian?
Valerian (Valeriana officinalis), a fellow member of the Valerianaceae family unit, is a perennial plant native to Europe and Asia and naturalized in Northward America . Information technology has a distinctive odor that many notice unpleasant [2,three]. Other names include setwall (English language),
(Greek). The genus
includes over 250 species, simply
is the species most often used in the Usa and Europe and is the just species discussed in this fact canvass [3,4].
What are common valerian preparations?
Preparations of valerian marketed equally dietary supplements are made from its roots, rhizomes (underground stems), and stolons (horizontal stems). Stale roots are prepared as teas or tinctures, and dried found materials and extracts are put into capsules or incorporated into tablets .
At that place is no scientific agreement every bit to the active constituents of valerian, and its activeness may result from interactions among multiple constituents rather than any one chemical compound or class of compounds . The content of volatile oils, including valerenic acids; the less volatile sesquiterpenes; or the valepotriates (esters of short-chain fatty acids) is sometimes used to standardize valerian extracts. As with most herbal preparations, many other compounds are besides nowadays.
Valerian is sometimes combined with other botanicals [v]. Because this fact canvass focuses on valerian as a unmarried ingredient, merely clinical studies evaluating valerian as a unmarried agent are included.
What are the historical uses of valerian?
Valerian has been used every bit a medicinal herb since at least the time of ancient Greece and Rome. Its therapeutic uses were described by Hippocrates, and in the 2nd century, Galen prescribed valerian for insomnia [v,7]. In the 16th century, it was used to treat nervousness, trembling, headaches, and heart palpitations . In the mid-19th century, valerian was considered a stimulant that caused some of the aforementioned complaints it is thought to care for and was generally held in low esteem as a medicinal herb [two]. During World State of war Ii, it was used in England to salve the stress of air raids .
In add-on to sleep disorders, valerian has been used for gastrointestinal spasms and distress, epileptic seizures, and attention arrears hyperactivity disorder. However, scientific evidence is not sufficient to support the use of valerian for these conditions [x].
What clinical studies have been done on valerian and slumber disorders?
In a systematic review of the scientific literature, nine randomized, placebo-controlled, double-bullheaded clinical trials of valerian and sleep disorders were identified and evaluated for testify of efficacy of valerian as a handling for indisposition . Reviewers rated the studies with a standard scoring arrangement to quantify the likelihood of bias inherent in the report design . Although all nine trials had flaws, three earned the highest rating (5 on a scale of 1 to five) and are described beneath. Unlike the half-dozen lower-rated studies, these iii studies described the randomization process and blinding method that were used and reported rates of participant withdrawal.
The beginning study used a repeated-measures pattern; 128 volunteers were given 400 mg of an aqueous extract of valerian, a commercial preparation containing threescore mg valerian and 30 mg hops, and a placebo . Participants took each one of the three preparations 3 times in random gild on nine nonconsecutive nights and filled out a questionnaire the forenoon after each handling. Compared with the placebo, the valerian extract resulted in a statistically significant subjective improvement in time required to autumn comatose (more or less hard than usual), sleep quality (improve or worse than usual), and number of nighttime awakenings (more or less than usual).This upshot was more than pronounced in a subgroup of 61 participants who identified themselves as poor sleepers on a questionnaire administered at the beginning of the study. The commercial preparation did not produce a statistically pregnant comeback in these three measures. The clinical significance of the use of valerian for insomnia cannot be determined from the results of this study because having indisposition was not a requirement for participation. In addition, the study had a participant withdrawal rate of 22.nine%, which may take influenced the results.
In the second written report, eight volunteers with balmy indisposition (unremarkably had problems falling comatose) were evaluated for the upshot of valerian on sleep latency (defined as the outset five-minute catamenia without move) . Results were based on dark motility measured past activeness meters worn on the wrist and on responses to questionnaires about sleep quality, latency, depth, and morning time sleepiness filled out the morning after each treatment. The examination samples were 450 or 900 mg of an aqueous valerian extract and a placebo. Each volunteer was randomly assigned to receive one test sample each nighttime, Mon through Th, for iii weeks for a full of 12 nights of evaluation. The 450-mg test sample of valerian excerpt reduced average sleep latency from about 16 to 9 minutes, which is like to the action of prescription benzodiazepine medication (used as a sedative or tranquilizer). No statistically meaning shortening of slumber latency was seen with the 900-mg test sample. Evaluation of the questionnaires showed a statistically meaning improvement in subjectively measured sleep. On a 9-point calibration, participants rated slumber latency every bit four.three after the 450-mg test sample and 4.9 later on the placebo. The 900-mg test sample increased the sleep improvement just participants noted an increment in sleepiness the next morning. Although statistically significant, this 7-minute reduction in sleep latency and the improvement in subjective slumber rating are probably not clinically significant. The small sample size makes it difficult to generalize the results to a broader population.
The third report examined longer-term effects in 121 participants with documented nonorganic insomnia . Participants received either 600 mg of a standardized commercial training of dried valerian root (LI 156, Sedonium?*) or placebo for 28 days. Several assessment tools were used to evaluate the effectiveness and tolerance of the interventions, including questionnaires on therapeutic consequence (given on days 14 and 28), change in sleep patterns (given on day 28), and changes in slumber quality and well-existence (given on days 0, 14, and 28). After 28 days, the group receiving the valerian extract showed a subtract in insomnia symptoms on all the assessment tools compared with the placebo group. The differences in improvement between valerian and placebo increased between the assessments done on days 14 and 28.
The mention of a specific brand name is non an endorsement of the production.
The reviewers concluded that these nine studies are not sufficient for determining the effectiveness of valerian to treat sleep disorders . For example, none of the studies checked the success of the blinding, none calculated the sample size necessary for seeing a statistical effect, only 1 partially controlled prebedtime variables [fifteen], and only one validated consequence measures .
Ii other randomized, controlled trials published after the systematic review described above  are presented below:
- In a randomized, double-blind study, 75 participants with documented nonorganic indisposition were randomly assigned to receive 600 mg of a standardized commercial valerian extract (LI 156) or ten mg oxazepam (a benzodiazepine medication) for 28 days . Assessment tools used to evaluate the effectiveness and tolerance of the interventions included validated sleep, mood scale, and anxiety questionnaires also equally slumber rating past a doctor (on days 0, 14, and 28). Treatment consequence was adamant via a iv-step rating calibration at the stop of the study (twenty-four hours 28). Both groups had the same improvement in slumber quality but the valerian group reported fewer side effects than did the oxazepam group. However, this study was designed to bear witness superiority, if any, of valerian over oxazepam and its results cannot be used to show equivalence.
- In a randomized, double-blind, placebo-controlled crossover written report, researchers evaluated slumber parameters with polysomnographic techniques that monitored sleep stages, slumber latency, and total sleep time to considerately measure slumber quality and stages . Questionnaires were used for subjective measurement of slumber parameters. Sixteen participants with medically documented nonorganic insomnia were randomly assigned to receive either a single dose and a 14-24-hour interval administration of 600 mg of a standardized commercial preparation of valerian (LI 156) or placebo. Valerian had no effect on any of the 15 objective or subjective measurements except for a decrease in slow-wave sleep onset (13.five minutes) compared with placebo (21.3 minutes). During wearisome-moving ridge sleep, arousability, skeletal muscle tone, heart rate, blood pressure, and respiratory frequency decreased. Increased time spent in slow-wave sleep may decrease insomnia symptoms. Nevertheless, because all but one of the fifteen endpoints showed no difference between placebo and valerian, the possibility that the single endpoint showing a difference was the effect of chance must be considered. The valerian group reported fewer adverse events than did the placebo group.
Although the results of some studies suggest that valerian may be useful for insomnia and other slumber disorders, results of other studies do not. Estimation of these studies is complicated by the fact the studies had modest sample sizes, used dissimilar amounts and sources of valerian, measured unlike outcomes, or did non consider potential bias resulting from high participant withdrawal rates. Overall, the evidence from these trials for the sleep-promoting effects of valerian is inconclusive.
How does valerian work?
Many chemic constituents of valerian have been identified, simply information technology is not known which may be responsible for its slumber-promoting furnishings in animals and in in vitro studies. It is probable that there is no single agile compound and that valerian’due south effects result from multiple constituents acting independently or synergistically [eighteen, reviewed in 19].
2 categories of constituents have been proposed as the major source of valerian’s sedative furnishings. The showtime category comprises the major constituents of its volatile oil including valerenic acid and its derivatives, which accept demonstrated sedative properties in beast studies [half-dozen,20]. However, valerian extracts with very piddling of these components also have sedative properties, making it probable that other components are responsible for these effects or that multiple constituents contribute to them . The second category comprises the iridoids, which include the valepotriates. Valepotriates and their derivatives are active as sedatives in vivo merely are unstable and break downwardly during storage or in an aqueous environment, making their activity difficult to appraise [half-dozen,20,22].
A possible mechanism past which a valerian extract may cause sedation is by increasing the amount of gamma aminobutyric acid (GABA, an inhibitory neurotransmitter) available in the synaptic scissure. Results from an in vitro written report using synaptosomes advise that a valerian excerpt may cause GABA to be released from brain nerve endings and then block GABA from existence taken back into nerve cells . In addition, valerenic acid inhibits an enzyme that destroys GABA [reviewed in 24]. Valerian extracts incorporate GABA in quantities sufficient to crusade a sedative effect, but whether GABA can cross the claret-brain barrier to contribute to valerian’s sedative furnishings is not known. Glutamine is nowadays in aqueous but not in booze extracts and may cross the blood-brain barrier and be converted to GABA . Levels of these constituents vary significantly among plants depending on when the plants are harvested, resulting in marked variability in the amounts establish in valerian preparations .
What is the regulatory status of valerian in the United states?
In the United States, valerian is sold equally a dietary supplement, and dietary supplements are regulated every bit foods, not drugs. Therefore, premarket evaluation and blessing by the Food and Drug Administration are non required unless claims are made for specific disease prevention or handling. Because dietary supplements are not always tested for manufacturing consistency, the composition may vary considerably between manufacturing lots.
Can valerian be harmful?
Few adverse events attributable to valerian have been reported for clinical study participants. Headaches, dizziness, pruritus, and gastrointestinal disturbances are the most common effects reported in clinical trials but similar effects were too reported for the placebo [14-17]. In one report an increment in sleepiness was noted the morn after 900 mg of valerian was taken . Investigators from another written report concluded that 600 mg of valerian (LI 156) did not take a clinically meaning effect on reaction fourth dimension, alertness, and concentration the morning after ingestion . Several instance reports described agin furnishings, but in one case where suicide was attempted with a massive overdose information technology is not possible to clearly attribute the symptoms to valerian [28-31].
Valepotriates, which are a component of valerian but are not necessarily present in commercial preparations, had cytotoxic activity in vitro simply were not carcinogenic in animal studies [32-35].
Who should non accept valerian?
- Women who are meaning or nursing should not take valerian without medical advice because the possible risks to the fetus or infant have non been evaluated .
- Children younger than 3 years old should not have valerian because the possible risks to children of this age take not been evaluated .
- Individuals taking valerian should be enlightened of the theoretical possibility of additive sedative effects from booze or sedative drugs, such every bit barbiturates and benzodiazepines [10,37,38].
Does valerian interact with whatever drugs or supplements or affect laboratory tests?
Valerian might have additive therapeutic and adverse effects if taken with sedatives, other medications, or sure herbs and dietary supplements with sedative properties . These include the following:
- Benzodiazepines such as Xanax®, Valium®, Ativan®, and Halcion®.
- Barbiturates or central nervous system (CNS) depressants such as phenobarbital (Luminal®), morphine, and propofol (Diprivan®).
- Dietary supplements such equally St. John’southward wort, kava, and melatonin.
Individuals taking these medications or supplements should discuss the apply of valerian with their healthcare providers.
Although valerian has not been reported to influence laboratory tests, this has not been rigorously studied [5,36,39].
What are some additional sources of scientific information on valerian?
Medical libraries are a source of information about medicinal herbs. Other sources include Web-based resources such as PubMed.
For general information on botanicals and their use as dietary supplements, delight see Background Data About Botanical Dietary Supplements and Background Information Almost Dietary Supplements from the Function of Dietary Supplements (ODS).
- Wichtl M, ed.: Valerianae radix. In: Bisset NG, trans-ed. Herbal Drugs and Phytopharmaceuticals: A Handbook for Exercise on a Scientific Footing. Boca Raton, FL: CRC Press, 1994: 513-516.
- Pereira J: Valeriana officinalis: mutual valerian. In: Carson J, ed. The Elements of Materia Medica and Therapeutics. tertiary ed. Philadelphia: Blanchard and Lea, 1854: 609-616.
- Schulz V, Hansel R, Tyler VE: Valerian. In: Rational Phytotherapy. 3rd ed. Berlin: Springer, 1998: 73-81.
- Davidson JRT, Connor KM: Valerian. In: Herbs for the Mind: Depression, Stress, Memory Loss, and Insomnia. New York: Guilford Press, 2000: 214-233.
- Blumenthal M, Goldberg A, Brinckmann J, eds.: Valerian root. In: Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications, 2000: 394-400.
- Hendriks H, Bos R, Allersma DP, Malingre Thou, Koster Every bit: Pharmacological screening of valerenal and some other components of essential oil of Valeriana officinalis. Planta Medica 42: 62-68, 1981 [PubMed abstract]
- Turner Westward: Of Valerianae. In: Chapman GTL, McCombie F, Wesencraft A, eds. A New Herbal, Parts II and III. Cambridge: Cambridge Academy Press, 1995: 464-466, 499-500, 764-765. [Republication of parts Ii and III of A New Herbal, by William Turner, originally published in 1562 and 1568, respectively.]
- Culpeper Due north: Garden valerian. In: Culpeper’s Consummate Herbal. New York: Due west. Foulsham, 1994: 295-297. [Republication of The English Physitian, past Nicholas Culpeper, originally published in 1652.]
- Grieve Thousand: Valerian. In: A Modern Herbal. New York: Hafner Printing, 1974: 824-830.
- Jellin JM, Gregory P, Batz F, et al.: Valerian In: Pharmacist’southward Letter/Prescriber’s Letter Natural Medicines Comprehensive Database. 3rd ed. Stockton, CA: Therapeutic Inquiry Faculty, 2000: 1052-1054.
- Stevinson C, Ernst E: Valerian for indisposition: a systematic review of randomized clinical trials. Slumber Medicine 1: 91-99, 2000. [PubMed abstract]
- Jadad AR, Moore RA, Carroll D, et al.: Assessing the quality of reports of randomized clinical trials: is blinding necessary? Controlled Clinical Trials 17: 1-12, 1996. [PubMed abstract]
- Leathwood PD, Chauffard F, Heck E, Munoz-Box R: Aqueous extract of valerian root (Valeriana officinalis L.) improves slumber quality in man. Pharmacology, Biochemistry and Behavior 17: 65-71, 1982. [PubMed abstract]
- Leathwood PD, Chauffard F: Aqueous excerpt of valerian reduces latency to fall asleep in man. Planta Medica 2: 144-148, 1985. [PubMed abstract]
- Vorbach EU, Gortelmeyer R, Bruning J: Treatment of insomnia: effectiveness and tolerance of a valerian extract [in German language]. Psychopharmakotherapie 3: 109-115, 1996.
- Dorn Yard: Valerian versus oxazepam: efficacy and tolerability in nonorganic and nonpsychiatric insomniacs: a randomized, double-blind, clinical comparative report [in German]. Forschende Komplementärmedizin und Klassische Naturheilkunde seven: 79-84, 2000. [PubMed abstract]
- 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 33: 47-53, 2000. [PubMed abstract]
- Russo EB: Valerian. In: Handbook of Psychotropic Herbs: A Scientific Analysis of Herbal Remedies in Psychiatric Weather. Binghamton, NY: Haworth Printing, 2001: 95-106.
- Houghton PJ: The scientific basis for the reputed action of valerian. Journal of Pharmacy and Pharmacology 51: 505-512, 1999.
- Hendriks H, Bos R, Woerdenbag HJ, Koster Equally. Central nervous depressant activity of valerenic acrid in the mouse. Planta Medica i: 28-31, 1985. [PubMed abstruse]
- Krieglstein VJ, Grusla D. Fundamental depressing components in Valerian: Valeportriates, valeric acid, valerone, and essential oil are inactive, withal [in German language]. Deutsche Apotheker Zeitung 128:2041-2046, 1988.
- Bos R, Woerdenbag HJ, Hendriks H, et al.: Analytical aspects of phytotherapeutic valerian preparations. Phytochemical Analysis 7: 143-151, 1996.
- Santos MS, Ferreira F, Cunha AP, Carvalho AP, Macedo T: An aqueous extract of valerian influences the transport of GABA in synaptosomes. Planta Medica sixty: 278-279, 1994. [PubMed abstract]
- Morazzoni P, Bombardelli E: Valeriana officinalis: traditional use and recent evaluation of activity. Fitoterapia 66: 99-112, 1995.
- Cavadas C, Araujo I, Cotrim MD, et al.: In vitro report on the interaction of Valeriana officinalis L. extracts and their amino acids on GABAA receptor in rat brain. Arzneimittel-Forschung Drug Research 45: 753-755, 1995. [PubMed abstract]
- Bos R, Woerdenbag HJ, van Putten FMS, Hendriks H, Scheffer JJC: Seasonal variation of the essential oil, valerenic acid and derivatives, and valepotriates in Valeriana officinalis roots and rhizomes, and the selection of plants suitable for phytomedicines. Planta Medica 64:143-147, 1998. [PubMed abstract]
- Kuhlmann J, Berger W, Podzuweit H, Schmidt U: The influence of valerian treatment on “reaction time, alacrity and concentration” in volunteers. Pharmacopsychiatry 32: 235-241, 1999. [PubMed abstract]
- MacGregor FB, Abernethy VE, Dahabra South, Cobden I, Hayes PC: Hepatotoxicity of herbal remedies. British Medical Journal 299: 1156-1157, 1989. [PubMed abstruse]
- Mullins ME, Horowitz BZ: The example of the salad shooters: intravenous injection of wild lettuce extract. Veterinary and Human Toxicology 40: 290-291, 1998. [PubMed abstract]
- Garges HP, Varia I, Doraiswamy PM: Cardiac complications and delirium associated with valerian root withdrawal. Journal of the American Medical Association 280: 1566-1567, 1998. [PubMed abstract]
- Willey LB, Mady SP, Cobaugh DJ, Wax PM: Valerian overdose: a case written report. Veterinarian and Human Toxicology 37: 364-365, 1995. [PubMed abstract]
- Bounthanh, C, Bergmann C, Beck JP, Haag-Berrurier M, Anton R. Valepotriates, a new course of cytotoxic and antitumor agents. Planta Medica 41: 21-28, 1981. [PubMed abstract]
- Bounthanh, C, Richert 50, Beck JP, Haag-Berrurier Grand, Anton R: The action of valepotriates on the synthesis of DNA and proteins of cultured hepatoma cells. Journal of Medicinal Establish Research 49: 138-142, 1983. [PubMed abstract]
- Tufik Due south, Fuhita One thousand, Seabra ML, Lobo LL: Effects of a prolonged administration of valepotriates in rats on the mothers and their offspring. Journal of Ethnopharmacology 41: 39-44, 1996. [PubMed abstract]
- Bos R, Hendriks H, Scheffer JJC, Woerdenbag HJ: Cytotoxic potential of valerian constituents and valerian tinctures. Phytomedicine 5: 219-225, 1998.
- European Scientific Cooperative on Phytotherapy: Valerianae radix: valerian root. In: Monographs on the Medicinal Uses of Constitute Drugs. Exeter, UK: ESCOP, 1997: ane-10.
- Rotblatt M, Ziment I. Valerian (Valeriana officinalis). In: Evidence-Based Herbal Medicine. Philadelphia: Hanley & Belfus, Inc., 2002: 355-359.
- Givens One thousand, Cupp MJ: Valerian. In: Cupps MJ, ed. Toxicology and Clinical Pharmacology of Herbal Products. Totowa, NJ: Humana Press, 2000: 53-66.
- Natural Medicine’due south Comprehensive Database. Valerian. 2013.
This fact canvas past the National Institutes of Wellness (NIH) Part of Dietary Supplements (ODS) provides information that should not have the place of medical advice. We encourage you to talk to your healthcare providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions virtually, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific production or service, or recommendation from an organization or professional social club, does not correspond an endorsement past ODS of that product, service, or expert advice.
March 15, 2013
Akar Dari 148