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Valerian For Anxiety Disorders

Valerian (Valeriana officinalis) is a perennial plant named after the Latin term “valere,” which roughly translates to “strong and healthy.”  The plant is considered native to Europe and various regions of Asia and tends to bloom pinkish and/or whitish flowers in the summer seasons.  Upon blooming, its flowers are universally known to have a sweet, pleasant scent; hence the reason valerian flower extracts were commonly applied as an herbal perfume throughout the 1500s.

In addition to its overall aesthetic appeal, valerian has long been regarded as an important medicinal herb.  Historians speculate that its medicinal usage dates back to the times of ancient Greece and Rome, where it treated conditions such as: chronic pain, convulsions, insomnia, and migraines.  These days, valerian extracts can be purchased as an over-the-counter dietary supplement and are popularly utilized as a treatment for acute insomnia and to attenuate stress.

Although the efficacy of valerian as a treatment for certain medical conditions is unknown, there preliminary evidence to suggest its possible efficacy for the treatment of anxiety disorders.  Valerian root is touted as an herbal Xanax alternative, without a propensity to impair cognition, induce dependence, and/or cause deleterious long-term effects – all of which often result from benzodiazepines.  For this reason, many individuals left unsatisfied with traditional pharmacological treatments have opted to test herbal anxiolytic interventions such as valerian root.

How Valerian May Treat Anxiety Disorders (Mechanism of Action)

To understand how valerian root elicits anxiolytic effects, it is necessary to assess its pharmacodynamics.  Due to the fact that it is an herb that contains a myriad of biochemical compounds, it is necessary to consider that each of these may alter neurophysiological functions and/or contribute to the overall anxiolytic effect.

Examples of biochemical derived from valerian include:

  • Alkaloids (actinidine, chatinine, shyanthine, valerianine, valerine)
  • Flavanones (hesperidin, 6-methylapigenin, linarin)
  • GABA (gamma-aminobutyric acid)
  • Iridoids (isovaltrate and valtrate)
  • Isovaleramide
  • Isovaleric acid
  • Sesquiterpenes (valerenic acid, hydroxyvalerenic acid, acetoxyvalerenic acid)

Despite the myriad of aforestated biochemical constituents, the anxiolytic efficacy of valerian is difficult to pinpoint to a specific compound.  Some research documents that ingestion of the sesquiterpene known as “valernic acid” inhibits enzymatic breakdown of GABA, thereby facilitating reduced psychomotor stimulation and anxiety.  Other evidence supports the idea that various compounds modulate the function of GABAA receptors similar to benzodiazepines.

GABAA receptor binding: Valerian likely induces an anxiolytic effect via binding to a subtype of GABA receptors known as “GABAA” receptors.  GABAA receptors are abundant within the CNS and consist of 5 protein subunits: 2-alpha, 2-beta, and 1-gamma.  Among individuals who aren’t under the influence of any drugs, the neurotransmitter GABA (gamma-aminobutyric acid) exhibits modest/weak binding to the alpha subunit of the receptor.

Weak binding of GABA to the GABAA alpha subunit results in cellular (neuronal) diffusion of negatively charged chloride ions.  However, upon ingestion of valerian, biochemical constituents within valerian bind to the “beta subunit” of GABAA receptors.  As a result of the “beta subunit” binding, the neurotransmitter GABA binds more substantially to the “alpha subunit” of the GABAA receptors.

The increase in GABA binding at the alpha subunit causes enhanced influx of negatively-charged chloride ions into the neuron, thereby leading to hyperpolarization of the neuron; the neuron has a greater negative charge inside than outside.  Hyperpolarization causes the neuron to become less reactive to EPSPs (excitatory postsynaptic potentials).  This ultimately suppresses activity of the CNS (central nervous system) for an anxiolytic and/or sedative effect.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/18602406
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/18095218/

GABA increases: Biochemical components of valerian (e.g. valernic acid) appear to inhibit the enzymatic breakdown of GABA (gamma-aminobutyric acid).  Enzymatic inhibition of GABA metabolism likely facilitates increases in GABA concentrations throughout the central nervous system.  Elevated concentrations of GABA, as a result of valerian administration, may facilitate increases in relaxation and decreased anxiety.

There is some evidence to suggest that simply increasing GABA levels throughout the brain can mitigate anxiety.  Furthermore, some studies note that valerian “root” in particular, harbors GABA (gamma-aminobutyric acid).  Although the bioavailability of exogenously administered GABA is up for debate, some individuals claim to effectively take GABA supplements for anxiety – which, if they really work, are thought to function by increasing GABA concentrations.

Essentially, valerian surely increases GABA via inhibition of its enzymatic breakdown, but may also directly increase GABA via ingestion of exogenous GABA within the root.  The result could be a substantial increase in GABA concentrations compared to a homeostatic baseline.  Moreover, the combination of heightened GABA concentrations, (resulting from enzymatic inhibition and possibly bioavailable exogenous GABA in the root), may prove synergistic to valerian’s “beta subunit” binding at the GABAA receptor; leaving a greater amount of GABA available for GABAA “alpha subunit” binding.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/10411208
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/2893744

Serotonin receptors: Another possible mechanism by which valerian attenuates symptoms of anxiety is via its action upon serotonin receptors.  Studies of valerian extracts noted that they exhibit a strong affinity for the 5-HT5A receptors, as well as a weak affinity for 5-HT2B receptors and the serotonin transporter (SERT).  Since it is believed that dysfunction in serotonergic signaling and/or concentrations may contribute to anxiety, perhaps valerian’s effect on serotonin receptors contributes to its anxiolytic properties.

  • 5-HT5A receptor: Valerian appears to bind with high affinity to the 5-HT5A receptors, and upon binding, acts as a partial agonist. Partial agonism of the 5-HT5A receptor is thought to alter functionality of neurons in the prefrontal cortex, but isn’t well-investigated.  It is possible that partial agonism contributes to an altered, yet relaxed state of consciousness. (Source: http://www.ncbi.nlm.nih.gov/pubmed/15921820).

Hippocampal neurogenesis: It is also possible to consider that valerian may stimulate the growth of new neurons in the hippocampus via a process known as neurogenesis.  One study documented the effects of valerian on concentrations of 5-HT (serotonin), cell proliferation, and neuronal count in the hippocampus – among 70 rats with depression as induced by chronic mild stress.  The study discovered that administration of valerian at low and medium doses, increased concentrations of serotonin in the hippocampus to a normal level.

These increases in serotonin were reported to have occurred within 3 weeks of valerian administration.  Furthermore, analysis with HPLC (high-performance liquid chromatography) and morphometry revealed that among rats administered valerian, there were a greater number of neurons in the hippocampus relative to untreated rats; suggestive of valerian-induced neurogenesis.  Since many pharmaceuticals are believed to provide therapeutic benefit via neurogenesis, this is another potential anxiolytic mechanism to consider.

Researchers mentioned that valerian appeared to “save” dying neurons in the hippocampus as a result of depression (from chronic mild stress).  While it is impossible to generalize the results from this study to humans, a similar effect could be hypothesized.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/18334150

Benefits of Valerian for Anxiety Disorders (Possibilities)

There are many benefits associated with testing valerian as an anxiolytic intervention.  Although it may not provide clinically significant benefit to all users, no pharmacological intervention can be considered universally efficacious anyways.  Advantages associated with using valerian over other interventions include: few side effects, immediate anxiolytic benefit, and the fact that it can be administered on an “as-needed” basis.

  • Adjunct option: Some speculate that since valerian has few contraindications, it can be used as an adjunctive intervention along with various medications and/or other herbal supplements. If you are considering valerian as an adjunct, be sure to discuss it with a medical professional to verify alleged safety given your current health profile and medication intake.  That said, many have managed to use valerian to augment the efficacy of a separate anxiolytic.
  • “As-needed”: Unlike SSRIs/SNRIs that need to be taken on a daily basis to maintain efficacy (and to avoid withdrawals), valerian can be taken on an “as-needed” basis. In other words, you don’t need to have a psychiatric drug influencing your neurophysiology 24/7; this is appealing to some individuals. If you don’t feel anxious all the time and/or simply have anxiety flare-ups, valerian could be the perfect PRN (“pro re nata”) or “when necessary” intervention.
  • Effective: Preliminary evidence suggests that valerian is effective for the attenuation of anxiety symptoms. All published research indicates that it significantly decreases level of anxiety among users.  It appears beneficial for the treatment of generalized anxiety disorder, OCD, and temporary stressors.  There isn’t any significant evidence to suggest against its efficacy (e.g. no trials noted that it failed to provide benefit).
  • Favorable over benzos: Benzodiazepines are highly-effective anxiolytics, but carry significant side effects. It is known that benzodiazepines are linked to dementia, impair ability to learn, and compromise memory.  Furthermore, benzodiazepines compromise ability to operate a motor vehicle, heavy machinery, and are associated with rapid-tolerance onset and hellacious withdrawals.  Since preliminary evidence suggests valerian may be safe and neurorestorative (or neuroprotective), it may be favorable over benzodiazepines.
  • Few side effects: Published studies of valerian note that it is associated with few unwanted side effects and that the side effects typically experienced are fairly benign. The most common side effect from valerian in somnolence (or feeling sleepier than usual).  However, not all users will experience this side effect and many can avoid it with a simple dosage adjustment.  Compared to pharmaceutical anxiolytics (e.g. low libido, weight gain, etc.) – those induced by valerian are mild.
  • Immediate relief: Perhaps the most significant benefit of valerian is that users won’t need to wait days before they notice a reduction in anxiety. The anxiolytic effect exerted by valerian is generally noticed within an hour or two of administration.  Many standard anxiety treatments such as antidepressants can take weeks of regular administration before they provide any sort of anxiolytic benefit.  If you aren’t too keen on waiting for relief, valerian could be a helpful herbal intervention.
  • Mechanism of action: The mechanism of valerian’s action is fairly well understood. It is known to act upon GABAA receptors (specifically at the “beta subunit”) and prevent the enzymatic breakdown of endogenous GABA.  Its anxiolytic benefit stems primarily from its ability to modulate the neurotransmission of GABA.  Knowing this mechanism of action makes valerian a logically-sound intervention to [at the very least] test for anxiety.
  • Minimal interactions: Authors of several studies report that there don’t appear to be any significant interactions associated with valerian. Assuming authors are accurate in their statements of few contraindications/interactions, valerian may be a promising adjunct to other medications and/or herbal supplements.  That said, all valerian users should remain cautious of potential interactions and discuss concomitantly administered substances with a medical professional.  Taking valerian with another CNS depressant may be deleterious and/or possibly deadly.
  • Minor withdrawal: Many pharmaceutical anxiolytics carry severe withdrawal symptoms upon discontinuation. By comparison, valerian is thought to carry extremely “weak” withdrawal symptoms such as slight increases in anxiety and insomnia. Additionally, the discontinuation effects associated with valerian aren’t thought to be long-lasting such as those associated with benzodiazepines.
  • Neurorestorative properties: In an animal study, administration of valerian stimulated neurogenesis in the hippocampus. The study administered valerian to a group of rats that were subject to chronic stress and noted changes in hippocampal density and neuron proliferation.  Results indicated that valerian saved neurons from dying (as a result of chronic stress) and helped mice grow new neurons, thereby increasing neurons in the hippocampus to a normal count.
  • Overall safety: Administration of valerian appears relatively safe in most users. No significant adverse effects and/or safety concerns were reported in the literature.  As a result, it should be suspected that valerian is a safe herbal intervention – regardless of whether it is effective for the treatment of any medical condition.
  • Sleep enhancement: There is strong evidence to suggest that valerian improves sleep quality. Since individuals with anxiety often struggle with insomnia (e.g. the anxiety triggers insomnia via increases in sympathetic activation, perpetuation of neuroelectrical beta waves, hormonal changes, etc.), decreasing insomnia may prove beneficial for overall anxiety.  Assuming you’re able to fall asleep at a normal time as a result of valerian, and are able to stop worrying – getting better sleep may reduce the severity of your anxiety.

Drawbacks of Valerian for Anxiety (Possibilities)

Although it is necessary to highlight potential benefits associated with valerian for anxiety, it is equally necessary to outline various potential drawbacks associated with this herbal anxiolytic.  Some hypothetical drawbacks associated with valerian include: cognitive impairment, tolerance, and ultimately – that it may prove ineffective as a treatment for anxiety.  Additionally, long-term effects and discontinuation symptoms associated with valerian aren’t known.

  • Cognitive impairment: Some evidence suggests that valerian impairs cognitive processes. One study documented that valerian administration compromised performance on a cognitively-demanding Stroop task.  Since valerian is a CNS depressant acting similar to benzodiazepines upon GABAA receptors, it could be thought that valerian interferes with memory encoding, learning, and critical thinking skills.
  • Fine motor skills: It should be suspected that valerian may compromise fine motor skills and coordination, especially when taken at high dosages. Assuming valerian compromises motor skills, this could impair a user’s ability to operate a motor vehicle and/or heavy machinery.  For this reason, some individuals with anxiety may prefer pharmaceutical anxiolytics (e.g. SSRIs) – as they do not appear to significantly affect motor skills.
  • Ineffective: There is insubstantial evidence to suggest that valerian is clinically effective for the treatment of anxiety disorders. Therefore, until proven effective, it is important to remain open to the possibility that valerian is completely ineffective or useless as an anxiolytic.  Years from now, a large-scale/robust clinical trial may be conducted and find that valerian is no more effective than a placebo for the treatment of anxiety.
  • Interactions: It is necessary to consider that valerian may interact with many more pharmaceuticals and/or supplements than is presently suspected. Since there is limited research investigating possible contraindications associated with valerian extracts, undiscovered interactions should be considered.  Since valerian is a CNS depressant, it should be hypothesized that a concomitantly administered CNS depressant could be deleterious and/or fatal (e.g. cause respiratory depression).
  • Long-term effects: The long-term effects of valerian administration are not well-understood. With FDA-approved agents such as SSRIs/SNRIs, researchers understand that they are fairly well-tolerated and maintain efficacy for months and/or years at a time.  It isn’t known as to whether any deleterious long-term effects may result from chronic, long-term usage of valerian.
  • Side effects: Since there are many limitations associated with valerian research, it is necessary to consider that its full side effect profile may remain unknown. Most studies suggest that its side effects are relatively benign and/or uncommon.  However, it appears as though valerian can cause drowsiness, somnolence, and potentially induce-sleep.  These side effects may be dangerous for someone that needs to retain psychomotor vigilance and acuity (e.g. operating machinery).
  • Smell: Most people don’t have an issue with the smell of medications and/or supplements, but valerian is particularly odorous. Some individuals may gag at the smell of valerian and as a result, dislike using it as a supplement.  That said, there may be sources of valerian that aren’t as pungent as others.
  • Tolerance: Even if valerian is effective as an anxiolytic over the short-term, it is unknown as to whether it is capable of maintaining anxiolytic efficacy over a long-term; no long-term studies have been published. It should be speculated that like related-anxiolytic agents, a user’s neurochemistry may become habituated to the effects of valerian when administered regularly over an extended duration.  In other words, the standard dosage of valerian that initially worked well for anxiety may “stop working” because your neurochemistry has adapted to the valerian by downregulating certain processes.
  • Withdrawal symptoms: While most sources suggest that valerian isn’t associated with any significant withdrawal symptoms, anecdotes have reported more severe discontinuation effects than expected. Withdrawal symptoms may be of substantial severity, especially when discontinued after chronic, long-term, high-dose usage.  Those that discontinue valerian abruptly may experience severe rebound anxiety, insomnia, dizziness, and palpitations.

Valerian for Anxiety Disorders (Review of Research)

When considering valerian as a treatment for anxiety disorders, it is necessary to review scientific studies that attempt to elucidate its safety and efficacy.  Since valerian is not a pharmaceutical drug, and therefore is unlikely to receive any major funding for clinical research, there are few published studies investigating its efficacy for the treatment of anxiety disorders.  Until larger-scale trials are conducted, it will be difficult to fully understand its therapeutic potential as an intervention for anxiety disorders.

2011: Use of valerian in anxiety and sleep disorders: what is the best evidence?

A report published by Nunes and Sousa (2011) investigated the evidence of valerian as an intervention for anxiety and sleep disorders.  Researchers noted that anxiety disorders are highly problematic in that they decrease quality of life and well-being, while increasing the number of primary care visits.  In the introduction, researchers pointed out the fact that valerian root extracts are historically known for anxiolytic, hypnotic, and sedative properties.

For this reason, they speculated that valerian root extracts could be a viable treatment for anxiety disorders.  As part of their investigation, researchers collected data from systematic reviews, meta-analyses, and randomized-controlled trials (RCTs).  Since their research was compiled for clinical practice guidelines, lower quality evidence (based on the Strength of Recommendation Taxonomy from American Family Physician) wasn’t included in this report.

All studies collected for this report were published between 2000 and 2010.  Researchers dug up 173 total studies, but only 4 met previously established inclusion criteria.  Results indicated that evidence was lacking to clinically recommend valerian for the treatment of anxiety disorders.

That said, there was some evidence to suggest that valerian may be effective for the treatment of sleep disorders.  Furthermore, it was considered well-tolerated and safe with no significant adverse effects.  Although the evidence to medically recommend usage of valerian for anxiety disorders is lacking, researchers concluded that it appears to be a safe dietary supplement.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/22863505

2011: Extract of valerian root (Valeriana officinalis L.) vs. placebo in treatment of obsessive-compulsive disorder: a randomized double-blind study.

A study conducted by Pakseresht, Boostani, Sayyah (2011) documented the efficacy of valerian root extract for the treatment of OCD (obsessive-compulsive disorder).  Researchers decided to investigate the efficacy of valerian in particular due to the fact that it is a well-researched herb and its anxiolytic mechanism of action is understood.  Additionally, compared to standard pharmaceutical anxiolytics, valerian appears to have a favorable side effect profile.

For the study, researchers recruited 31 outpatients diagnosed with OCD (in accordance with DSM-IV criteria).  The study was considered randomized, placebo-controlled, and double-blinded.  All 31 outpatients received either: valerian root extract (765 mg/day) or placebo (30 mg/day) for a duration of 8 weeks.

Results indicated that individuals receiving the valerian root extract for 8 weeks exhibited significantly fewer OCD symptoms – as compared to those receiving the placebo.  The only side effect that occurred among more frequently among those taking valerian was somnolence.  Researchers concluded that valerian root extract has antiobsessive and anticompulsive effects, possibly making it useful as a treatment for OCD.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/22718671

2006: Valerian for anxiety disorders.

A systematic review conducted by Miyasaka, Atallah, and Soares (2006) was published in the Cochrane Database.  For this review, researchers sought to elucidate the safety and efficacy of valerian as an herbal treatment for anxiety disorders.  Since anxiety is a common mental health disorder and herbal medicines are commonly used to cope with symptoms, investigation of valerian root as an anxiolytic made logical sense.

The team of researchers scoured electronic databases for randomized controlled trials (RCTs) and quasi-randomized trials of valerian extract administered to individuals diagnosed with any type of anxiety.  Clinical outcome measures and various anxiety symptom scales were used to determine the anxiolytic efficacy of valerian root extract.  Of all studies examined, only one randomized controlled trial (RCT) met inclusion criteria.

This lone RCT tested the effects of valerian on 36 patients with generalized anxiety disorder over a period of 4 weeks.  It compared the effects of valerian to Valium (diazepam) and a placebo.  Based on measures of anxiety collected with the Hamilton Rating Scale for Anxiety (HAM-A), there appeared to be no differences in anxiolytic efficacy between the valerian, Valium (diazepam), and placebo.

The authors concluded that since only one small-scale study was included in this review, there is insufficient data to elucidate the safety and efficacy of valerian for anxiety disorders.  They further noted that larger-scale randomized controlled trials are warranted to better understand the efficacy of valerian in treating anxiety disorders.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/17054208

2006: Anxiolytic effects of a combination of Melissa officinalis and Valeriana officinalis during laboratory induced stress.

A study conducted by Kennedy et al. (2006) investigated the anxiolytic effects of valerian combined with lemon balm.  Both valerian and lemon balm are understood to elicit anxiolytic, hypnotic, and sedative effects.  Since valerian and lemon balm are commonly sold together as complementary herbs, researchers conducted a trial to determine whether the combination of valerian and lemon balm would attenuate stress.

Researchers set-up a double-blinded, placebo-controlled, randomized, cross-over trial.  A total of 24 healthy participants received a valerian/lemon balm blend (at separate single dosages of 600 mg, 1200 mg, 1800 mg) and a placebo.  Changes in participant mood and anxiety were documented with the Defined Intensity Stressor Simulation (DISS) battery.  Measures of cognitive function was also recorded for 4 tasks.

Results indicated that the low 600 mg dosage of the valerian/lemon balm blend decreased the intensity of stressors on the DISS battery.  A reduction in stressor intensity is indicative of a reduction in level of anxiety compared to the placebo.  At the high dosage of 1800 mg, individuals experienced a significant increase in anxiety compared to the placebo.

Furthermore, regardless of dosage of valerian/lemon balm – all impaired cognitive function (as evidenced by scores on Stroop tasks).  Researchers note that low dose administration of valerian/lemon balm may yield anxiolytic benefits.  However, it should be noted that cognitive deficits may result from this blend and exacerbation of anxiety may occur at high doses.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/16444660

2002: Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study.

A study conducted by Andreatini et al. analyzed the anxiolytic effects of valepotriates (valerian extract).  For this pilot-study, researchers recruited 36 outpatients diagnosed with generalized anxiety disorder (in accordance with DSM-III-R criteria).  The 36 participants were set to receive one of three treatments: valerian extract (~81.3 mg/day), diazepam (~6.5 mg/day), or a placebo – for a duration of 4-weeks.

Researchers implemented a parallel, double-blind, flexible-dose, placebo-controlled framework.  Throughout the trial, researchers documented changes in anxiety levels with the Hamilton Anxiety Scale (HAM-A) and the State-Trait Anxiety Inventory (STAI-trait).  By the end of the 4-week period, all three groups (valerian, diazepam, placebo) had significantly lower anxiety (as recorded by HAM-A scores).

However, solely the valerian and diazepam groups exhibited reduced scores on a subset of HAM-A measures known as “psychic factor.”  Additionally, only the diazepam group exhibited significant reductions on STAI-trait scores by the end of the 4-week trial.  Since valerian significantly reduced HAM-A scores, as well as the subset of “psychic factor” measures after 4-weeks, researchers speculate that it may be an effective treatment for psychic symptoms of anxiety.

Due to the fact that this study was extremely small-scale, and no differences were noted between the placebo, herbal intervention, and pharmaceutical – it’s difficult to draw any conclusions regarding the safety and/or efficacy of valerian.  Follow-up research with larger sample sizes are necessary to fully understand that anxiolytic efficacy of valerian extract.  That said, it is also important to avoid dismissing the fact that anxiolytic benefit was attained among those receiving valerian.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/12410546

Limitations associated with research of Valerian for anxiety

Upon examination of research investigating valerian as a treatment for anxiety, there appear to be many limitations.  Perhaps the most notable limitations associated with valerian research include: small sample sizes and suboptimal trial designs.  In other words, most studies have limited numbers of participants and/or lack robust designs from which we can draw any conclusions regarding valerian’s safety and/or anxiolytic efficacy.

  • Anxiety diagnoses: Few studies examine valerian’s efficacy among individuals specifically diagnosed with anxiety disorders (based on Diagnostic Statistical Manual criteria). In total, there are only 2 studies that tested valerian’s efficacy specifically for the treatment of anxiety disorders.  One study tested valerian as a treatment for OCD (obsessive-compulsive disorder), while the other tested valerian as a treatment for generalized anxiety disorder.  Other studies tested valerian’s efficacy in reducing laboratory-induced “stress,” which is entirely different than a clinically diagnosable anxiety disorder.
  • Anxiety subtypes: There are many different types of anxiety disorders such as: generalized anxiety disorder, OCD, panic disorder, PTSD, social anxiety disorder, etc. Unfortunately, research hasn’t specifically investigated valerian for the treatment of specific anxiety disorder subtypes.  Since each specific subtype of anxiety can be distinguished from others as a result of its unique neurophysiologic footprint, it is necessary to consider that valerian may only be effective for a subset of anxiety disorder subtypes; this hasn’t been investigated in the research.
  • Dosage/Format: Currently it is unclear as to what dosage of valerian and/or the specific format works best for anxiety. It is possible that a dosage of one valerian extract may contain a density of biochemical compounds that differs from another.  Due to hypothesized differences in biochemical compound density, it is necessary to speculate that dosages may be subject to the specific source of the valerian extract.  Research hasn’t yet addressed the possible differences in valerian extract formats and/or their therapeutic dosages.
  • Few studies: Unfortunately, it remains difficult to draw any definitive conclusions regarding valerian’s anxiolytic efficacy because few trials have investigated it for this purpose. To determine whether valerian is capable of decreasing stress, enhancing relaxation, and/or reducing anxiety – a greater number of trials need to be conducted.  Even small-scale studies that support its ability to reduce stress would provide a bit more evidence to suggest that it could help with anxiety.
  • Lack of funding: A prominent limitation associated with the research of any dietary supplement, including valerian, is a lack of funding. Most researchers that investigate substances for the treatment of neuropsychiatric disorders need proper funding to carry out their study.  Without adequate funding, they simply cannot recruit a big sample size, incorporate a robust design, and/or carry out a long-term study.  Researchers typically rely on pharmaceutical companies for their funding, and since valerian cannot be patented, there’s a lack of motivation to prove (or disprove) its anxiolytic efficacy.
  • Small sample-sizes: Studies with small sample-sizes can sometimes provide useful data, but not always. It is relatively difficult to interpret the anxiolytic efficacy of any substance when looking at results from an extremely small-scale study.  The fewer participants in a particular trial, the more likely that the results could be subject to inaccuracies.  Whenever there’s a small sample, all it takes is a few atypical responders and/or outliers to corrupt the entire data set.  The largest trial of valerian for anxiety involved 36 patients.  While valerian significantly reduced participant anxiety, so did the placebo – suggesting that the small sample-size was problematic.
  • Trial designs: In systematic reviews of valerian as a treatment for anxiety disorders, researchers noted that only one randomized-controlled trial (RCT) fit inclusion criteria for the review. In addition to increasing sample sizes, researchers need to incorporate robust study designs such as placebo-controlled, double-blinded, and randomized – whenever possible.  By strengthening the trial designs, it should bolster legitimacy of study findings.
  • Tolerance investigation: Although usage of valerian isn’t associated with [fast] tolerance onset, tolerance resulting from valerian hasn’t been subject to significant investigation. Due to the fact that it shares a similar mechanism of action with benzodiazepines (e.g. binding to the GABAA receptor), it could be thought that tolerance may be quicker than previously reported.  Future studies should attempt to elucidate whether users of valerian [for anxiety] may become tolerant to its effects with regular long-term usage.

Verdict: Efficacy of valerian for anxiety disorders remains “unknown”

Based upon the available scientific literature, it is premature to assume that valerian is an efficacious treatment for anxiety disorders.  To suggest that valerian effectively treats any type of anxiety disorder is a relative stretch and based solely upon anecdote rather than scientific data.  Until the aforestated limitations associated with valerian research [as an anxiolytic] are acknowledged and overcome, it will remain difficult to understand whether valerian is capable of attenuating neuropsychiatric anxiety disorders.

As of current, its efficacy as a clinical intervention for the treatment of anxiety should be considered unknown; with the available evidence, it is neither possible to prove nor dismiss its therapeutic potential.  That said, it is important to consider valerian’s hypothesized pharmacodynamics and evidence from presently-available research.  Upon examination of its pharmacodynamics, it appears to function similarly to benzodiazepines.

It binds to the GABAA receptor at the “beta subunit,” thereby allowing endogenous GABA to bind to the “alpha subunit,” which in turn hyperpolarizes the neuron and facilitates a reduction in CNS activation.  With this mechanism of action in mind, it is of sound logic to suspect that valerian likely decreases anxiety.  Whether the decrease in anxiety is of therapeutic benefit to those with anxiety disorders is an entirely separate debate.

Most can agree that valerian root elicits an anxiolytic effect in users via modulation of GABAergic activity.  Furthermore, when considering the available studies of valerian for the treatment of anxiety, all noted it as significantly reducing anxious symptoms.  Although its efficacy couldn’t be distinguished from a placebo in one study, the placebo was found to be highly effective as well – so it wasn’t suggesting that the valerian provided no significant benefit.

Available evidence indicates that valerian administration may provide benefit to individuals with generalized anxiety disorder, OCD, and laboratory-induced stress.  It also appears to be well-tolerated and isn’t associated with any significant adverse effects.  With these considerations in mind, valerian may be a worthwhile herbal experiment among those with anxiety disorders, particularly among individuals that resist traditional pharmaceutical medications.

Have you tried Valerian for anxiety disorders?

If you’ve tested valerian as a treatment for anxiety, be sure to share your experience in the comments section below.  To help others get a better understanding of your situation, mention the type of anxiety you’re targeting with valerian, the specific brand of valerian you use, as well as your dosage.  Also note your frequency of administration, total duration over which you’ve been using it, and whether you perceive it as providing significant anxiolytic benefit.

On a scale of 1 to 10, mention the degree to which valerian decreases your anxiety.  Do you take valerian as a standalone anxiolytic or along with other pharmaceuticals and/or supplements?  Have you experienced any unwanted side effects from valerian or become tolerant to its therapeutic efficacy?

It is important to understand that although valerian may not prove efficacious for all individuals with anxiety disorders, some may find that it provides additional symptomatic relief.  Since valerian is generally regarded as safe and is considered a “natural” substance, it retains mainstream appeal as an anxiolytic among those who wish to avoid pharmaceuticals.  Due to the fact that it’s efficacy remains unknown for the treatment of anxiety disorders, it may be worth anecdotally testing under supervision of a medical professional.

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