Valerian insomnia treatment

Antihistamines such as diphenhydramine are known for their sedating properties and are frequently used over-the-counter medications (usual doses 25-50 mg) for difficulty sleeping. Diphenhydramine is approved by the FDA for the treatment of insomnia and can be effective at reducing sleep latency and increasing sleep time.43 However, diphenhydramine produces undesirable anticholinergic effects and carryover sedation that limit its use. As with TCAs and BZDRAs, diphenhydramine should be used with caution in the elderly. Valerian root is an herbal sleep remedy that has inconsistent effects on sleep but may reduce sleep latency and efficiency at commonly used doses of 400 to 900 mg valerian extract. Ramelteon, a new melatonin receptor agonist, is indicated for insomnia characterized by difficulty with sleep onset. The recommended dose is 8 mg at bedtime. Ramelteon is not a controlled substance and thus may be a viable option for patients with a history of substance abuse. 

The use of valerian extends back at least 1000 years, and it gained a reputation in sixteenth-century Europe as a treatment for epilepsy (Tyler 1994 Temkin 1971). Its reported uses are broad (digestive aid, muscle relaxant, antipyretic, etc.) but it is commonly known to treat insomnia and anxiety (Gruenwald et al. 1998 Kowalchick and Hylton 1987). Valerian has a distinct, unpleasant odor. Perhaps appropriately, it is believed to be an herb in the writings of Galen and Dioscorides, called phu (Leyel 1994). 

Once recognized as a tonic, tranquilizer, and antispasmodic, skullcap was therefore used as an ingredient in many patent medicines for female weakness. It was also combined with other reputedly calming herbs, such as hops and valerian, and promoted as a sedative or anxiolytic. Other traditional uses include treatment of epilepsy, headache, insomnia, various other neurological and psychiatric disorders, hypertension, fever, rheumatism, and stress. 

Today, valerian is used for treating insomnia. It is known to have sedative, mild anodyne, hypnotic, antispasmodic, carminative, and hypotensive properties. Traditionally, it has been used for the treatment of fatigue, seizures, hysterical states, excitability, insomnia, hypochondriasis, migraine, cramp, intestinal colic, rheumatic pains, dysmenorrhea, and specifically for conditions producing nervous excitability. 

Valerian is used in the treatment of insomnia and stress and anxiety. The important active compounds of valerian are the valepotriates (iridoid molecules) and valeric acid. These compounds are found exclusively in valerian. Originally, it was thought that just the valepotriates were responsible for valerian s sedative effects but, recently, an aqueous extract of valerian has also been shown to have a sedative effect. As the valepotriates are not soluble in water, it was concluded that valeric acid also possesses sedative action and is the chemical factor responsible for the sedative effect noted in human clinical trials with aqueous extracts of valerian (Murray, 1995). Valerian inhibits the uptake of GABA and enhances the release of GABA. 

Valerian is used in the short-term treatment of insomnia characterized by difficulty in falling asleep and poor sleep quality. Valeriana officinalis L. inhibits reuptake of and stimulates the release of y-aminobutyric acid (GABA), contributing to its sedative properties. 

The properties of Scullcap are said to have been first appreciated by Vandesveer in 1772 for use against hydrophobia. Scullcap is now employed, often with Valerian, in hysteria and insomnia, and is reputed to be effective in the treatment of epilepsy. 

In a pilot study, 24 patients with stress-induced insomnia were treated for 6 weeks with kava 120 mg/day, followed by a 2-week washout period and then treatment with valerian 600 mg/day for another 6 weeks (4). Stress was measured in three areas, including social, personal, and life events, and insomnia was assessed by evaluating the time taken to fall... 

Wheatley D. Kava and valerian in the treatment of stress-induced insomnia. Phytother Res 2001 15(6) 549-51. 

Valerian is promoted in the United States primarily as a sedative-hypnotic for treatment of insomnia, and as an anxiolytic for restlessness and sleeping disorders associated with anxiety (4,7). 

Valerian is promoted in the United States for treatment of insomnia (USP, 1998). 

Vorbach, E., Gortehnayer, R., and Runing, R., Treatment of insomnia Efficacy and tolerance of a valerian extract, Psychopharmakotherapie, 3,109,1996. 

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