Valerian sedation

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. 

Valerian, an herbal product, is also available without a prescription. The recommended dose is 300 to 600 mg. Purity and potency concerns are an issue. It may cause daytime sedation. 

Diazepam (Valium, Diastal-) [C-IV] [Anxiolytic, Skeletal Muscle Relaxant, Anticonvufsant, Sedative/Hypnotic/ Benzodiazepine] Uses Anxiety, EtOH withdrawal, muscle spasm, status epilepticus, panic disorders, amnesia, preprocedure sedation Action Benzodiazepine Dose Adults. Status epilepticus 5-10 mg IV/IM Anxiety 2-5 mg IM/IV Preprocedure 5-10 mg IV just prior to procedure Feds. Status epilepticus 0.5-2 mg IV/IM Sedation 0.2-0.5 mg/kg IV (onset w/in 5 IV and 30 min IM duration about 1 h IV and IM) Caution [D, / -] Contra Coma, CNS depression, resp depression, NAG, severe uncontrolled pain, PRG Disp Tabs 2, 5, 10 mg soln 1, 5 mg/mL inj 5 mg/mL rectal gel 2.5, 5, 10, 20 mg/mL SE Sedation, amnesia, bradycardia, BP, rash, i resp rate Interactions T Effects W/ antihistamines, azole antifungals, BBs, CNS depressants, cimetidine, ciprofloxin, clisulfiram, INH, OCP, omeprazole, phenytoin, valproic acid, verapamil, EtOH, kava kava, valerian T effects OF digoxin, diuretics effects w/ barbiturates, carbamazepine,... 

Tea Tree (Melaleuca alternifolia) Uses Rx of superficial wounds (bacterial, viral, fungal, insect bites, minor burns, cold sores, acne Action Broad-spectrum antibiotic activity against E. coli, S. aureus, C. albicans Available forms Topical creams, lotions, oint, oil apply topically PRN Notes/SE Ataxia, contact dermatitis, D, drowsiness, GI mucosal irritation Interactions Effects OF drugs that affect histamine release EMS effects of Benadryl Valerian (Valeriana officinalis) Uses Anxiolytic, antispasmodic, dys-menorrheal, restlessness, sedative Action Inhibits uptake stimulates release of GABA, which T GABA concentration extracellularly causes sedation Available forms Ext 400-900 mg PO 30 min < hs, tea 2-3 g (1 tsp of crude herb) qid, PRN, tine 3-5 mL (1/2-1 tsp) (1 5 ratio) PO qid, PRN Efficacy Probably effective sedative (reduces sleep latency) Notes/SE GI upset, HA, insomnia, N/V, palpitations, restlessness, vision changes Interactions T Effects OF barbiturates, benzodiazepines, opiates, EtOH, catnip, hops, kavakava, passion flower, skullcap effects OF MAOIs, phenytoin, warfarin EMS T Effects of benzodiazepines and opiates abruptly D/C may cause withdrawal symptoms... 

In a double-blind, randomized, placebo-controlled, crossover study of the comparative pharmacodynamics of single doses of temazepam (15 and 30 mg), diphenhydramine (50 and 75 mg), and valerian (400 and 800 mg) in 14 healthy elderly volunteers, temazepam had dose-dependent effects on sedation and psychomotor ability with a distinct time course (4). Temazepam 30 mg and both doses of diphenhydramine elicited significantly greater sedation than placebo, and temazepam had the greatest effect. There were no differences in sedation scores between 50 and 75 mg of diphenhydramine. Psychomotor impairment was evident after diphenhydramine 75 mg compared with placebo on the manual tracking test this was less than the impairment with temazepam 30 mg but similar to that with temazepam 15 mg. There was no psychomotor impairment with diphenhydramine 50 mg. Valerian was not different from placebo on any measure of psychomotor performance or sedation. 

Eszopiclone has a rapid onset and a duration of action of up to 6 hours. The most common adverse effects are somnolence, unpleasant taste, headache, and dry mouth. It may be taken nightly for up to 6 months. Valerian, an herbal product, is also available without a prescription. The recommended dose is 300 to 600 mg. Purity and potency concerns are an issue. It may cause daytime sedation. 

Ashwagandha 2. Celery 3. Chamomile 4. German chamomile 5. Goldenseal 6. Hops 7. Kava kava 8. Valerian 1. Melatonin May cause t sedation Unknown mechanism Be aware... 

Sedation is mediated predominantly through the inhibitory neurotransmitter GABA. Although the mechanism of action of valerian as a sleep aid is not fully understood, it may involve inhibition of the enzyme that breaks down... 

Valerian root Valeriana officianalis Valeriana edulis Sleep aid Sedation vomiting. 

Biologicalacdvity V. have an equilibrating effect, i. e., sedating in states of excitement and stimulating in states of tiredness. Valerian teas and tinctures do not contain V. but rather valerenic, valerenolic, and ace-tylvalerenolic acids that are purported to be responsible for the sedative activity of valerian preparations V. or their metabolites exhibit in vivo alkylating, cell toxic, and mutagenic activities. ... 

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