2003-10-21
Joanne Kabak

THE PRODUCT AND WHAT IT'S MARKETED FOR: Valerian is an herb that is marketed for "relief of occasional sleeplessness" by Pharmavite LLC of Northridge, Calif., under its Nature's Resource brand. The cost for 100 capsules is typically .99. The recommendation is to take one or two of the 400-milligram capsules about an hour before bedtime. Valerian is manufactured by several other companies and is also sold in tablet, tea or tincture form.

WHAT'S KNOWN: Although scientists do not know precisely how valerian works, it appears that compounds in the root of one of its major species, Valeriana officinalis, can have a sedating effect on the central nervous system. As a sleep aid, it is often associated with improving sleeplessness induced by nervousness.

Its use in medicine dates to the ancient Greeks; many recent studies have been conducted using double- blind, randomized methods to investigate its validity as a modern alternative to prescription sleep medications. For example, in a study published in the November 2002 edition of the European Journal of Medical Research and cited by Nature's Resource, 202 patients with nonorganic insomnia were given either 600 milligrams of valerian or 10 milligrams of oxazepam, a benzodiazepine that is in the family of drugs that includes Xanax. After six weeks, the study found that "valerian was at least as efficacious" as oxazepam, with no serious adverse drug reactions.

In a review of multiple studies published in the April 15, 2003, edition of American Family Physician, co-author Dr. Susan Hadley of Middlesex Hospital in Middletown, Conn., found that valerian appeared to be a safe herbal choice for mild insomnia and that it was well tolerated, but that more rigorous studies were needed. In particular, valerian appears helpful with sleep latency or the amount of time it takes to fall asleep. Further, she said it doesn't have a hangover effect so that "it can be taken at any time in the night -- even when patients wake up at 4 a.m."

However, she cautioned that to be safe and effective, valerian needs to come from "the true, pure, unadulterated herb." That can be a challenge. The independent testing firm Consumerlab.com examined 17 valerian products to see if the type and amount of valerian stated on the label were actually to be found in the product. The results, reported in its publication "Guide to Buying Vitamins and Supplements" and on its Web site showed that only nine, including the Nature's Resource version, passed the test.

THE BOTTOM LINE: It depends on how you view the evidence. On one hand, Gary Zammit, director of the Sleep Disorders Institute at St. Luke's-Roosevelt Hospital Center in Manhattan says that "while there are a number of studies that have examined the use of valerian as a treatment for insomnia, there are no studies that are considered to be well controlled that produce sufficient evidence to indicate that valerian could be used as an effective treatment for insomnia." Instead, he attributes at least some of the positive results to a placebo response.

On the other hand, Daniel Moerman, a professor at the University of Michigan Dearborn who has researched botanicals for 30 years, says that "I respectfully disagree with the specialists, and would suggest that valerian has ample evidence of effectiveness and safety for short-term use for nonorganic insomnia." He said that valerian studies were not necessarily any weaker than those typically used to approve prescription drugs. What is missing about valerian is long-term safety data, "which exist for precious few drugs," he said, and is not a concern with valerian if used as recommended in the short term.

He also pointed to valerian's long history, wide contemporary use throughout Europe and approval as a sleep aid by the German Commission E, the agency that uses rigorous standards to evaluate botanicals. At least in the case of Nature's Resource, consumers have help in making a more informed choice at the point of purchase. Senior product manager John Metz said that its brand is the first to include a multipage booklet under a peel-off label describing valerian's possible side effects, warnings and study results. Its content is based on information from the American Botanical Council, www.herbalgram.org, an independent research and education organization in Austin, Texas, that provides information on the medicinal uses of plants.

ALTERNATIVES: Zammit said there are "rational, good, safe choices available," including the prescription drug Ambien. Lauren Broch of the New York Hospital-Cornell Medical Center Sleep-Wake Disorders Center in White Plains identified many behavioral techniques, including keeping a sleep log to record your sleep times so you know where to make adjustments in your habits. For some people, relaxation techniques like deep breathing and yoga are helpful, she said. The National Sleep Foundation (www.sleepfoundation.org) is a comprehensive source of information about sleep disorders, treatments and resources.

Joanne Kabak is a freelance writer

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