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Scientific Name(s): Centranthus ruber L., Valeriana officinalis L., Valeriana sambucifolia Mik., Valeriana wallichi DC.
Common Name(s): Baldrian, Cat's love, Cat's valerian, Garden heliotrope, Garden valerian, Kesso root, Radix valerianae, St. George's herb, Valerian, Valerian fragrant, Vandal root
Drug class: Herbal products

Medically reviewed by Last updated on Jun 9, 2021.

Clinical Overview


The evidence to support the common use of valerian in insomnia remains weak. However, as valerian preparations seem to have a wide margin of safety, further trials for insomnia and anxiety may be warranted. Very limited data have been published concerning use for dysmenorrhea and obsessive-compulsvie disorder.


Anxiety: Valeprotriates 150 mg/day in 3 divided doses for 4 weeks has been used in a clinical trial. Other trials used the dried herb 0.5 to 2 g, extract 0.5 to 2 mL, and valerian tincture 2 to 4 mL for anxiety. Insomnia: Valerian extract 400 to 600 mg/day taken 1 hour before bedtime for 2 to 4 weeks has been used in clinical trials. Single-dose studies have consistently found no effect for single doses of valerian in insomnia.


Contraindications have not been identified.


Information regarding safety and efficacy in pregnancy and lactation is lacking.


None well documented.

Adverse Reactions

In general, clinical studies have found valerian to have a wide margin of safety, be devoid of adverse effects, and have fewer adverse reactions than positive control drugs, such as diazepam. Headache and diarrhea have been reported in clinical trials, but hangover is seldom reported. Several cases of hepatotoxicity have been reported.


Valerian has been classified as GRAS (generally recognized as safe) in the United States for food use; extracts and the root oil are used as flavorings in foods and beverages. The observed in vitro cytotoxicity of valepotriate compounds may not be relevant in vivo because of limited absorption.

Scientific Family

  • Valerianaceae


Members of the genus Valeriana are herbaceous perennials widely distributed in the temperate regions of North America, Europe, and Asia. The hollow stemmed plant can grow up to 2 m and is branched at the terminal end with opposite leaves and small white or pink flowers. Fruits are oblong, 4-ridged, and single seeded. Of approximately 200 known species, the Eurasian Vakeruaba officinalis is most often cultivated for medicinal use. The dried rhizome used in valerian extracts has numerous rootlets and one or more stolons and contains a volatile oil with a distinctive, unpleasant odor.1, 2, 3, 4


Valerian has been used in Unani, Ayurvedic, and traditional Chinese health systems and for homeopathic uses for cardiotonic and sedative properties, as well as in epilepsy, hysteria, and other conditions.5 Despite its odor, valerian was considered a perfume in 16th-century Europe. The tincture has been used for its sedative properties for centuries; it is still widely used in France, Germany, and Switzerland as a sleep aid.6 Other uses attributed to valerian include a digestive aid, emmenagogue, and antiperspirant.2


Three distinct classes of compounds have been associated with the sedative properties of valerian. These compounds consist of mono- and sesquiterpenes and iridoid triesters (valepotriates). Other compounds identified include flavonoids, triterpenes, lignans, and alkaloids. The composition of the volatile oil varies markedly between cultivars and species, as does the amount and relative proportion of cytotoxic valepotriates, making chemical standardization difficult but highly desirable.

The most important sesquiterpenes include valerenic acid and its congeners, although in Japan, V. officinalis var. latifolia, kessyl alcohols, and esters predominate. Valtrate, acevaltrate, and didrovaltrate are the most important iridoids; European valerian extracts were formerly standardized on these unstable compounds, which have a short shelf life in the tincture.

The alkaloid concentration in roots and rhizomes is low, usually less than 0.2%. The aqueous extract of valerian contains substantial quantities of gamma-aminobutyric acid (GABA); however, it is doubtful whether GABA penetrates the blood-brain barrier.

Many analytical high performance liquid chromatographic methods have been developed for the sesquiterpenes and valepotriates. The seasonal variation in valerenic acids and valepotriates has been studied. Tissue culture of valerian species has focused on the production of valepotriates.2, 7, 8, 9, 10, 11, 12

Uses and Pharmacology

Several in vitro and animal experiments have attempted to elucidate the mechanism of action for various valerian compounds. Many of these experiments provide contradictory evidence, but most attribute the observed actions of valerian extracts to central actions on GABA, serotonin, and adenosine receptors. The sesquiterpene valerenic acid and its derivatives and the valepotriates are generally thought to be the active constituents; however, wide variations in the composition of commercial preparations make interpretation of clinical data difficult.9, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22

Anxiolytic effect

Both a meta-analysis and systematic review comment on the lack of trials meeting inclusion criteria because of poor methodology, the use of healthy volunteers, and combination therapies.14, 23 One small, pilot clinical trial meeting inclusion criteria evaluated the effect of valepotriates 150 mg per day in 3 divided doses over 4 weeks in generalized anxiety disorder.24 No difference was demonstrated for the standardized valerian extract versus placebo or diazepam 20 mg.24 Until studies with a larger sample size are conducted, the efficacy of valerian remains unclear.14, 23

Another review of clinical trials and in vitro experiments suggests the effect of valerian may be because of anxiolytic action, rather than sedation.13 This was demonstrated by a laboratory experiment with rodents that found no decrease in spontaneous locomotor activity and no increase in ether-induced anesthesia, but did find a reduction in anxiety using the elevated plus maize test.25 Older experiments in rodents found conflicting results for spontaneous motor activity.22, 26


One randomized, controlled clinical trial evaluated the use of valerian compared with identical placebo in college-age women for management of dysmenorrhea symptoms. Both valerian and placebo produced significant reductions in pain compared with baseline scores, but the pain reduction seen with valerian was significantly larger compared with placebo. Severity of systemic symptoms was reduced with both valerian and placebo, with valerian’s scores nonsignificantly lower than placebo scores for all symptoms except syncope. Valerian’s reduction of syncope was significantly lower compared with placebo.57 A Cochrane systematic review and meta-analysis of dietary supplements for dysmenorrhea identified only low or very low quality studies with very small sample sizes. Very limited evidence of effectiveness was found for the treatment of primary dysmenorrhea with valerian 255 mg root powder 3 times daily compared to placebo or no treatment (1 randomized clinical trial, n = 100); however, no difference was identified between valerian 250 mg compared to mefenamic acid 250 mg (1 randomized clinical trial, n = 99).61


Single-dose studies have consistently found no effect for a single dose of valerian in improving sleep latency or quality.27, 28, 29

A meta-analysis of studies published through September, 2008 evaluated data from eighteen randomized controlled trials (>1300 patients). The authors did not find significant benefits for sleep latency time or sleep quality as rated by visual analogue scale. Patients’ subjective rating of sleep quality did significantly favor valerian.30 Reviews of older trials not included in the meta-analysis found valerian to exert an effect similar to the benzodiazepines, but a number of negative trials are also described.5, 13

Two additional studies, one in oncology patients, and the other in postmenopausal females, were published after the meta-analysis mentioned above. The study in cancer patients was a phase III trial that found no significant benefit for insomnia, but valerian did provide statistically significant improvements for the patient-rated, secondary outcomes of fatigue and mood.31 The study in postmenopausal women found a significant improvement in patient-rated sleep quality with valerian compared with placebo.32 Valerian 160 mg combined with lemon balm 80 mg taken for 1 month also significantly improved sleep quality compared with baseline (P = 0.001) and placebo (P = 0.0001) in women experiencing sleep disruption/disorders subsequent to natural menopause. The placebo group in this randomized trial (n = 100) also experienced a significant improvement in sleep scores compared with baseline (P = 0.0001). No adverse events were reported.59

The American Academy of Sleep Medicine clinical practice guideline for the pharmacologic treatment for chronic insomnia (2017) suggests that valerian not be used as a treatment for sleep onset or sleep maintenance insomnia (versus no treatment) in adults. Benefits are considered to be approximately equal to risks (Weak; Low).54

Obsessive-compulsive disorder

A randomized, double-blind, placebo-controlled pilot study evaluated valerian in a small group of patients who qualified for inclusion according to DSM-IV-TR criteria for obsessive-compulsive disorder, and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores 21 or higher. The valerian group had significantly lower Y-BOCS scores beginning 4 weeks after study initiation, and this significant difference continued through the end of study at week 8. Somnolence was reported more frequently in the valerian group.58

Postoperative cognitive dysfunction

Cognitive dysfunction has become a common complication after cardiac surgery since the introduction of cardiopulmonary bypass (CPB) in the 1950s and leads to increased length of hospital stay, costs, risk of dementia, and mortality. Mechanisms involved include acute inflammation and decreased serotonin levels. A double-blind, randomized, placebo-controlled trial enrolled 61 adult Iranians who were candidates for coronary artery bypass surgery using CPB to evaluate the effect of V. officinalis (530 mg root extract every 12 hours × 8 weeks) on the prevention of postoperative cognitive dysfunction. Cognitive function was assessed using the Mini-Mental State Examination at baseline, 10 days postoperation, and 60 days postoperation. Patients receiving valerian had reduced odds of cognitive dysfunction compared to placebo based on a generalized estimation equation (estimate, −2.2; odds ratio, 0.108; 95% confidence interval, 0.022 to 0.545).60

Restless legs syndrome

Guidelines have been published regarding the use of valerian in restless legs syndrome (RLS). A joint European task force developed evidence-based guidelines on the management of RLS (2012) and stated that a low quality study with valerian failed to demonstrate efficacy in the treatment of RLS symptoms or sleep.55 Likewise, an American Academy of Sleep Medicine evidence-based guideline (2012) determined there is insufficient evidence at present to evaluate the use of valerian for RLS based on one small controlled trial.56

Other uses

The valepotriates, isovaltrate, and valtrate, along with valerenone, had antispasmodic effects in isolated guinea pig ileum and other smooth muscle preparations.33

Valerian had no effect on haloperidol-induced orofacial dyskinesia in rats.34

Oral administration of valerian root extracts was protective against vasopressin-induced coronary spasms and pressor response in guinea pigs.7 In the same experiment, bronchial resistance was reduced in both histamine- and antigen-induced bronchospasm.7

In a triple-blind, randomized, placebo-controlled study that enrolled 60 postmenopausal Iranian women, administration of valerian 530 mg twice daily for 2 months significantly reduced severity (50% none, 40% mild; P=0.02) and frequency (mean diff, −3/day; P=0.03) of hot flushes compared to placebo (0% none, 30% mild and +0.26/day, respectively). Valerian was well tolerated an no side effects were reported.63


A dose of a commercial preparations of valerian extract 600 mg in healthy subjects peaked at 30 minutes to 2 hours, with an elimination half-life of 1.1 ± 0.6 hours, and the marker valerenic acid was in the serum for at least 5 hours after dosing.35


A clinical trial evaluating valerian as an anxiolytic used valeprotriates 150 mg in 3 divided doses for 4 weeks.24 Other trials have used valerian dried herb 0.5 to 2 g, extract 0.5 to 2 mL, and tincture 2 to 4 mL.14


Valerian extract 400 to 600 mg taken 1 hour before bedtime for 2 to 4 weeks has been used in clinical trials evaluating valerian in insomnia.13, 31, 32 A study conducted in children with insomnia (mean age, 11 years) used valerian extract 20 mg/kg body weight at night for 2 weeks. No adverse reactions were noted at this dosage; however, results were inconclusive.6, 36 Studies have consistently found no effect for a single dose of valerian in improving sleep latency or quality.27, 28, 29

Valerian extract up to 1,215 mg has been used as a sedative, but clinical trials have not established an optimal dose, and issues of standardization of content and preparation quality have been raised.6, 13 Many commercial preparations exist either as valerian alone or in combination with other compounds.

Pregnancy / Lactation

Despite common use without apparent harm during pregnancy, the use of valerian preparations in pregnancy and lactation cannot be supported without evidence of safety. Widespread differences in dosages, duration, and preparations exist, and the stage of pregnancy may be a factor.37 Valerian is reported in the Complete German Commission E Monographs to stimulate uterine contractions.38 Information regarding safety and efficacy in pregnancy and lactation is lacking.


Benzodiazepines: Valerian may enhance the adverse/toxic effect of Benzodiazepines. Monitor therapy.48, 49, 50, 51, 52, 53

Adverse Reactions

Valerian has been classified as GRAS in the United States for food use; extracts and the root oil are used as flavorings in foods and beverages.13

Generally, clinical studies have found that valerian has a wide margin of safety, is devoid of adverse effects, and has fewer adverse reactions than positive control drugs, such as diazepam. Headache and diarrhea have been reported in clinical trials, but hangover is seldom reported.5, 6, 13, 24, 30, 31, 32

An intentional overdose has been reported, in which 20 times the recommended dose was ingested; the patient experienced mild symptoms that resolved within 24 hours.42 A case of withdrawal after chronic use of valerian has been reported; however, the complex nature of the patient's medical history provides weak evidence of valerian's role.43 Farmers growing valerian were evaluated for adverse reactions, with few notable effects observed.44

Hepatotoxicity associated with valerian use was first reported in 1989. Six cases have been reported in women, all of whom reported marked improvement or normalization of liver function tests over 1 to 19 months after valerian discontinuation. However, one case of severe acute hepatitis refractory to improvement subsequent to valerian discontinuation was reported in a 57-year-old man. He had taken 2 g/day of valerian for 3 days and developed worsening liver function over the following 4 weeks. He was successfully treated with oral prednisolone 50 mg daily.62


Concern was raised following the discovery that valepotriates are mutagenic in the Ames assay; however, their poor bioavailability and hepatic detoxification makes them a dubious source of toxicity for patients.2, 45 The cytotoxicity of baldrinal compounds (metabolites of the valepotriates) is higher in vivo than in vitro because they are more readily absorbed, and these metabolites have been detected in commercial preparations.2

No teratogenicity or overt toxicity of valepotriate compounds was found in rodents in 2 different studies.2, 13, 46 Mice receiving doses of valerian more than 1 g/kg by oral and intraperitoneal routes have experienced ataxia, muscle relaxation, and hypothermia.47

No evidence of hepatitis was observed following consumption of oral valerian at average dosages of 2.5 g/day for 4 years.46

Index Terms

  • Vakeruaba officinalis


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7. Circosta C, De Pasquale R, Samperi S, Pino A, Occhiuto F. Biological and analytical characterization of two extracts from Valeriana officinalis. J Ethnopharmacol. 2007;112(2):361-367.17467210
8. Gao XQ, Björk L. Valerenic acid derivatives and valepotriates among individuals, varieties and species of Valeriana. Fitoterapia. 2000;71(1):19-24.11449465
9. Santos MS, Ferreira F, Faro C, et al. The amount of GABA present in aqueous extracts of valerian is sufficient to account for [3H]GABA release in synaptosomes. Planta Med. 1994;60(5):475-476.7997482
10. Bos R, Woerdenbag HJ, Hendriks H, et al. Analytical aspects of phytotherapeutic valerian preparations. Phytochem Anal. 1996;7(3):143-151.
11. Bos R, Woerdenbag HJ, van Putten FM, Hendriks H, Scheffer JJ. 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 Med. 1998;64(2):143-147.9556440
12. Gränicher F, Christen P, Vuagnat P. Rapid high performance liquid chromatographic quantification of valepotriates in hairy root cultures of Valeriana officinalis L. var. sambucifolia Mikan. Phytochem Anal. 1994;5(6):297-301.
13. Block KI, Gyllenhaal C, Mead MN. Safety and efficacy of herbal sedatives in cancer care. Integr Cancer Ther. 2004;3(2):128-148.15165499
14. Miyasaka LS, Atallah AN, Soares B. Valerian for anxiety disorders. Cochrane Database Syst Rev. 2006;(4):CD004515.17054208
15. Dietz BM, Mahady GB, Pauli GF, Farnsworth NR. Valerian extract and valerenic acid are partial agonists of the 5-HT5a receptor in vitro. Brain Res Mol Brain Res. 2005;138(2):191-197.15921820
16. Ortiz JG, Rassi N, Maldonado PM, González-Cabrera S, Ramos I. Commercial valerian interactions with [3H]flunitrazepam and [3H]MK-801 binding to rat synaptic membranes. Phytother Res. 2006;20(9):794-798.16819753
17. Sichardt K, Vissiennon Z, Koetter U, Brattström A, Nieber K. Modulation of postsynaptic potentials in rat cortical neurons by valerian extracts macerated with different alcohols: involvement of adenosine A1- and GABAA-receptors. Phytother Res. 2007;21(10):932-937.17582590
18. Hiller K-O, Zetler G. Neuropharmacological studies on ethanol extracts of Valeriana officinalis L: behavioural and anticonvulsant properties. Phytother Res. 1996;10(2):145-151.
19. Leuschner J, Müller J, Rudmann M. Characterization of the central nervous depressant activity of a commercially available valerian root extract. Arzneimittelforschung. 1993;43(6):638-641.8352816
20. Krieglstein JG, Frusia D. Central depressant constituents in Valeriana. Valepotriate, valerenic acid, valeranone and volatile oil are ineffective afterall. Dtsch Apoth Ztg. 1988;128:2041.
21. Riedel E, Hänsel R, Ehrke G. Inhibition of gamma-aminobutyric acid catabolism by valerenic acid derivatives [in German]. Planta Med. 1982;46(4):219-220.7163416
22. Hendriks H, Bos R, Woerdenbag HJ, Koster AS. Central nervous depressant activity of valerenic acid in the mouse. Planta Med. 1985;51(1):28-31.17340394
23. Ernst E. Herbal remedies for anxiety - a systematic review of controlled clinical trials. Phytomedicine. 2006;13(3):205-208.16428031
24. Andreatini R, Sartori VA, Seabra ML, Leite JR. Effect of valepotriates (valerian extract) in generalized anxiety disorder: a randomized placebo-controlled pilot study. Phytother Res. 2002;16(7):650-654.12410546
25. Hattesohl M, Feistel B, Sievers H, Lehnfeld R, Hegger M, Winterhoff H. Extracts of Valeriana officinalis L. s.l. show anxiolytic and antidepressant effects but neither sedative nor myorelaxant properties. Phytomedicine. 2008;15(1-2):2-15.18160026
26. Hendriks H, Bos R, Allersma DP, Malingré TM, Koster AS. Pharmacological screening of valerenal and some other components of essential oil of Valeriana officinalis. Planta Med. 1981;42(1):62-68.7255569
27. 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. 2000;33(2):47-53.10761819
28. Diaper A, Hindmarch I. A double-blind, placebo-controlled investigation of the effects of two doses of a valerian preparation on the sleep, cognitive and psychomotor function of sleep-disturbed older adults. Phytother Res. 2004;18(10):831-836.15551388
29. Hallam KT, Olver JS, McGrath C, Norman TR. Comparative cognitive and psychomotor effects of single doses of Valeriana officianalis and triazolam in healthy volunteers. Hum Psychopharmacol. 2003;18(8):619-625.14696021
30. Fernández-San-Martín MI, Masa-Font R, Palacios-Soler L, Sancho-Gómez P, Calbó-Caldentey C, Flores-Mateo G. Effectiveness of Valerian on insomnia: a meta-analysis of randomized placebo-controlled trials. Sleep Med. 2010;11(6):505-511.2034738910.1016/j.sleep.2009.12.009
31. Atherton PJ, Bauer BA, Moore DF Jr, et al.The use of Valeriana officinalis (Valerian) in improving sleep in patients who are undergoing treatment for cancer: a phase III randomized, placebo-controlled, double-blind study (NCCTG Trial, N01C5). Barton DL, J Support Oncol. 2011;9(1):24-31.10.1016/j.suponc.2010.12.008
32. Taavoni S, Ekbatani N, Kashaniyan M, Haghani H. Effect of valerian on sleep quality in postmenopausal women: a randomized placebo-controlled clinical trial. Menopause. 2011;18(9):951-955.2177591010.1097/gme.0b013e31820e9acf
33. Hazelhoff B, Malingré TM, Meijer DK. Antispasmodic effects of Valeriana compounds: an in-vivo and in-vitro study on the guinea-pig ileum. Arch Int Pharmacodyn Ther. 1982;257(2):274-287.7114974
34. Fachinetto R, Villarinho JG, Wagner C, et al. Valeriana officinalis does not alter the orofacial dyskinesia induced by haloperidol in rats: role of dopamine transporter. Prog Neuropsychopharmacol Biol Psychiatry. 2007;31(7):1478-1486.17669571
35. Anderson GD, Elmer GW, Kantor ED, Templeton IE, Vitiello MV. Pharmacokinetics of valerenic acid after administration of valerian in healthy subjects. Phytother Res. 2005;19(9):801-803.16220575
36. Hrastinger A, Dietz B, Bauer R, Sagraves R, Mahady G. Is there clinical evidence supporting the use of botanical dietary supplements in children? J Pediatr. 2005;146(3):311-317.15756210
37. Holst L, Nordeng H, Haavik S. Use of herbal drugs during early pregnancy in relation to maternal characteristics and pregnancy outcome. Pharmacoepidemiol Drug Saf. 2008;17(2):151-159.17992658
38. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. 2002;109(3):227-235.11950176
39. Hellum BH, Nilsen OG. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.18331390
40. Engdal S, Klepp O, Nilsen OG. Identification and exploration of herb-drug combinations used by cancer patients. Integr Cancer Ther. 2009;8(1):29-36.19174505
41. Chaplin RL Jr, Jedynak J, Johnson D, Heiter D, Shovelton L, Garrett N. The effects of valerian on the time course of emergence from general anesthesia in Sprague-Dawley rats (Rattus norvegicus). AANA J. 2007;75(6):431-435.18179003
42. Willey LB, Mady SP, Cobaugh DJ, Wax PM. Valerian overdose: a case report. Vet Hum Toxicol. 1995;37(4):364-365.8540231
43. Garges HP, Varia I, Doraiswamy PM. Cardiac complications and delirium associated with valerian root withdrawal. JAMA. 1998;280(18):1566-1567.9820254
44. Skórska C, Golec M, Mackiewicz B, Góra A, Dutkiewicz J. Health effects of exposure to herb dust in valerian growing farmers. Ann Agric Environ Med. 2005;12(2):247-252.16457481
45. von der Hude W, Scheutwinkel-Reich M, Braun R. Bacterial mutagenicity of the tranquilizing constituents of Valerianaceae roots. Mutat Res. 1986;169(1-2):23-27.3511364
46. Yao M, Ritchie HE, Brown-Woodman PD. A developmental toxicity-screening test of valerian. J Ethnopharmacol. 2007;113(2):204-209.17611059
47. Hobbs C. Valerian: a literature review. HerbalGram. 1989;21(1-2):19-34.
48. Carrasco MC, Vallejo JR, Pardo-de-Santayana M, et al. Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam. Phytother Res. 2009;23(12):1795-1796.19441067
49. Khom S, Baburin I, Timin E, et al. Valerenic acid potentiates and inhibits GABA(A) receptors: molecular mechanism and subunit specificity. Neuropharmacology. 2007;53(1):178-187.17585957
50. Appel K, Rose T, Fiebich B, et al. Modulation of the gamma-aminobutyric acid (GABA) system by Passiflora incarnata L. Phytother Res. 2011;25(6):838-843.21089181
51. Gutierrez S, Ang-Lee MK, Walker DJ, et al. Assessing subjective and psychomotor effects of the herbal medication valerian in healthy volunteers. Pharmacol Biochem Behav. 2004;78(1):57-64.15159134
52. Ugalde M, Reza V, Gonzalez-Trujano ME, et al. Isobolographic analysis of the sedative interaction between six central nervous system depressant drugs and Valeriana edulis hydroalcoholic extract in mice. J Pharm Pharmacol. 2005;57(5):631-639.15901352
53. Hattesohl M, Feistel B, Sievers H, et al. Extracts of Valeriana officinalis L. s.l. show anxiolytic and antidepressant effects but neither sedative nor myorelaxant properties. Phytomedicine. 2008;15(1-2):2-15.18160026
54. Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017;13(2):307-349.27998379
55. Garcia-Borreguero D, Ferini-Strambi L, Kohnen R, et al; European Federation of Neurological Societies; European Neurological Society; European Sleep Research Society. European guidelines on management of restless legs syndrome: report of a joint task force by the European Federation of Neurological Societies, the European Neurological Society and the European Sleep Research Society. Eur J Neurol. 2012;19(11):1385-1396.22937989
56. Aurora RN, Kristo DA, Bista SR, et al. The treatment of restless legs syndrome and periodic limb movement disorder in adults-an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline. Sleep. 2012;35(8):1039-1062.22851801
57. Mirabi P, Dolatian M, Mojab F, Majd HA. Effects of valerian on the severity and systemic manifestations of dysmenorrhea. Int J Gynaecol Obstet. 2011;115(3):285-288.2195906810.1016/j.ijgo.2011.06.022
58. Pakseresht S, Boostani H, Sayyah M. Extract of valerian root (Valeriana officinalis L.) vs. placebo in treatment of obsessive-compulsive disorder: a randomized double-blind study. J Complement Integr Med. 2011 Oct 11;8. pii: /j/jcim.2011.8.issue-1/1553-3840.1465/1553-3840.1465.xml.2271867110.2202/1553-3840.1465
59. Taavoni S, Nazem egbatani N, Haghani H. Valerian/lemon balm use for sleep disorders during menopause. Complement Ther Clin Pract. 2013;19(4):193-196.24199972
60. Hassani S, Alipour A, Khezri HD, et al. Can Valeriana officinalis root extract prevent early postoperative cognitive dysfunction after CABG surgery? A randomized, double-blind, placebo-controlled trial. Psychopharmacology (Berl). 2015;232(5):843-850.
61. Pattanittum P, Kunyanone N, Brown J, et al. Dietary supplements for dysmenorrhoea. Cochrane Database Syst Rev. 2016;3: CD002124.27000311
62. Kia YH, Alexander S, Dowling D, Standish R. A case of steroid-responsive alerian-associated hepatitis. Intern Med J. 2016;46(1):118-119.26813905
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