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Adverse Effects & Toxicity
In a review it has been indicated that, studies of better-known herbal sedatives, notably valerian and kava, showed moderate evidence for both safety and efficacy for valerian while revealing disturbing toxicity concerns for kava. Block 2004
[A riddle solved--why valerian-hops extract makes you drowsy] [Article in German]. Holzgrabe 2004
In vitro toxicity of high doses of valerian & peppermint oil(PO) in cultured human hepatoma cells & at doses 2-3 orders of magnitude greater than those recommended for human use, increase in rat bile flow after acute PO & increase in alkaline phosphatase after chronic PO were demonstrated. Vo 2003
Complications can arise from Echinacea, ephedra garlic, ginkgo, kava, St John's wort & Valerian by their direct and pharmacodynamic or pharmacokinetic effects. Pharmacodynamic herb-drug interactions include potentiation of the sedative effect of anaesthetics by kava and valerian. Ang-Lee 2001
Herbs affecting the central nervous system: gingko, kava, St. John's wort, and valerian. Assemi 2001
Valerian is used as an anti-anxiety drug & reported to have sedative & antidepressant properties. There are several reports on valerian root toxicity which includes nephrotoxicity, headaches, chest tightness, mydriasis, abdominal pain & tremor of the hands & feet. [Article in Hebrew] Boniel 2001
Review usage and adverse effects of Valerian, melatonin, St John's wort and kava -kava Heiligenstein 1998
'Sleep-Qik' (valerian dry extract 75 mg, hyoscine HBr 0.25 mg, cyproheptadine HCl 2 mg) associated with CNS depression and anticholinergic poisoning in 23 patients who had taken 7-160 doses; no evidence of liver damage Chan 1995
An individual taking 20 times the normal dose had mild symptoms which resolved within 24 h. Willey 1995
Letter warns of liver damage warning with insomnia remedy Shepherd 1993
300 and 600 mg/kg/day of V. officinalis and Crataegus oxyacantha for 30 days to rats to test for toxicity Fehri 1991
Toxicity evaluation of Valerian and Crataegus in rats given 300 and 600 mg/kg/24 h for 30 days Fehri 1991
Baldrinals, metabolites of valtrate and isovaltrate, but not dihydro-valtrate, appears to be mutagenic in the sensitive Salmonella assay von der Hude 1986
Interactions
An evidence-based literature review of five commonly used herbs in Denmark namely St John's wort, ginkgo biloba, valerian, garlic & ginseng were presented and attention to clinical practice & recommendations for discontinuation of the five herbs were given before surgery.[Article in Danish]. Kistorp 2002
Examples of synergy which may occur in psychoactive herbs through pharmacokinetic and/or pharmacodynamic interactions includes Hypericum perforatum, Piper methysticum, and Valeriana officinalis which may be due to additive and supra-additive effects of plant's multiple constituents. Spinella 2002
28 articles have been identified that describe interactions between herbal (i.e. St. John's wort, ginkgo biloba, kava, valerian, and ginseng) and conventional drug therapies used for the treatment of dementia. Gold 2001
A 23-year-old woman with no psychiatric history developed acute mania & psychosis while using a high dosage of Valdispert'balans', a combination of valerian extract and hypericin). Discontinuation of product & treatment with olanzapine led to complete recovery. [Article in Dutch]. Guzelcan 2001
Herbs including Ginkgo biloba, Piper methysticum (Kava-Kava), Glycyrrhiza glabra, Hypericum perforatum, Valeriana officinalis, Cannabis sativa, Salix alba and others have been reviewed for the synergistic interactions in experimental, in vitro as well as clinical studies. Williamson 2001
Use of problematic plants like Echinacea, Allium cepa, Gingko biloba, Panax ginseng and Valeriana officinalis should be limited, or completely excluded in cases of simultaneous therapy with, e.g., warfarin, hepatotoxic agents, MAOI inhibitors, phenelzin sulphate, or phenytoin. [Article in Czech]. Tumova 2000
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