Primary Name: Valerian (Valeriana officinalis)
Other Names: All Heal, Garden Heliotrope, vandal root
Indications/Homeopathic Use:
- pain reliever
- sedative
- sleep aid
Perioperative Concerns
Valerian may enhance the sedative effects of anesthetics, including benzodiazepines, or necessitate higher doses of anesthetics with prolonged usage. Furthermore, valerian can amplify the effects of anesthesia and its adjuncts by acting on the GABA system. Patients using valerian who are scheduled for surgical procedures should be counseled to gradually reduce their valerian intake before completely stopping it. The recommended cessation period for valerian use before surgery is generally at least 2 weeks.
Additional Information
Valerian is sometimes utilized as an alternative to benzodiazepines, with its main pharmacological components being sesquiterpenes. It serves various purposes, including pain relief, sedation, and as a sleep aid, with its sedative and hypnotic effects being dose-dependent. Far from being a stimulant, valerian acts as a potent sedative and antispasmodic, exerting a significant effect on the cerebrospinal system. Therefore, it is employed to alleviate conditions like nervousness, hypochondriasis, and neuralgic pains.
| Herbal | Interacting agents | Effect |
|---|---|---|
| Ephedra | Drugs provoking tachycardia or hypertension; halothane; MAOIs | Myocardial ischemia and stroke; ventricular arrhythmias with halothane; life-threatening MAOI interactions |
| Ginseng | Calcium channel blockers, beta-blockers, opioids | Intensified adverse inotropic and chronotropic effects; not recommended in cardiac disease, hypertension or diabetes |
| Kava kava | Barbiturates, midazolam and diazepam, narcotics, anti-nausea drugs, inhalation agents | Prolonged CNS depression after surgery |
| Kava kava | Levodopa and other Parkinson drugs; metoclopramide | Interference with dopamine action — avoid the combination |
| St. John’s wort | Benzodiazepines, digoxin, diltiazem, fentanyl, midazolam, naloxone, ondansetron, propofol, steroids, tramadol, warfarin | Induction of hepatic CYP450 3A4 may accelerate metabolism; serotonin-syndrome-like symptoms reported |
| Valerian | Benzodiazepines and other anesthetics and adjuncts | Amplified sedation through the GABA system; prolonged use may require higher anesthetic doses |
