VUH-lare-ee-en

Therapeutic Classification: antianxiety agents, sedative/hypnotics

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

• Insomnia
• Anxiety

• May increase concentrations of the inhibitory CNS transmitter GABA.

• Improvement in sleep quality.

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-life: Unknown.

Contraindicated in:

• Pregnancy and lactation.

Use Cautiously in:

• Alcohol use (may have additive sedative effects)
• Surgery (discontinue use 2 wk prior to elective procedures)
• Children (do not use longer than 8 wk).

CNS: drowsiness, headache.

GI: dry mouth.
Misc: Benzodiazepine-like withdrawal symptoms with discontinuation after long-term use.

Natural-Drug Products:

• Additive CNS depression with alcohol, antihistamines, anesthetic agents, sedative hypnotics, and other CNS depressants.
• Alcohol-containing preparations may interact with disulfiram and metronidazole.

Natural-Natural Products:

• Additive sedative effects can occur when used with herbal supplements with sedative properties such as kava, l-tryptophan, melatonin, SAMe, and St. John's wort.

• PO (Adults): Tea: 1 cup tea 1–5 times daily. Tea is made by steeping 2–3 g root in 150 mL boiling water for 5–10 min then straining. Tincture: 1–3 mL 1–5 times daily. Extract: 400–900 mg up to 2 hr before bedtime or 300–450 mg divided tid.

• Capsules: ^OTC;
• Extract: ^OTC;
• Tea: ^OTC;
• Tincture: ^OTC;

• Assess degree of anxiety and level of sedation prior to and periodically throughout therapy.
• Assess sleep patterns.
• Assess response in the elderly population where drowsiness and loss of balance may pose a significant risk for injury.

• Take 1–2 hr before bedtime if used for nighttime hypnotic.
• Administer orally three to five times daily to control anxiety.

• Encourage patients to avoid stimulants such as caffeine and to provide an environment that promotes restful sleep.
• May cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to drug is known.
• Caution patient to avoid use of alcohol and other medications or herbals that have a sedative effect; may increase drowsiness.
• Advise patients to discontinue 2 wk prior to elective surgical procedures.
• Inform patients that dependence with withdrawal symptoms may develop with prolonged use.
• Advise females of reproductive potential to avoid valerian if pregnancy is planned or suspected or breast feeding.

• Decreased anxiety level.
• Improvement in sleep with a feeling of restfulness without drowsiness upon awakening.

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