Valerian and Sedating Medications: What You Need to Know About CNS Depression Risk

Combining valerian with sedating medications can be dangerous - even if you think it’s just a natural remedy. Many people take valerian root to help with sleep or anxiety, believing it’s harmless because it’s herbal. But when mixed with prescription sedatives, alcohol, or even over-the-counter sleep aids, it can slow your breathing, make you dangerously drowsy, or even stop your breathing entirely. This isn’t theoretical. It’s a real, documented risk - and it’s happening more often than you’d think.

What Is Valerian, Really?

Valerian (Valeriana officinalis) is a flowering plant whose roots have been used for over 2,000 years to calm nerves and help people sleep. Ancient Greeks and Romans used it. Today, it’s one of the most popular herbal sleep aids in the U.S. and Australia. But unlike pharmaceuticals, valerian supplements aren’t tested for consistency, purity, or strength by the FDA or any major health regulator. One bottle might contain enough valerenic acid to affect your brain chemistry. Another might have almost none. You won’t know which you’re getting unless you pay for a third-party tested product - and even then, results vary.

The active ingredients in valerian - like valerenic acid and valepotriates - work by increasing GABA, a calming neurotransmitter in your brain. That’s the same mechanism used by benzodiazepines like Xanax and sleep pills like Ambien. So if you’re already taking something that boosts GABA, adding valerian is like turning up the volume on a speaker that’s already at maximum. You’re not just adding more sound - you’re risking a blowout.

Which Medications Are Dangerous to Mix With Valerian?

The list of medications that can interact dangerously with valerian is long - and includes things many people don’t even think of as sedatives.

• Alcohol - Even one drink with valerian can make you feel extremely sleepy or dizzy. Driving or operating machinery after this combo is risky.
• Benzodiazepines - Xanax, Klonopin, Ativan, Valium. These are prescribed for anxiety and insomnia. Valerian can double their sedative effect.
• Barbiturates - Older sleep and seizure meds like phenobarbital. Rare today, but still in use. The risk here is severe respiratory depression.
• Opioids - Oxycodone, hydrocodone, codeine. Mixing these with valerian increases the chance of overdose - slowed breathing, unconsciousness, death.
• Antidepressants - Some, like trazodone or mirtazapine, have strong sedative effects. Valerian can push them over the edge.
• Over-the-counter sleep aids - Products like NyQuil, Tylenol PM, or Unisom contain diphenhydramine or doxylamine. These are antihistamines that cause drowsiness. Add valerian? You’re asking for trouble.

WebMD classifies the interaction with alcohol and alprazolam as major - meaning do not take together. For other sedatives, it’s labeled moderate - meaning use extreme caution. But here’s the problem: moderate doesn’t mean safe. It just means the risk isn’t guaranteed. That’s cold comfort if you end up in the ER because you couldn’t wake up.

Why Is This Risk So Hard to Predict?

Valerian isn’t one thing. It’s a messy mix of chemicals. Different brands use different parts of the root. Some use dried powder. Others use alcohol extracts. Some are standardized to contain valerenic acid. Others aren’t. A 2022 NIH report confirmed that even supplements labeled as “standardized” can vary wildly in active ingredient levels. One study found valerenic acid content ranged from 0.01% to 0.8% - a 80-fold difference.

That means two people taking the same “dose” of valerian could have completely different experiences. One might feel mildly relaxed. The other might fall asleep mid-sentence. And if that second person is also on a benzodiazepine? The outcome could be deadly.

There’s also the issue of delayed effects. Valerian doesn’t always kick in right away. You might take it at night, feel fine in the morning, and then take your morning anxiety pill - unaware that the valerian is still in your system. GABA effects can linger for hours. That’s why people often don’t connect the dots until it’s too late.

What About That Study That Said It’s Safe?

You might have heard about a 2005 study from Mexico that found valerian didn’t increase sedation when mixed with common CNS depressants in mice. That study is often cited by supplement sellers to downplay risks. But here’s what they don’t tell you:

• It used Valeriana edulis, not Valeriana officinalis - the species most people take.
• It was done on mice. Human brains process GABA differently.
• It tested pure extracts in controlled doses. Real-world supplements? Unpredictable.

That study doesn’t prove safety. It just shows that under very specific lab conditions, one type of valerian didn’t cause an effect in rodents. It doesn’t override decades of clinical warnings, pharmacological data, and real-world case reports.

Who’s at the Highest Risk?

Not everyone who takes valerian will have a bad reaction. But certain people are far more vulnerable:

• Older adults - Metabolism slows with age. Sedatives stay in the system longer.
• People with liver disease - Their bodies can’t break down drugs or herbs efficiently.
• Patients on multiple sedatives - Even small additions can tip the balance.
• People preparing for surgery or dental work - Many take valerian to calm nerves before procedures. But if they don’t tell their doctor, they could be given anesthesia that pushes them into respiratory arrest.

Dental offices in Sydney and across Australia have reported cases where patients arrived overly sedated after taking valerian before a procedure. Some needed oxygen support. Others had to reschedule. And none of them had told their dentist.

What Should You Do?

If you’re taking any sedating medication - prescription or not - stop using valerian. Period. Don’t assume it’s safe because it’s “natural.” Don’t rely on a supplement label. Don’t wait for a doctor to ask you about it. Most doctors don’t ask. They assume you’re not taking anything herbal.

Here’s what to do instead:

1. Stop taking valerian if you’re on any CNS depressant - even if you’ve been doing it for years.
2. Talk to your doctor about your sleep or anxiety. There are safer, regulated options.
3. Be honest about every supplement, herb, or tea you take. Write them down. Bring the bottle.
4. Ask your pharmacist to check for interactions. They’re trained to spot these.
5. Consider non-drug solutions - Cognitive behavioral therapy for insomnia (CBT-I) is more effective long-term than any pill or herb.

If you’re trying to quit a sedative, don’t use valerian as a replacement. That’s like replacing a faulty car brake with a rubber band. You might think it’s helping - until you need to stop.

What If You’ve Already Combined Them?

If you’ve taken valerian with a sedative and feel unusually drowsy, confused, slow to respond, or have trouble breathing - get help immediately. Call emergency services. Don’t wait. Don’t try to sleep it off. CNS depression doesn’t always show symptoms right away. It can creep up slowly.

If you’re not having symptoms but are worried, stop both substances and talk to your doctor within 24 hours. They may want to check your liver function or adjust your medication.

Bottom Line

Valerian isn’t the villain. But it’s not harmless, either. When paired with sedating medications, it becomes a silent multiplier - quietly boosting effects you didn’t ask for and can’t control. The science is clear: the risk is real. The warnings are consistent across Mayo Clinic, NIH, WebMD, and the American Academy of Family Physicians. The one study that says it’s safe? It’s not enough to override that.

If you care about your health, don’t gamble with your nervous system. Natural doesn’t mean safe. Herbal doesn’t mean harmless. And when it comes to CNS depression - there’s no second chance.