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

Many people turn to valerian root as a natural way to improve sleep or calm anxiety. It’s been used for centuries, and today, millions take it without thinking twice. But here’s the thing: if you’re also taking a prescription sleep aid, anti-anxiety med, or even just having a drink at night, combining it with valerian could be riskier than you realize.

What Is Valerian, Really?

Valerian (Valeriana officinalis) is a flowering plant whose root is dried and turned into capsules, teas, or tinctures. It’s one of the most popular herbal sleep aids in the U.S., used by people looking to avoid pharmaceuticals. Unlike many supplements, valerian has actual research behind it-not just anecdotal claims. Studies dating back to the 1980s show it can improve sleep quality, especially in people with mild insomnia.

But how does it work? The active parts of valerian-mainly valerenic acid and valepotriates-interact with your brain’s GABA system. GABA is your body’s main calming neurotransmitter. Think of it like a brake pedal for your nervous system. Valerian helps keep GABA around longer by blocking the enzyme that breaks it down. That’s why you feel relaxed, maybe even drowsy.

Here’s the catch: many prescription drugs do the exact same thing.

Why Combining Valerian With Sedatives Is Dangerous

When you take valerian with anything that also slows down your central nervous system (CNS), you’re stacking effects. It’s not just more sleepiness-it’s deeper, potentially dangerous sedation.

Common medications that can interact with valerian include:

• Alcohol - Even one drink can double the drowsiness from valerian.
• Benzodiazepines - Like Xanax (alprazolam), Valium (diazepam), or Ativan (lorazepam). These are prescribed for anxiety and insomnia. Add valerian, and you’re at risk for extreme drowsiness, confusion, or slowed breathing.
• Barbiturates - Older sleep or seizure meds like phenobarbital. These are less common now, but still used in some cases.
• Opioids - Pain meds like oxycodone or hydrocodone. Mixing these with valerian raises the risk of respiratory depression-a condition where breathing slows so much it can become life-threatening.
• Antidepressants and antipsychotics - Some of these, especially those with sedating properties like trazodone or quetiapine, can also add to the effect.

WebMD classifies the interaction between valerian and alcohol or alprazolam as major-meaning you should avoid it entirely. For other drugs metabolized by liver enzymes like CYP3A4 and CYP2D6, the risk is labeled moderate. That doesn’t mean it’s safe-it means you need to be extra careful.

What the Science Actually Says

You might have heard conflicting things. One 2005 study in mice using a different species of valerian (Valeriana edulis) found no increased sedation when combined with common CNS depressants. That study gets cited often to downplay the risk.

But here’s why that doesn’t ease concerns:

• It was done on mice, not humans.
• It used a different plant species-Valeriana edulis isn’t what’s sold in U.S. stores.
• It didn’t test real-world doses or long-term use.

Meanwhile, the Mayo Clinic, NIH, and WebMD all agree: the pharmacological mechanism is clear. Valerian boosts GABA. So do most sedative medications. Combine them, and you’re asking for trouble.

There’s also the issue of product quality. The FDA doesn’t regulate supplements like it does drugs. So one bottle of valerian might have enough valerenic acid to cause a reaction, while another-same brand, same label-might have almost none. You can’t know what you’re getting.

Real-World Risks No One Talks About

Most people don’t tell their doctor they’re taking valerian. They think it’s “natural,” so it’s safe. But that’s where the danger hides.

Imagine this: a patient takes valerian before a dental appointment because they’re nervous. They also take Xanax for anxiety. The dentist gives them a local anesthetic with epinephrine, which can raise heart rate. But with both drugs slowing their CNS, their breathing becomes shallow. They pass out. It’s not common-but it’s happened.

Doctors and dentists are now being trained to ask: “What supplements are you taking?” Not just meds. Not just vitamins. Supplements. Because people don’t think of valerian as a drug-but it acts like one.

What Should You Do?

If you’re taking any sedating medication-prescription or not-here’s what you need to do:

1. Stop self-prescribing. Don’t start valerian just because it’s “natural.”
2. Talk to your doctor or pharmacist. Bring your supplement bottle with you. Don’t assume they know what’s in it.
3. Check your meds. If your prescription label says “may cause drowsiness,” “avoid alcohol,” or “may impair mental alertness,” valerian is probably not safe to mix with it.
4. Wait before surgery or procedures. If you’re scheduled for anything that requires sedation-even a colonoscopy-stop valerian at least 48 hours beforehand. Tell your provider you took it.
5. Look for alternatives. If you’re using valerian for sleep, consider sleep hygiene first: consistent bedtime, no screens before bed, keeping your room cool. If anxiety is the issue, therapy or low-dose SSRIs might be safer long-term options.

Why This Matters More Than You Think

People don’t die from valerian alone. But when it’s mixed with other depressants? That’s when the real danger kicks in.

In Australia, where I’m based, the Therapeutic Goods Administration (TGA) doesn’t require supplement manufacturers to prove safety before selling. That means you’re essentially playing Russian roulette with your nervous system. One bottle might be fine. The next might have 3x the valerenic acid. And you won’t know until it’s too late.

The NIH says valerian is “generally recognized as safe” in recommended doses. But that’s only if you’re not stacking it with other CNS depressants. The moment you add alcohol, Xanax, or even a sleep aid like diphenhydramine (Benadryl), you’re crossing a line.

And here’s the uncomfortable truth: your doctor probably doesn’t know you’re taking it. Most patients don’t volunteer that info. They think it’s harmless. It’s not.

Bottom Line

Valerian isn’t evil. It can help. But it’s not a harmless tea. It’s a bioactive compound that changes how your brain works. And when you combine it with other sedatives, you’re turning a gentle calming effect into a potential medical emergency.

If you’re using valerian and taking any medication that makes you sleepy-stop. Talk to your doctor. Don’t wait for a bad reaction to happen. Better yet, explore non-drug options for sleep and anxiety. They’re safer, and they work.

There’s no shortcut to rest. And there’s no safe way to stack sedatives-even if one of them comes from a plant.