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

Many people turn to valerian root to help with sleep or anxiety. It’s natural, widely available, and often seen as harmless. But if you’re already taking a sedative - whether it’s a prescription like Xanax, a sleep pill, or even just alcohol - mixing it with valerian can be dangerous. The risk isn’t theoretical. It’s called additive central nervous system (CNS) depression, and it can slow your breathing to a life-threatening level.

What is valerian, really?

Valerian (Valeriana officinalis) is a flowering plant whose roots have been used for over 2,000 years as a natural sleep aid. Ancient Greeks and Romans used it. Today, millions of people in the U.S. and Europe take it in capsules, teas, or tinctures. It’s one of the most popular herbal remedies for insomnia. But unlike prescription drugs, it’s not tightly regulated. What’s in your bottle? That’s the problem.

The active parts of valerian - mainly valerenic acid and valepotriates - work on your brain’s GABA system. GABA is the main calming neurotransmitter in your nervous system. When it’s active, you feel relaxed. Valerian helps keep GABA around longer by blocking the enzyme that breaks it down. That’s why it makes you sleepy. But so do benzodiazepines, barbiturates, alcohol, and many sleep medications. When you combine them, the effect doesn’t just add up - it multiplies.

Why mixing valerian with sedatives is risky

Think of your central nervous system like a dimmer switch. Sedatives turn it down. Valerian turns it down further. Together, they can push it past safe levels. The result? Excessive drowsiness, confusion, slowed breathing, or even respiratory failure.

Major health sources like the Mayo Clinic, WebMD, and the NIH Office of Dietary Supplements all warn about this. They say valerian can make sedatives work too well - and that’s not a good thing. For example:

• Combining valerian with alcohol can make you dangerously sleepy, even if you only had one drink.
• With alprazolam (Xanax), the risk of over-sedation is so high that WebMD labels it a “Major” interaction - meaning don’t do it.
• Even over-the-counter sleep aids like diphenhydramine (Benadryl) can become unsafe when mixed with valerian.

And it’s not just about sleepiness. Slowed breathing is the real danger. If you’re on opioids, benzodiazepines, or have sleep apnea, this combination can be deadly. There aren’t hundreds of documented deaths from valerian alone - but that’s because most people don’t realize they’re at risk. They take their pill, then a valerian capsule before bed, and wake up groggy. They don’t connect the dots.

The confusing science: Why some studies say it’s safe

You might have heard that valerian doesn’t interact with sedatives. That comes from a 2005 mouse study using a different species of valerian (Valeriana edulis). The researchers found no added sedation when mixing it with common CNS depressants. On the surface, that sounds reassuring.

But here’s the catch: that study used mice. And it used a different plant. Most people in the U.S. and Europe take Valeriana officinalis, the kind studied in human trials. Also, mice metabolize drugs differently than humans. What’s safe in a mouse lab doesn’t mean it’s safe in a human body.

Plus, valerian supplements vary wildly. One bottle might have 0.5% valerenic acid. Another might have 2.5%. Some don’t even contain valerian at all. The FDA doesn’t test herbal products like it does pills. So even if you think you’re taking a “low dose,” you might not be.

Who’s most at risk?

You’re at higher risk if you:

• Take benzodiazepines (like lorazepam, clonazepam, or diazepam)
• Use sleep medications like zolpidem (Ambien) or eszopiclone (Lunesta)
• Are on opioids for pain (oxycodone, hydrocodone, etc.)
• Drink alcohol regularly
• Have lung problems like COPD or sleep apnea
• Are older - your body clears drugs slower
• Are preparing for surgery or a dental procedure

Dentists and surgeons see this all the time. Patients come in, say they “just took a valerian capsule for nerves,” and then end up overly sedated during the procedure. They didn’t think it mattered. But it does.

What the experts say - and what you should do

The American Academy of Family Physicians says no major interactions have been reported. That sounds comforting. But they also admit valerian “may potentiate” sedatives - meaning it could make them stronger. That’s a warning, not a green light.

The NIH, Mayo Clinic, and WebMD all agree: talk to your doctor before taking valerian if you’re on any sedating medication. That includes antidepressants, antihistamines, muscle relaxants, and even some cold medicines.

Here’s what to do:

1. Stop taking valerian if you’re on any CNS depressant - until you’ve spoken to your doctor.
2. Don’t assume “natural” means safe. Herbal supplements can be just as powerful - and dangerous - as pills.
3. Keep a list of everything you take: prescriptions, supplements, vitamins, even herbal teas. Show it to your doctor at every visit.
4. If you’re using valerian for sleep, ask your doctor why you’re having trouble sleeping. Insomnia can be a sign of anxiety, depression, sleep apnea, or another condition that needs real treatment.

Alternatives to valerian

If you’re avoiding valerian because of drug interactions, what can you try instead?

• Good sleep hygiene: Go to bed and wake up at the same time every day. Keep your room dark and cool. No screens an hour before bed.
• Melatonin: A hormone your body makes naturally. Low doses (0.5-3 mg) can help reset your sleep cycle without interacting with most sedatives.
• Cognitive behavioral therapy for insomnia (CBT-I): The gold standard for long-term sleep improvement. No pills. No risks.
• Magnesium glycinate: Some studies show it helps with relaxation and sleep, especially in older adults. It’s generally safe with most medications.

None of these are magic fixes. But they’re safer than mixing unregulated herbs with powerful drugs.

The bottom line

Valerian isn’t evil. It’s not a poison. But it’s not harmless either - especially when you’re already taking something that slows your brain down. The risk of additive CNS depression is real, even if it doesn’t happen every time. And when it does, it can be fatal.

Don’t gamble with your breathing. If you’re on a sedative - even a mild one - skip the valerian. Talk to your doctor. Find a safer way to sleep. Your nervous system will thank you.