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 harmless because it’s natural. Valerian root has been used for centuries to help with sleep and anxiety, but if you’re taking anything that makes you drowsy-like alcohol, Xanax, sleeping pills, or painkillers-adding valerian could push your central nervous system too far. The result? Extreme sleepiness, slowed breathing, or even life-threatening respiratory depression. This isn’t just a theoretical risk. It’s a real, documented danger that doctors and pharmacists warn about.

How Valerian Works in Your Brain

Valerian doesn’t work like a prescription drug, but it affects the same system. Its active compounds-like valerenic acid and valepotriates-interact with GABA, a calming neurotransmitter in your brain. GABA slows down nerve signals, which is why it’s targeted by medications like benzodiazepines and barbiturates. Valerian boosts GABA by stopping the enzyme that breaks it down and by preventing nerve cells from reabsorbing it. This means more GABA stays active in your brain, making you feel relaxed or sleepy.

Here’s the catch: if you’re already taking a drug that does the same thing, valerian adds to the effect. It’s not just doubling up-it’s stacking. Think of it like turning up the volume on a speaker that’s already at max. You don’t need to add much more to cause distortion-or in this case, dangerous sedation.

The Medications That Can Clash With Valerian

Valerian doesn’t just mix poorly with alcohol-it’s risky with many common prescriptions. Here are the top categories you need to avoid combining it with:

• Alcohol: Even one drink with valerian can make you feel overly drowsy, dizzy, or uncoordinated. This isn’t just about feeling sleepy-it’s about impaired judgment and reaction time.
• Benzodiazepines (like alprazolam/Xanax, lorazepam/Ativan, diazepam/Valium): These are designed to calm your nervous system. Valerian can amplify their effects, leading to confusion, extreme drowsiness, or trouble breathing.
• Barbiturates (like phenobarbital): Older sedatives, still used for seizures or anesthesia prep. Valerian may increase their potency, raising the risk of overdose.
• Opioids (like oxycodone, hydrocodone, morphine): These already carry a black box warning for respiratory depression. Adding valerian increases that risk without any added benefit.
• Sleeping pills (like zolpidem/Ambien, eszopiclone/Lunesta): These are meant to help you sleep. Valerian can push you into a deeper, harder-to-wake state.
• Anesthetics: If you’re scheduled for surgery, taking valerian beforehand can interfere with how your body responds to anesthesia.

WebMD classifies the interaction with alcohol and alprazolam as major-meaning don’t take them together. For other drugs metabolized by liver enzymes CYP3A4 and CYP2D6, the risk is labeled moderate, but that doesn’t mean it’s safe. Moderate still means you could end up in the ER.

Why the Risk Isn’t Always Obvious

One reason people think valerian is harmless is because it’s sold as a supplement, not a drug. That means it’s not regulated by the FDA the same way prescription meds are. You can’t be sure what’s in the bottle. One brand might have high levels of valerenic acid-making it strong. Another might have almost none. The label might say “500 mg valerian root,” but that doesn’t tell you how much active compound is actually there.

Plus, many people don’t tell their doctors they’re taking it. They assume herbal = safe. But dental patients who take valerian before a procedure have been found to be over-sedated. One patient might feel fine. Another might stop breathing. There’s no way to predict who’s at risk without knowing exactly what’s in the supplement and what else they’re taking.

What About That Study Saying It’s Safe?

You might have heard about a 2005 study from Mexico that found valerian didn’t increase sedation when combined with CNS depressants in mice. It’s often cited to downplay the risk. But here’s what that study didn’t tell you:

• It used Valeriana edulis, not the common Valeriana officinalis found in U.S. supplements.
• It was done on mice-not humans.
• It tested specific extracts under controlled lab conditions, not real-world supplement variability.

Animal studies don’t replace human data. And even if the risk is lower than we thought, the consequences of getting it wrong are too high. A single case of respiratory failure is one too many.

Who’s Most at Risk?

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

• Older adults-slower metabolism, more sensitive to sedatives.
• People with liver or kidney disease-can’t clear drugs or supplements efficiently.
• Those on multiple sedating medications-even low doses add up.
• Anyone taking valerian before surgery, dental work, or driving.

And here’s the hidden danger: people often start valerian because they’re not sleeping well. But persistent insomnia isn’t usually solved by herbs. It’s a sign of something else-sleep apnea, anxiety, depression, or a medical condition. Relying on valerian while ignoring the root cause can delay proper treatment.

What Should You Do?

If you’re taking any sedating medication, don’t start valerian without talking to your doctor or pharmacist. That includes over-the-counter sleep aids, antihistamines like diphenhydramine (Benadryl), or even muscle relaxants. Don’t assume it’s safe because it’s natural. It’s not.

Here’s what to do instead:

1. Make a list of everything you take-prescriptions, supplements, vitamins, even occasional alcohol.
2. Bring it to your next appointment. Ask: “Could any of these interact with valerian?”
3. If you’re already taking valerian, don’t stop suddenly. Talk to your provider about how to taper off safely.
4. For sleep issues, try non-drug approaches first: consistent bedtime, limiting screens before sleep, avoiding caffeine after noon, and cognitive behavioral therapy for insomnia (CBT-I), which has stronger evidence than any supplement.

Final Reality Check

Valerian isn’t evil. It’s not a poison. But it’s not harmless either. When you mix it with other substances that slow your brain down, you’re playing with fire. The science isn’t perfect, but the stakes are high enough that caution isn’t optional.

Thousands of people take valerian without problems. But thousands more don’t tell anyone they’re taking it. And when something goes wrong-when someone doesn’t wake up after surgery, or gets into a car accident after taking a supplement with their nightcap-it’s too late to ask if it was worth it.

If you’re considering valerian for sleep or anxiety, ask yourself: Am I using this to avoid dealing with the real issue? And am I willing to risk my safety for a supplement that isn’t even guaranteed to work?

The answer isn’t always yes. And that’s okay. There are safer ways to sleep well.