Valerian for Children: An Effective and Safe Alternative for ADHD and Sleep Disturbances?

Valerian (Valeriana officinalis) has a long history of use in traditional medicine for a variety of conditions, notably its application as a sleep aid and treatment for anxiety. Today, its application has expanded to include attention deficit and hyperactivity syndromes, helping to calm and focus the mind.¹ Despite its historical and contemporary uses in adult populations, research on valerian’s efficacy and safety in pediatric medicine is limited.

Consider the case of a 7-year-old boy named Alex,* who has been experiencing significant hyperactivity, restlessness, and difficulty concentrating in school. His symptoms have led to frequent disruptions in the classroom and challenges in completing homework, causing concern for his parents and teachers. Additionally, Alex’s restlessness makes it hard for him to fall asleep at bedtime, resulting in inadequate sleep and exacerbating his daytime symptoms. Although Alex’s parents have consulted with a pediatrician, they are hesitant to start him on pharmaceutical treatments due to potential side effects. Instead, they are interested in exploring natural alternatives that could help manage his symptoms without the associated risks of conventional medications.

In this article, we will explore the historical use, current evidence, and safety profile of valerian, and its potential as an effective treatment option for families like Alex’s. By compiling current research, this article aims to provide functional and naturopathic medicine clinicians with a comprehensive overview of valerian’s benefits and its role in pediatric care. 

[*To protect his privacy Alex is not his real name ]

Traditional uses 

Valerian has a long history of traditional use for a variety of conditions. Its therapeutic properties were described by Hippocrates, and in the 2nd century Galen prescribed valerian for insomnia.^2,3 By the 16th century, it was commonly used to treat nervousness, trembling, headaches, and heart palpitations.⁴ In 1860, B.W. Hardee, MD, noted the use of ethereal tincture valerian as an antispasmodic for treating convulsions in young children.⁵ During World War II, valerian was utilized in England to relieve the stress of air raids.⁶ 

Valerian is perhaps most renowned for its use in treating insomnia, but it has also been historically utilized to address migraines, fatigue, restlessness, hysteria, emotional stress, and pain.^1,7 Additionally, it has been used to manage depression, soothe anxiety and nervous irritation, alleviate symptoms of nervous asthma, and manage cardiovascular arrhythmias.¹ Herbalist Susan Weed suggests that placing a dropperful of valerian tincture under the mother’s tongue can help calm shakes after delivery, allowing midwives to suture more effectively. She also highlights valerian’s benefits for managing elevated blood pressure during pregnancy and as an ingredient in anti-hemorrhage formulas.⁸

Valerian has also been employed to relieve gastrointestinal cramping, ease menstrual cramps, and provide relief from pain associated with shingles and backaches.¹ This versatile herb is valued in herbal medicine for its broad spectrum of therapeutic applications, offering a natural solution for numerous physical and emotional ailments. 

Early Naturopathic Use

Valerian has been a staple in naturopathic medicine for centuries, with its uses well-documented in early naturopathic texts. In the 1920s, naturopathic practitioners recommended valerian root tea for a variety of ailments, including head congestion, giddiness, fainting, nervous stomach, insomnia, hysteria, abdominal cramps and heart palpitations.

Sebastian Kneipp, in “The Kneipp Water Cure Monthly” from 1900, described valerian’s habitat and growth patterns: “Valerian grows in thin woods, on the edge of thickets, generally in rather damp places though it will grow in dry soil on sparsely covered slopes. It flowers in June and July.” This detailed observation underscored the plant’s versatility and adaptability contributing to its widespread use.

Benedict Lust, a pioneering figure in naturopathy, highlighted valerian’s significance in his 1908 edition of “The Naturopath and Herald of Health, IX.” He noted Valerian officinalis was a key plant for its effects on the nervous system. Lust also classified it among plants rich in “acids that aid secretions,” emphasizing its multifaceted benefits.

In the 1920 edition of “Herald of Health and Naturopath, XXV” Lust provided an extensive overview of valerian’s medicinal properties: “Latin, Valeriana officinalis; German, Baldrian; French, Valerian; Spanish, Valeriana. This plant grows in marshy forests and it is also cultivated in gardens. Its root is the only part adapted for remedial purposes. Out of the root, a tea is made which should be taken only in small quantities at a time. This tea is an excellent remedy for congestion in the head, attacks of giddiness, and fainting fits. It is highly prized also in cases of nervous stomach troubles, sleeplessness, and hysteria. Cramp-like conditions, abdominal troubles, and palpitation of the heart, too, are readily reduced by tea of valerian root. In the form of a powder it may be taken one-half a teaspoon-full at a time.” 

These early naturopathic references highlight valerian’s esteemed place in herbal medicine, revered for its ability to address a wide range of physical and emotional ailments. The detailed accounts from Kneipp and Lust provide valuable insights into the historical use and enduring relevance of valerian in naturopathic practice. 

Phytochemistry

Valerian officinalis has a complex phytochemistry that includes a variety of chemical compounds. These consist of esterified iridoid derivatives known as valepotriates, sesquiterpenes, flavonoids, lignans, alkaloids, triterpenes, and monoterpenes. Overall, valerian root extract contains over 150 chemical constituents.⁹

Among its constituents, valerinic acid is a marker compound for the standardization of the root extracts and is reported to be responsible for the plant’s anxiolytic action in many in vitro and in vivo studies.⁹ Valerian root is believed to aid sleep, anxiety, hyperactivity, and restlessness primarily through its modulation of GABA receptors. Research indicates that valerian extract components exhibit significant dose-dependent GABA agonist activity. Specifically, 6-methylapigenin acts as a potent positive modulator of GABA, likely binding to the benzodiazepine site at the interface of alpha and gamma subunits, while valernic acid and valerenol interact with the receptor’s beta subunit.¹⁰  Additionally, valerian root extract may inhibit the enzymatic destruction of GABA, thereby increasing its availability and it interacts directly with serotonin receptors, contributing to its calming and sleep-inducing effects.¹⁰ Furthermore, isovaleric acid, didrovaltrate, borneol, and some lignans have also been proposed to contribute to the plant’s anxiolytic effect. 

Safety

Valerian is generally considered safe for pediatric populations, though it does come with some potential side effects. According to the National Center for Complementary and Integrative health, these side effects can include headache, stomach upset, mental dullness, excitability, uneasiness, heart disturbances and even insomnia in some individuals.⁷ Some children might also experience morning drowsiness, particularly with higher doses, as well as dry mouth or vivid dreams.⁷ Though rare, other reported adverse events include contact allergies, restless sleep and mydriasis.¹¹ The European Scientific Cooperative on Phytotherapy has approved valerian for children aged 3 to 12 years, further supporting its safety profile.11Th The U.S. Food and Drug Administration labels valerian as “generally recognized as safe” (GRAS) for use in food. However, valerian is not recommended during lactation due to theoretical concerns over its valepotriates and baldrinals, which have shown cytotoxic and mutagenic effects in vitro. Since there is no published experience with valerian during breastfeeding, an alternative therapy may be preferred, especially when nursing a newborn or preterm infant.¹² Despite its general safety, it is important to monitor children for any adverse reactions when using valerian. 

In my practice, I feel comfortable using valerian in children over the age of 5 and avoid its use in pregnancy and breastfeeding, preferring other herbal support with known safety profiles. 

Medicinal Use

Valerian has been extensively researched in adult populations, demonstrating potential benefits for conditions such as anxiety, obsessive-compulsive disorder, sleep disorders, dysmenorrhea, hot flashes, and migraines.^13–19 Despite these promising findings, there is significant need for more research on the use of valerian in pediatric populations. However, preliminary evidence supports its use as a sleep aid for children and shows potential benefits for managing symptoms of ADHD. 

Sleep

Parents and clinicians face numerous challenges when dealing with sleep difficulties and disorders in children and adolescents. Up to 50% of children experience sleep problems, which, if left unaddressed can lead to daytime sleepiness, irritability, learning difficulties, developmental, cognitive or growth delays, and poor academic performance.²⁰ These issues are particularly prevalent among children with neurodevelopmental disorders/intellectual deficits (ID), such as autism spectrum disorder and ADHD, affecting up to 80% of this population.²¹ Given the limitations and variability in conventional treatments, there is growing interest in alternative medicine, such as valerian, which has shown potential in improving sleep quality and duration.

Valerian has been utilized for centuries to promote restful sleep and alleviate insomnia. Despite its long-standing reputation and widespread use, contemporary research presents mixed results regarding its efficacy. Some studies suggest valerian may improve sleep quality and reduce the time it takes to fall asleep, while others find no significant benefits compared to placebo. 

A systematic review and meta-analysis published in 2020 investigated the effectiveness of valerian as a sleep aid and its impact on associated disorders such as anxiety, using data from 60 studies with a total of 6,894 adult participants. Meta-analyses of 10 studies (n=1,065) on subjective sleep quality and 8 studies (n=535) on anxiety reduction indicated that inconsistent outcomes may stem from a varying quality of herbal extracts. Reliable effects were more likely when using the whole root/rhizome and when combined with other appropriate herbs. No severe adverse events were reported in participants aged 7 to 80. The authors concluded that valerian shows potential as a safe and effective treatment for sleep problems and related disorders, though improvements in quality control and standardization are needed to enhance its reliability.¹³ 

Studies on valerian’s efficacy for children’s sleep disturbances are limited, but a 2006 open, multicenter study offers promising results. This study investigated the efficacy and tolerability of a combined valerian and lemon balm preparation, Euvegal forte, in 918 children under 12 years suffering from restlessness and nervous sleep disturbance (dyssomnia). Results showed a significant reduction in symptom severity for both dyssomnia and restlessness, with 80.9% of patients experiencing improvement in dyssomnia and 70.4% in restlessness. Both parents and investigators rated the efficacy as “very good” or “good (60.5% and 67.7%, respectively). Tolerability was also high, with 96.7% of patients judged to have “very good” or “good” tolerability, and no medication-related adverse events reported. Euvegal forte was concluded to be effective and well-tolerated for treating restlessness and dyssomnia in children.²² 

A 2002 clinical trial examined the effects of valerian alone on children with intellectual deficits (IDs) who had persistent sleep issues. In this eight-week study, five children were monitored ina double-blind, placebo controlled, randomized design. Despite the small sample size, valerian treatment led to promising outcomes, including significant reductions in the time it took to fall asleep (sleep latencies) and nocturnal awakenings. Additionally, total sleep time increased, and overall sleep quality improved compared to baseline and placebo. These positive effects were particularly notable in children with hyperactivity-related deficits.²³ 

ADHD

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders in children, characterized by a pattern of inattention, impulsivity, and hyperactivity that leads to functional impairment in multiple settings. From 2020 to 2022, the prevalence of diagnosed ADHD in children aged 5-17 was 11.3%, with boys (14.5%) more frequently diagnosed than girls (8.0%).²⁴ despite the widespread use of stimulant medications like methylphenidate and amphetamine, which are effective in managing ADHD symptoms, these drugs are associated with a range of side effects, including sleep disorders, appetite loss, and potential cardiovascular issues.²⁵ The rising use of pharmacotherapy, including stimulants and atomoxetine, highlights concerns about long-term impact on children’s growth, nutritional status, and mental health. Given the side effects and need for safer alternatives, parents are increasingly turning to alternative therapies to manage their child’s ADHD or related symptoms.  

As discussed above, valerian root and lemon balm extracts have shown promise in treating restlessness and insomnia in children under 12 years of age. Following up on this research, a 2014 German observational study investigated the efficacy of a combination formula including valerian and lemon balm on 169 primary school children experiencing hyperactivity and concentration difficulties, though not meeting ADHD criteria. Treated with daily doses of 640 mg valerian root extract (WS® 1014) and 320 mg lemon balm extract (WS® 1303) (Sandrin®), the children were evaluated at baseline, and after 2 and 7 weeks. The study found significant improvements: children with strong symptoms of poor focus decreased from 75% to 14%, hyperactivity from 61% to 13%, and impulsiveness from 59% to 22%. Parents also noted improvements in social behavior, sleep, and overall symptoms. Only two children experienced mild, transient side effects. The study concluded that WS® 1014 and WS® 1303 (Sandrin®) are viable options for managing these symptoms in children.²⁶ 

Homeopathy is increasingly becoming a sought-after treatment for ADHD.²⁷ A three-week double-blind, placebo-controlled pilot study investigated the efficacy of homeopathic Valeriana officinalis in treating ADHD in children. Thirty children aged 5 to 11, pre-diagnosed with ADHD, were divided into three groups: Valeriana officinalis mother tincture (MT), 3X potency, and placebo. The treatments were administered orally three times a day for two weeks. Efficacy was assessed using the Barkley and DuPaul teacher rating scale, the children’s checking task, and parent symptom questionnaire at baseline, the end of weeks two and three and one week after treatment cessation. The study found a statistically significant improvement in behavior and sustained attention, anxiety, and impulsivity/hyperactivity in both the MT and 3X groups compared to placebo.²⁸

Conclusion

For families like Alex’s, who seek natural and safer alternatives to conventional pharmaceuticals for managing pediatric conditions such as hyperactivity and sleep disturbances, valerian presents a promising option. Valerian has demonstrated a wide range of potential benefits in adult populations for conditions such as anxiety, obsessive-compulsive disorder, sleep disorders, dysmenorrhea, hot flashes, and migraines. However, there remains a significant gap in research regarding its use in pediatric populations. Preliminary evidence supports its effectiveness as a sleep aid and for managing ADHD symptoms in children. Studies have shown valerian to be generally safe for children, with minimal and transient side effects. As the demand for non-pharmaceutical treatments for pediatric conditions grows, valerian presents a promising option. Further research is essential to establish standardized dosing, long-term safety, and efficacy. By expanding our understanding of valerian in pediatric care, we can offer families like Alex’s safer, effective alternatives to traditional pharmacotherapy. This approach aligns with the holistic principles of naturopathic and functional medicine, providing comprehensive care that prioritizes the well-being of young patients. 

An interesting side note on historical use of valerian for Epilepsy

Valerian has a long history of use in treating epilepsy, dating back to the 16th century. The first documented successful use of valerian for epilepsy was by Fabio Colonna (Fabius Coumna, 1567-1650), a Neapolitan nobleman who suffered from the disorder himself. Colonna found that taking powdered valerian root several times per day controlled his seizures, an account he detailed in his classic work Phytobasanos published in 1592. Despite his findings, valerian’s anticonvulsants were nto widely recognized by medical practitioners for many years.

In the 18th and 19th centuries, valerian gained popularity as an anticonvulsant in continental Europe. The renowned physician Tissot, in the 1770s, regarded valerian as the treatment of first choice for epilepsy and documented several cases of successful treatment, helping establish valerian as a leading antiepileptic drug in Europe during this period. 

Despite historical use, there is a lack of current scientific evidence to justify the widespread clinical use of valerian for treating epilepsy. More research is needed to confirm its efficacy and safety. While valerian has been noted for its anticonvulsant properties for centuries, contemporary studies are essential to validate these traditional claims and to understand the mechanisms behind its effects.

With that said, recent research has begun to explore valerian’s potential in epilepsy treatment using advanced methodologies. For instance, a 2021 study published in the Journal of Ethnopharmacology investigated the anticonvulsant properties of Valeriana edulis spp. procera using in situ electroencephalographic (EEG) analysis on PTZ-induced convulsive behavior in rats. The study found that valerian significantly reduced excitatory activity and inhibited paraxystic activity, suggesting potential benefits. Chromatographic analysis identified valepotriates such as isodihydrovaltrate, homovaltrate, 10-acetoxy-valtrathydrin, and valtrate, while in silico predictions suggested involvement of GABAA and cannabinoid CB2 receptors in the anticonvulsant mechanism. While these results are promising, there is need for further research to substantiate valerian’s role in modern epilepsy treatment. 

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