Home / Research Paper / Valeriana Officinalis (Valerian) and Its’ Potential Use in Treating the Myriad of Symptoms, Research Paper Example

Valeriana Officinalis (Valerian) and Its’ Potential Use in Treating the Myriad of Symptoms, Research Paper Example

Pages: 9

Words: 2391

Research Paper

Abstract

The objective of this work in writing is to review one or more in vitro or in vivo (animal) studies involving whole plant extracts of active constituents of valerian relating to pharmacokinetics or pharmacodynamics including a brief statement about the relevancy of this work to clinical herbal medicine. In addition, this work will summarize one or more human studies relating to pharmacodynamics or pharmacokinetics (excluding interactions) relevant to valerian or primary constituents of the herb including a brief statement about the relevancy of the work to clinical herbal medicine. Finally, this work will briefly describe any study examining synergy relating to valerian and explain the relevant to clinical herbal medicine.

Objective

Introduction

Valerian has been used in modern history and historically for sedative and anxiolytic purposes and for treating a nervous stomach. (Kemper, 1999) Clinical trials are reported to have demonstrated that valerian extract “is effective in the treatment of mild to moderate sleeping disorders and states of restlessness and tension.” (Kemper, 1999) It is reported that the Greek physician, Discorides used valerian root in treatment disorders including those as follows: (1) heart palpitations; (2) digestive problems; (3) epilepsy; and (4) urinary tract infections. (Kemper, 1999) Valerian is also reported to have been recommended by Galen during the second century for treating insomnia. Valerian is also recommended in the Herbal PDR for treating: (1) nervousness; (2) insomnia; (3) lack of concentration; (4) stress headache; (5) menstrual states of agitation; (6) neuralgia; (7) nervous stomach; and (8) states of angst. (Kemper, 1999) Valerian has also been used for assisting in the reduction of hypertension and the reduction of the effects of stress and tension. (Kemper, 1999, paraphrased) In addition, Valerian is used “in combination with other sedative herbs such as chamomile, lemon balm, passion flower, St. John’s Wort, hawthorn berries and hops.” (Kemper, 1999) It is reported that valerian is combined with melatonin by some consumers. (Kemper, 1999, paraphrased) Valerian officinalis (roots and rhizomes) is reported to be used as a mild sedative or sleep-aid and antispasmodic. (Jellin, 1999) Valerian may potentially increase the effects of certain anti-seizure medications or prolong the effects of sedative and certain anesthetic agents.” (Lambrecht, et al, 2000)

Valerian and Treatment of Fibromyalgia

Fibromyalgia is referred to in the medical community as the ‘invisible illness’ because individuals with fibromyalgia generally do not appear to be sick and the typical medical tests return with negative results. Fibromyalgia is a “complex, chronic condition which causes widespread pain and fatigue as well as a variety of other symptoms. The name fibromyalgia comes from ‘fibro’ meaning fibrous tissues (such as tendons and ligaments) ‘my’ meaning muscles and ‘algia’ meaning pain.” (National Fibromyalgia Partnership, Inc., 2004) FM is unlike arthritis in that it “does not cause pain or swelling in the joints. Rather it produces pain in the soft tissues located around joints and in skin and organs throughout the body.” (National Fibromyalgia Partnership, Inc., 2004) The pain associated with fibromyalgia is comprised by “diffused aching or burning described as ‘head-to-toe’ and it is often accompanied by muscle spasm.” (National Fibromyalgia Partnership, Inc., 2004) Fibromyalgia can be so severe that it interferes the individual’s performance of the simplest of tasks and in other individuals it may cause only mild to moderate discomfort. The symptoms of fibromyalgia include the following stated symptoms:

Stiffness – generally experienced upon awakening and after long periods of standing or sitting in one position and also linked to changes in relative humidity;
Headaches and Facial Pain – This is experienced due to stiff or tender neck and shoulder muscles and pain, which radiates upwards. May also accompany temporo-mandibular joint (TMJ) dysfunction;
Sleep disturbances – even when sleeping a sufficient period of time the patient may wake up feeling unrefreshed. As well, they may have trouble falling or staying asleep. There have been alpha wave disruption in the deep, or delta wave, sleep of some patients with FM;
Cognitive Disorders – These are various and also vary daily. Some patients experience decreased blood flow to the cerebrum
Gastrointestinal Complaints – Includes digestive disturbances, abdominal pain, bloating, constipation and diarrhea and difficulty swallowing food;
Genito-Urinary Problems;
Parethesia – Numbness or tingling in hands and feet;
Myofascial Trigger Points – painful trigger points in muscles and connective tissues;
Chest symptoms – chest and upper body pain and dysfunction;
Dysequilibrium – light-headedness and balance problems. Researchers at Johns Hopkins Medical Center have also shown that some FM patients have a condition known as neurally mediated hypotension which causes a drop in blood pressure and heart rate upon standing with resulting light-headedness, nausea, and difficulty thinking clearly;
Leg Sensation – some individuals develop the neurologic disorder known as restless legs syndrome;
Sensory Sensitivity/Allergic Symptoms – hypersensitivity to light, sound, touch and odors due the hyperactive nervous system;
Skin complaints – symptoms including itchy, dry or blotching skin, dryness of the eyes and mouth, swelling in extremities;
Depression and anxiety. (National Fibromyalgia Partnership, Inc., 2004)

According to the Center for Holistic Pediatric Education and Research in an article written by Kathi J. Kemper, MD, MPH who cites the work of Melnizky (1999) “Some spas put valerian in whirlpool baths to help reduce pain and enhance sleep for patients with fibromyalgia.” (1999) A study reported in the work of Ammer and Melnizky (1999) reports that when a study examined whether whirl baths with water containing pine oil or valerian have a different influence on pain, disturbed sleep or tender point count, and in what was a randomized comparative and investigator-blinded study, and which additionally measured general pain and change of intensity of pain during the day, general well-being and occurrence of disturbed sleep findings, that when 30 patients were statistically evaluated that the patients report that medicinal baths reduced pain, improved well-being and sleep. It is reported that Valerian root has not been individually studied for Fibromyalgia treatment however, it is reported that Dr. Jacob Teitelbaum conducted a study and in his work entitled “Effective Treatment of Fibromyalgia and Chronic Fatigue Syndrome – A Report of a Randomized, Double-Blind, Placebo-Controlled Study” that treatment of Fibromyalgia has been found to be effective with Valerian. (FMS Information Guide Pro-Health, Inc. 2000)

Valerian: Biochemistry (Potentially Active Chemical Constituents)

Listed as the biochemistry of Valerian and specifically the potentially active chemical constituents of Valerian are the following: (1) Iridoid valepotriates (0.5% -2.0%) 36: valtrates, isovaltrate, didrovaltrate, valerosidate and others; (2) Volatile essential oil (0.2 – 02.8%) 37 : bornyl isovalerenate and bornyl acetate; valerenic, valeric, isovaleric and acetoxyvalerenic acids; valerenal, valeranone, cryptofaurinol; and other monoterpenes and sesquiterpenes • Alkaloids (0.01 – 0.05%): valeranine, chatinine, alpha-methyl pyrrylketone, actinidine, skyanthine and naphthyridylmethylketone 38-41; and (3) Lignans: hydroxypinoresinol (Coates, 2005)

Evaluation of Interactions of Valerian with Other Drugs

It is reported that there are several approaches both: (1) in vitro; and (2) in vivo which are used for evaluation of herbal drug interactions. (Sharman, Jain, Patel and Gupta, 2010) Most research is reported to have had as its focus on the in vitro evlu8ation of herbal constituents in microsomal systems, supersomes, cytosols, expressed enzymes or cell culture systems such as transfected cell lines, primary cultures of human hepatocytes and tumor derived cells.” (MacGregor et al., 2001). These studies are reported to be valuable for evaluating multiple products and multiple components, provide mechanistic information about any potential interaction and are simple to conduct. It has certain limitations as to the simple component used in the test; a typical of higher concentrations than clinical relevance and it does not account for the poor bioavailability of the active component or the binding of the same in vivo to plasma proteins.” (Venkataramanan et al., 2006 in: Sharman, Jain, Patel and Gupta, 2010). Studies have also been carried in vivo animals including: (1) normal; (2) transgenic; and (3) humanized and as well such studies have been carried out in primarily healthy human beings. (Sharman, Jain, Patel and Gupta, 2010) In such studies the subjects generally receive a single dose of a test drug or a cocktail of drugs that are reported to be markers for “various enzymes on day 1 and then followed by a multiple daily dose treatment with the herbal product and on the last day of treatment, administration of the test drug or the cocktail of drugs is accomplished.” (Sharman, Jain, Patel and Gupta, 2010) Next conducted is a comparison of the “various pharmacokinetic parameters or phenotypic measures are used as a method to evaluate the effect of herbal products on the pharmacokinetics of test drug or activity of various drug metabolizing enzymes.” (Pekthong et al., 2009 in: Sharman, Jain, Patel and Gupta, 2010). Stated to be ideal in vivo study designs are the following: (1) evaluation of the composition of the herbal product used; (2) evaluation of the disintegration and dissolution property of product used; (3) Using chronic dosing of the herbal products (at least one week); (4) Co-administering herb and drug product on study day to maximize potential for interaction; (5) Using positive controls in the study design (for example, rifampin to document induction and ketoconazole to document inhibition and give a comparative effect of the herbal product being tested); and (6) Measuring some herbal component in the blood or plasma to verify systemic levels of some components from the herbal product.” (Sharman, Jain, Patel and Gupta, 2010)

Human Studies Involving Use of Valerian

In a study of the evidence of mild to moderate sedative and tranquilizing effects of valerian root extract involving EEG studies in health volunteers and specifically female subjects with sleeping disorders it is reported that 400 mg of aqueous valerian root extract did not induce significant changes in the objective measures of sleep” and furthermore the results indicate “tendencies towards a shorter mean sleep latency and an increased mean latency to first awakening.” (Upton, 2010) It is reported that more sleep investigations were conducted using the same aqueous extract in a study involving eight subjects without a major sleeping disorder. These individuals spent five nights in the sleep laboratory and the first of the five nights without being given medication and a placebo givens on the second and third nights with 900 mg of valerian root extract administered on night four followed by a placebo being given on night five. The study reports that there was not a difference between placebo and valerian root extract in the sleep EEG” it is state however, that in the subjective assessment of quality of sleep, reported to have been determined through use of a visual analogue scale “the time taken to fall asleep and the time spent awake during the night were reduced under treatment with the valerian root preparation.” (Upton, 2010) The work of Upton (1999) reports the pharmacodynamics of Valerian and states that research in this area in relation to valerian has primarily focused on the “sedative and spasmolytic properties” of Valerian. Specifically reported by Upton (1999) is the following information:

“Individual components have displayed activity, but no single constituent has been shown to account for valerian’s total action. Early in the 20th century, it was believed that the essential oil was the component responsible for the sedative effect of valerian (Houghton 1988). However, work by Gestirmer and Kind published in 1951 indicated that the essential oil accounted for only one-third of the sedative activity of the extract (Gestirmer and Kind 1951). In 1969, Eickstedt and Rahman reported that valepotriate esters isolated from valerian demonstrated sedative activity in mice (Eickstedt and Rahman 1969).

It is additionally reported that an in vivo study that conducted measurement of cerebral glucose turnover in rats found that while a dichloromethane extract demonstrated depressant activity, this activity could not be accounted for by valepotriates,” (Upton, 1999)

Summary and Conclusion

Valerian has been found to be useful in treating sleeping disorders as well as in bringing about a state of relaxation in the individual. Valerian is used throughout the world successfully by many individuals for a myriad of health problems. Valerian, while not thoroughly tested for use in treating fibromyalgia, has been used throughout history to treat symptoms that have been found to be symptoms of fibromyalgia. There is a need for further study in determining the effectiveness and efficacy of Valerian in treating the myriad symptoms of Fibromyalgia.

References

Ammer K, Melnizky P. Medicinal baths for treatment of generalized fibromyalgia. Forsch Komplementarmed 1999; 6:80-5.

Coates, Paul M. (2006) Encyclopedia of Dietary Supplements. Dekker Encyclopedia Series. CRC Press 2005. Retrieved from: http://books.google.com/books?id=Sfmc-fRCj10C&dq=(1)+Iridoid+valepotriates+(0.5%25+-2.0%25)+36:+valtrates,+isovaltrate,+didrovaltrate,+valerosidate+and+others%3B&source=gbs_navlinks_s

Eickstedt KW, Rahman S. 1969.Psychopharmakologische Wirkungen von Valepotriaten. Arzneim Forsch Drug Res 19:316-9 in: Upton, Roy (1999) Valierian Root: Valeriana Officinalis:: Analytical, Quality Control, and Therapeutic Monograph. April 1999. American Herbal Pharmacopoeia and Therapeutic Compendium. Retrieved from: http://www.herbal-ahp.org/documents/sample/valerian.pdf

Houghton PJ. 1988. The biological activity of valerian and related plants. J Ethnopharmac 22:121-42 in: Upton, Roy (1999) Valierian Root: Valeriana Officinalis:: Analytical, Quality Control, and Therapeutic Monograph. April 1999. American Herbal Pharmacopoeia and Therapeutic Compendium. Retrieved from: http://www.herbal-ahp.org/documents/sample/valerian.pdf

JE Teitelbaum, M.D., B Bird, M.T., C.L.S, R Greenfield, M.D., A Weiss, M.D., L Muenz, P.h.D, L Gould in: FMS Information Guide (2000) Pro-Health, Inc. Retrieved from: http://www.immunesupport.com/fms_research/articles/fm_supps.htm

Kemper, Kathi J. (1999) Valerian (Valeriana officinalis) The Longwood Herbal Task Force. The Center for Holistic Pediatric Education and Research. Retrieved from: http://www.longwoodherbal.org/valerian/valerian.pdf

Literature Review (nd) Part I. Retrieved from: http://ietd.inflibnet.ac.in/bitstream/10603/1327/11/11_part%20i.pdf

Radix, L. (2007) Assessment Report on Valeriana Officinalis Committee on Herbal Medicinal Products (HMPC) European Medicine Agencies. 29 Nov 2007. Retrieved from: http://www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_HMPC_assessment_report/2009/12/WC500017929.pdf

Sharma, M., Jain, U.K., Patel, A. and Gupta, N. (2010) A Comprehensive Pharmacognotic Report on Valerian. International Journal of Pharmaceutical Sciences and Research. Vol. 1 Issue 7. 3 May 2010. Retrieved from: http://www.ijpsr.com/V1I7/2%20Vol%201%20Issue%207%20Review%202.pdf

Upton, Roy (1999) Valerian Root: Valeriana Officinalis:: Analytical, Quality Control, and Therapeutic Monograph. April 1999. American Herbal Pharmacopoeia and Therapeutic Compendium. Retrieved from: http://www.herbal-ahp.org/documents/sample/valerian.pdf

FM Monograph Fibromyalgia: Symptoms, Diagnosis, Treatment & Research (2004) National Fibromyalgia Partnership, Inc. Retrieved from: http://www.fmpartnership.org/documents/Monograph04-PDF.pdf