What happens when you take valerian tea with benzodiazepines?
Valerian root (Valeriana officinalis) is one of the oldest sleep and anxiety remedies in Western herbalism, used since the time of Hippocrates. Its active constituents include valerenic acid, valerenol, and a family of valepotriates. These compounds are now known to act on the gamma-aminobutyric acid type A (GABA-A) receptor, the same inhibitory neurotransmitter receptor that benzodiazepines target.
Valerenic acid is a positive allosteric modulator of GABA-A receptors containing the beta-3 subunit, while valerian extract also appears to inhibit the breakdown and reuptake of GABA in the synaptic cleft. The net effect is enhanced inhibitory neurotransmission in the central nervous system.
Benzodiazepines such as alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium), clonazepam (Klonopin), and temazepam (Restoril) bind to a different allosteric site on the same GABA-A receptor complex, increasing the frequency at which the receptor's chloride channel opens in response to GABA. When valerian and a benzodiazepine are taken together, both push the same receptor system in the same direction. The result is a pharmacodynamic synergy that can deepen sedation, slow reflexes, impair memory, and prolong the duration of the drug's effect.
Why is this important?
Benzodiazepines already carry significant risk on their own. They are central nervous system depressants. They are sedating, they impair driving and operating machinery, they can cause anterograde amnesia, they increase the risk of falls and fractures in older adults, and in overdose, especially combined with opioids or alcohol, they can cause fatal respiratory depression.
Valerian by itself is gentle. Stacked on top of a benzodiazepine, that gentleness is misleading. Patients often think of an herbal sleep tea as a benign nighttime ritual, not as a CNS depressant. They may not mention it to a prescriber, and the prescriber may not ask. The combination can produce:
- Excessive morning grogginess or "hangover" the next day
- Reduced reaction time while driving, particularly the morning after
- Increased fall risk, especially for older adults going to the bathroom at night
- Worsening of benzodiazepine-related cognitive impairment
- Difficulty in distinguishing whether a dose change in the benzodiazepine is causing a new symptom, because the herbal contribution is invisible to the medical record
The risk is amplified by alcohol, opioids, sleep medications such as zolpidem (Ambien) or eszopiclone (Lunesta), sedating antihistamines such as diphenhydramine, antipsychotics, and other sedating herbs such as kava, hops, and California poppy.
What should you do?
If you have been prescribed a benzodiazepine, the simplest rule is to not add valerian tea, capsules, or tinctures without first talking to the prescriber.
If you are already drinking valerian tea regularly and have just been prescribed a benzodiazepine for the first time, tell the prescriber. They will want to know about it for two reasons: to assess whether you can stop the valerian (you usually can, with no withdrawal in moderate users), and to choose a starting benzodiazepine dose that accounts for the additional sedative load if you intend to continue both.
If you choose to continue both, do not drive or operate dangerous machinery until you know the combined effect of an evening dose. Take the benzodiazepine and the valerian tea at the same time of evening (do not space them so the sedation drags into morning). Avoid alcohol entirely. Be cautious with other sedating medications and supplements.
If you are tapering off a benzodiazepine under medical supervision, do not start valerian tea as a self-directed substitute without telling the clinician overseeing the taper. Adding valerian during the taper can mask early withdrawal signals and confuse the picture.
Special caution applies to older adults (over 65), people with sleep apnea, people on opioid pain medications, and anyone with a history of falls.
Which specific products are affected?
The interaction applies to all benzodiazepines, including alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium), clonazepam (Klonopin), temazepam (Restoril), oxazepam (Serax), chlordiazepoxide (Librium), midazolam (Versed), and triazolam (Halcion). It also applies, by the same mechanism, to the so-called Z-drugs such as zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta), and to barbiturates.
On the valerian side, the interaction applies to valerian tea bags (commonly marketed for sleep), loose valerian root infusions, valerian tinctures and liquid extracts, standardized valerian capsules and tablets, and combination herbal sleep blends such as those containing valerian plus hops, lemon balm, passionflower, chamomile, or melatonin.
The bottom line
Valerian tea and benzodiazepines act on the same GABA-A receptor system and have additive sedative effects. Combining them can cause excessive drowsiness, impaired reaction time, increased fall risk, and amplified morning grogginess. If you take a benzodiazepine, treat valerian like a second sedative drug: clear it with your prescriber, avoid alcohol, do not drive after the first combined dose, and be especially cautious if you are over 65 or have sleep apnea.