melatonin
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Uses
- insomnia[5]*
- effective for jet lag[14]
- anti-aging agent
- potentially anti-amyloidogenic
- may have protective effect against Alzheimer's disease[23]
- adjunct agent in combination with chemotherapy for breast cancer
- weight gain in patients taking atypical antipsychotics[10]
- reduces risk of self-harm in adolescents with psychiatric disorders[21]
* safe but may be ineffective for some sleep disorders[6]
* insufficient evidence to support use for cognitive impairment[13]
* American Academy of Sleep recommends against use for insomnia[18] Contrandications:
- does not prevent delirium after major cardiac surgery[17]
Function
- role in seasonal time measurement[7]
- transducer of photoperiod (day length)
- marker of oscillation of the circadian pacemaker in the suprachiasmatic nucleus of the hypothalamus
Expression
- melatonin levels vary with age & sleep-wake cycle[7]
- in young men levels are 7% greater during sleep, but in elderly men are 37% lower
- in elderly women, levels are 11% lower during sleep
Dosage
* long-acting melatonin is more effective than short-acting melatonin
Adverse effects
- no reported serious adverse effects or toxicity[9]
- may increase reactive aggression in men[15]
Drug interactions
- may impair efficacy of some calcium channel blockers
- diminishes efficacy of nifedipine (Procardia XL)
- may increase effects of fluvoxamine (Luvox)
- no interaction noted[11]
- may interact with SSRI & SNRI[11]
- antiplatelet agents[9]
- no interaction noted[11]
- anticoagulants[9]
- no interaction noted[11]
- may diminish effects of hypoglycemic agents[9]
- no interaction noted[11]
- may enhance effects of tamoxifen[11]
- may enhance effects of benzodiazepines[11]
Notes
- over-the-counter products containing melatonin
- melatonin content ranged from 74-347% of the labeled content
- only 12% of products with melatonin content within 10% of the labeled content
- 20% of products declared to contain cannabidiol 10.6-31.3 mg/serving
- cannabidiol content ranged from 104-118% of the labeled content
- melatonin content ranged from 74-347% of the labeled content
More general terms
Additional terms
Component of
References
- ↑ Prescriber's Letter 7(8):46 2000
- ↑ Prescriber's Letter 7(11):59 2000
- ↑ Prescriber's Letter 8(5):29 2001
- ↑ 4.0 4.1 Prescriber's Letter 8(11):62 2001
- ↑ 5.0 5.1 Journal Watch 24(5):43, 2004 Leger D et al, Am J Med 116:91, 2004 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14715322
- ↑ 6.0 6.1 Buscemi N, Vandermeer B, Hooton N et al The efficacy and safety of exogenous melatonin for primary sleep disorders. A meta-analysis. J Gen Intern Med. 2005 Dec;20(12):1151-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16423108 Free PMC Article
Buscemi N, Vandermeer B, Hooton N et al, Efficiency and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: Meta-analysis. BMJ 2006; 332:385 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16473858 Free PMC Article
Herxheimer A, Does melatonin help people sleep? It's a misapplied but probably safe miracle drug. BMJ 2006; 332372 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16484240 - ↑ 7.0 7.1 7.2 Zeiter JM et al, Plasma melatonin rhythms in young and older humans during sleep, sleep deprivation, and wake. Sleep 2007, 30:1437 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18041478
- ↑ Prescriber's Letter 17(5): 2010 COMMENTARY: Melatonin for Insomnia in Kids PATIENT HANDOUT: Strategies for Getting a Good Night's Sleep PATIENT HANDOUT SPANISH VERSION: Estrategias para poder dormir bien en la noche Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260508&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 9.0 9.1 9.2 9.3 9.4 Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ 10.0 10.1 Romo-Nava F et al. Melatonin attenuates antipsychotic metabolic effects: An eight-week randomized, double-blind, parallel-group, placebo- controlled trial. Bipolar Disord 2014 Mar 17 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24636483 <Internet> http://onlinelibrary.wiley.com/doi/10.1111/bdi.12196/abstract
- ↑ 11.0 11.1 11.2 11.3 11.4 11.5 11.6 11.7 Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
- ↑ Wade AG, Ford I, Crawford G, McConnachie A et al Nightly treatment of primary insomnia with prolonged release melatonin for 6 months: a randomized placebo controlled trial on age and endogenous melatonin as predictors of efficacy and safety. BMC Med. 2010 Aug 16;8:51. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20712869 Free PMC Article
- ↑ 13.0 13.1 Jansen SL, Forbes DA, Duncan V, Morgan DG. Melatonin for cognitive impairment. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD003802. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16437462
- ↑ 14.0 14.1 Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev. 2002;(2):CD001520. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12076414 Similar articles
- ↑ 15.0 15.1 Liu J, Zhong R, Xiong W, Liu H, Eisenegger C, Zhou X. Melatonin increases reactive aggression in humans. Psychopharmacology (Berl) 2017 Jul 21; PMID: https://www.ncbi.nlm.nih.gov/pubmed/28733812
- ↑ Marshall L As Melatonin Use Rises, So Do Safety Concerns. Medscape - Nov 13, 2018. https://www.medscape.com/viewarticle/904828
- ↑ 17.0 17.1 Ford AH, Flicker L, Kelly R et al The Healthy Heart-Mind Trial: Randomized Controlled Trial of Melatonin for Prevention of Delirium. J Am Geriatr Soc. 2019 Oct 8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31595489
- ↑ 18.0 18.1 18.2 Lillie L Deprived of Sleep, Many Turn to Melatonin Despite Risks. Medscape. April 19, 2022 https://www.medscape.com/viewarticle/972397
Li J, Somers VK, Xu H et al Trends in Use of Melatonin Supplements Among US Adults, 1999-2018. JAMA. 2022;327(5):483-485. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35103775 PMCID: PMC8808329 (available on 2022-08-01) https://jamanetwork.com/journals/jama/article-abstract/2788539 - ↑ WebMD: Melatonin https://www.webmd.com/vitamins/ai/ingredientmono-940/melatonin
- ↑ Melatonin (Herb/Suppl). Medscape Drugs & Diseases https://reference.medscape.com/drug/n-acetyl-5-methoxytryptamine-pineal-hormone-melatonin-melatonin-344545
- ↑ 21.0 21.1 Anderson P Melatonin a New Way to Reduce Self-Harm? Medscape. March 27, 2023 https://www.medscape.com/viewarticle/990150
Leone M, Kuja-Halkola R, Lagerberg T et al Melatonin use and the risk of self-harm and unintentional injuries in youths with and without psychiatric disorders. J Child Pscychol Psychiatr 2023. March 23 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36950769 - ↑ Cohen PA, Avula B, Wang YH et al Quantity of Melatonin and CBD in Melatonin Gummies Sold in the US. JAMA. 2023;329(16):1401-1402 PMID: https://www.ncbi.nlm.nih.gov/pubmed/37097362 PMCID: PMC10130950 Free PMC article https://jamanetwork.com/journals/jama/fullarticle/2804077
- ↑ 23.0 23.1 Zhang Z, Xue P, Bendlin BB et al Melatonin: A potential nighttime guardian against Alzheimer's. Mol Psychiatry. 2024 Aug 11. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39128995 Review. https://www.nature.com/articles/s41380-024-02691-6
- ↑ Xie Z, Chen F, Li WA et al. A review of sleep disorders and melatonin. Neurol Res. 2017;39(6):559-565 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28460563 https://www.tandfonline.com/doi/full/10.1080/01616412.2017.1315864