Download Melatonin (05/2017)

Melatonin
Melatonin is a natural hormone produced by the pineal gland in the brain, however much of
what you see in the supplement aisle is synthetically made in laboratories. Melatonin
production and release are stimulated with darkness and suppressed with light, which suggests
that melatonin helps regulate our circadian rhythm, or sleep-wake cycle. Therefore, many
people use melatonin as a remedy for many causes of sleep disorders.
The evidence concerning melatonin shows the greatest effect when treating circadian rhythm
sleep disorders in the blind, delayed sleep phase syndrome (DSPS) in children and young adults,
insomnia (including disturbances due to mental disabilities/disorders), and jet lag. Melatonin
appears to improve symptoms of these sleep disorders primarily by reducing the time it takes
to fall asleep, but some populations are also able to stay asleep longer and report an improved
quality of sleep. For other uses, such as shift work disorder, melatonin does not appear to
improve the time it takes to fall asleep, either due to the underlying cause of the sleep
disturbance or because there has not been enough research to determine its efficacy. It is
interesting to note that although melatonin may be deemed possibly ineffective for treating
shift work disorder and other sleep disturbances, some people have reported other sleep
benefits like increased total sleep time or overall sleep quality. Therefore, the evidence
surrounding certain sleep disorders may be incomplete.
Melatonin is generally safe and well-tolerated when used as directed. In most cases, melatonin
should only be used for a short-term period up to 3 months. Typical dosing is 3 to 5 mg taken at
night, shortly before the intended bedtime. In people who may be more sensitive to melatonin
effects (such as the elderly), a lower starting dose of 1 mg daily may be considered when first
beginning therapy. The daily dose may be titrated up to 10 mg total. The most common side
effects are headache, dizziness, nausea, and drowsiness. Other side effects that have been
reported with oral melatonin include transient depressive symptoms, mild tremor, mild anxiety,
abdominal cramps, irritability, reduced alertness, confusion or disorientation, and hypotension.
Some case reports raise concerns about increased risk of seizure with melatonin treatment, but
conflicting evidence exists. Melatonin can potentially worsen bleeding disorders, high blood
pressure, diabetes, and increase risk of transplant rejection. Women who are pregnant or trying
to become pregnant should avoid melatonin. Always consult your doctor before beginning a
new treatment.
For more information about whether melatonin is right for you, please speak with our friendly
pharmacists here at Dexter Pharmacy or visit the following resources:

http://www.mayoclinic.org/drugs-supplements/melatonin/background/hrb-20059770
Rebecca Sarkozi, PharmD Candidate 2017

https://naturalmedicines-therapeuticresearchcom.proxy.lib.umich.edu/databases/food,-herbssupplements/professional.aspx?productid=940#interactionsWithDiseases
Rebecca Sarkozi, PharmD Candidate 2017