Melatonin: 7 things you should know
Medically reviewed by Carmen Fookes, BPharm. Last updated on April 10, 2020.
1. How it works
- Melatonin is a supplement that may be used in the treatment of sleep disorders.
- Most melatonin that is available as a supplement is a synthetic version of the naturally-occurring hormone, melatonin, produced by the pineal gland and other parts of our body.
- Environmental light inhibits the secretion of melatonin and darkness stimulates the secretion of melatonin. Secretion of melatonin in humans starts around 9 pm and peaks between 2 and 4 am; with the duration of melatonin production varying from season to season.
- Melatonin is classed as a supplement which means it is available without a prescription from pharmacies, nutrition stores, and other retail outlets.
- Melatonin may be used to treat jet lag, sleep disorders in the blind, shift-work sleep disorders, and for general insomnia. It is an antioxidant and is purported to have numerous other properties (such as boosting the immune system and treating headaches).
- May improve sleep problems in children with autism, Asperger syndrome, or pervasive developmental disorder.
- May be used for a number of other conditions (such as fibromyalgia).
- The majority of trials have investigated the use of melatonin for jet-lag. A review found melatonin to be very effective at decreasing jet lag from eastward flights crossing five or more time zones. A dosage of 0.5 mg/day immediately before bedtime once at the destination appears just as effective as a dosage of 5 mg/day; however, onset and quality of sleep is better with the 5mg dosage. The 2mg slow-release dose appears ineffective; suggesting that a short-lived, high-peak concentration of melatonin works better.
- Melatonin appears more effective the more time zones crossed, and less effective for westward flights.
- Occasional short-term use appears safe.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Dizziness, drowsiness, bed-wetting, headache, nausea and excessive daytime sedation are the most common side effects.
- Melatonin may cause drowsiness that persists and affects a person's ability to drive or operate machinery the next day.
- Not FDA approved.
- May not be suitable for some people including those with epilepsy or autoimmune diseases, or taking warfarin. Caffeine and fluvoxamine may elevate plasma concentrations of melatonin. Melatonin may decrease plasma concentrations of nifedipine.
- If melatonin is not taken at the right time of day it may cause drowsiness and delay adaption to local time.
- Some melatonin supplements use naturally occurring melatonin derived from animal pineal tissue. Their use is to be discouraged because of the risk of contamination or viral transmission.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
- For jet lag, take melatonin as close to bedtime at your destination as possible (10 pm to midnight). Take short-acting rather than slow-release melatonin for jet lag.
- For westbound travel, melatonin should be taken for four nights once in the new time zone. For eastbound travel, one dose of melatonin should be taken before the flight in the early evening, followed by once at night for four nights after arrival.
- For sleep disorders, melatonin 5mg should be taken three to four hours before a defined, set, bedtime. people who have difficulty maintaining sleep should consider high-dose, repeated low-dose, or controlled-release melatonin.
- Buy melatonin from a reputable brand with good quality control measures.
- Do not drive or operate machinery if you feel sleepy with melatonin or the sleepiness persists the next day.
- Caffeine (contained in coffee and cola) may increase the effects of melatonin, causing increased or prolonged sedation.
- Talk to your doctor if you experience any unusual reactions after taking melatonin.
- Melatonin should only be used short-term unless a doctor has advised you to take it long-term.
6. Response and Effectiveness
- Drowsiness may be experienced within 30 minutes of taking melatonin and generally persists for at least an hour.
- Supplements of 5mg increase peak melatonin levels by around 25 times; however, they do not alter the natural physiological release of melatonin.
- Plasma levels of melatonin return to normal within 24 hours of a single dose of melatonin.
Medicines that interact with melatonin may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with melatonin. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with melatonin include:
- medications that also cause sedation, such as alprazolam, diazepam, temazepam, zaleplon, or zolpidem
- PARP inhibitors, such as olaparib
- some quinolone antibiotics, such as moxifloxacin
Note that this list is not all-inclusive and includes only common medications that may interact with melatonin. You should refer to the prescribing information for melatonin for a complete list of interactions.
Melatonin. Reviewed July 2018. Drugs.com https://www.drugs.com/npp/melatonin.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use melatonin only for the indication prescribed.
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