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Melatonin (N-acetyl-5-methoxytryptamine)
Natural Standard Flashcard. Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This flashcard is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Summary

  • Melatonin is a hormone made in the brain. Levels of melatonin are affected by light and dark, and are highest before bedtime. Melatonin has been used for many conditions. It is most often used for people who have trouble sleeping.

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

GRADING SYSTEM LINK

Delayed sleep phase syndrome (DSPS)

B

Insomnia (children)

B

Insomnia (elderly)

B

Jet lag

B

Sleep disorders (people with behavior, development, or mental disorders)

B

Sleep enhancement in healthy people

B

Age-related macular degeneration (vision loss with age)

C

Aging (body temperature control)

C

Alzheimer's disease

C

Anti-inflammatory

C

Benzodiazepine withdrawal (antianxiety drugs)

C

Cancer treatment

C

Chronic fatigue syndrome

C

Chronic obstructive lung disease (disorder making it hard to breathe)

C

Circadian rhythm sleep disorders (people with and without vision problems)

C

Delirium (confusion)

C

Depression

C

Diabetes (taken with regular therapy)

C

Exercise performance

C

Fertility

C

Fibromyalgia (chronic body-wide pain)

C

Glaucoma (high eye pressure)

C

Headache

C

Heart disease

C

High blood pressure

C

High cholesterol

C

HIV/AIDS

C

Liver inflammation

C

Low platelets in the blood

C

Memory

C

Menopause

C

Pain

C

Parkinson's disease

C

Periodic limb movement disorder (limb movements during sleep)

C

REM sleep behavior disorder (acting out dreams during sleep)

C

Restless leg syndrome

C

Rett's syndrome (brain disorder)

C

Ringing in the ears

C

Sarcoidosis (chronic inflammation)

C

Schizophrenia (mental disorder)

C

Seasonal affective disorder (SAD)

C

Seizure disorder

C

Skin damage from the sun

C

Sleep disturbance

C

Smoking

C

Stomach and intestine disorders

C

Stroke

C

Surgery

C

Tardive dyskinesia (uncontrolled muscle movements)

C

Ulcers

C

Urinating at night

C

Work shift sleep disorder

D

Safety

  • Melatonin is likely safe when taken by mouth for up to three months. Melatonin is likely safe for long-term use in children.
  • Use caution in people who have changes in hormone levels, eye disorders, frequent feelings of cold, genital or urinary disorders (including children with a history of bedwetting), heart disease, hyperactivity, immune disorders, inflammatory disorders, mental disorders, muscle control problems, nervous system disorders, seizures, skin disorders, and stomach and intestine problems.
  • Use caution in people taking agents that affect the immune system, anti-inflammatory agents, depressants, hormonal agents, stimulants, or sedatives.
  • Use caution in breastfeeding women.
  • Caution is advised in people taking drugs, herbs, or supplements that affect blood pressure.
  • Caution is advised in people with diabetes or low blood sugar and those taking drugs, herbs, or supplements that affect blood sugar.
  • Caution is advised in people with bleeding or clotting disorders or those taking drugs that may affect bleeding.
  • Use caution in people who are driving or operating heavy machinery (including aircraft).
  • Melatonin may affect the way the liver processes certain drugs, herbs or supplements.
  • Avoid in women who are pregnant or trying to get pregnant.
  • Avoid if allergic or sensitive to melatonin or related products.

Possible side effects

  • Abnormal heartbeat, aggression, amnesia, bedwetting (in children), body pain, changes in bleeding or clotting risk, changes in blood pressure, changes in blood sugar, changes in body temperature or feeling cold, changes in cholesterol levels, changes in the immune system, chest pain, confusion, decreased sex drive, decreased sperm count, delusions, disorientation, dizziness, drowsiness, eye damage or increased eye pressure, fatigue or irregular sleep-wake schedule, fogginess, hallucinations, headache, hormonal effects, hyperactivity, increased heart rate, increased risk of development disorders (in unborn children of pregnant women), increased seizure risk (particularly in children), inflammation, insomnia, irritability, liver inflammation, mood changes, muscle control problems or weakness, musculoskeletal disorders, nightmares, nighttime awakening, poor sleep quality, psychotic symptoms, reduced ovary function, skin reactions (flushing, itching, painful lumps, paleness, and rash), sleepwalking, slow reaction time, stomach or intestinal disorders (changes in appetite, cramping, diarrhea, esophagus inflammation, nausea, odd taste in mouth, stomach pain, and vomiting), vivid dreaming, weakness, worsened behavior, yawning.

Possible interactions

  • 5-HTP, ACE inhibitors, agents passed by the kidneys, agents processed by the liver, agents that affect bleeding or clotting risk, agents that affect blood pressure (including beta blockers such as propranolol [Inderal®], atenolol [Tenormin®], and metoprolol [Lopressor®, Toprol®]), agents that affect blood sugar, agents that affect blood vessel width, agents that affect GABA, agents that affect the immune system, agents that affect the nervous system, agents that harm the liver, agents that increase drowsiness (including antidepressants, benzodiazepines, and diazepam), agents that increase seizure risk, agents that increase urine flow, agents that lower vitamin B6 levels (including birth control, hormone replacement therapy, loop diuretics, hydralazine, and theophylline), agents that protect against radiation, agents that regulate body temperature, agents that treat liver disorders, agents that treat Parkinson's disease, agents that treat seizures, alcohol, Alzheimer's agents, anesthetics, antiaging agents, antiarthritis agents, antiasthma agents, anticancer agents, anti-inflammatory agents, antioxidants, antiparasite agents, antipsychotic agents, antiulcer agents, antivirals, anxiety agents, birth control, caffeine and caffeine-containing agents, calcium channel blockers, chasteberry, cholesterol-lowering agents, cognitive agents, dental agents, dextromethorphan, DHEA, ear agents, echinacea, epithalamin, estradiol, estrogens, exercise performance agents, eye agents, fertility agents, flumazenil, folate, GABA, genital and urinary disorder agents, glaucoma agents, headache agents, heart agents, heart rate-regulating agents, hormonal agents, isoniazid, light therapy, lithium, lung agents, magnetic fields, meditation, methamphetamines, methoxamine, musculoskeletal agents, music therapy, neuromuscular blockers, NSAIDs (including ibuprofen [Motrin®, Advil®] or naproxen [Naprosyn®, Aleve®]), opioids, osteoporosis agents, pain relievers, phytoestrogens, remifentanil, sevoflurane, skin agents, somatostatin, stomach agents, tacrine, temazepam, thyroid hormones, vaccines, valproic acid, verapamil, vitamin B12, weight loss agents, and herbs or supplements with similar effects.

Dosing

    Adults (18 years and older)

    • Melatonin has been taken by mouth in the form of capsules (both immediate-release and slow-release melatonin [Circadin®]) and melatonin-rich night milk. Melatonin has been placed under the tongue or in the cheek. Melatonin has been applied to the skin as a gel or solution. Melatonin has been injected into the vein.

    Children (younger than 18 years)

    • Melatonin has been taken by mouth and injected into the vein. However, caution is advised due to lack of safety data. Melatonin use should be discussed with a healthcare provider.
    The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.