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Melatonin

By Melissa G. Marko, PhD; Ara DerMarderosian, PhD

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Melatonin, a hormone produced by the pineal gland, regulates circadian rhythms. It can be derived from animals, but most melatonin is manufactured synthetically. In some countries, melatonin is considered a drug and is regulated as such.

Claims

Melatonin is used for the short-term regulation of sleep patterns, including jet lag and insomnia. Research into the use of melatonin supplementation for people affected by seasonal affective disorder, regulation of sleep patterns in people who work late shifts, and the resynchronization of the sleep/wake cycle in people with early Alzheimer disease is currently being evaluated.

Evidence

Some scientific evidence supports use of melatonin to minimize the effects of jet lag, especially in people traveling eastward over 2 to 5 time zones (1-2). However, in one well-designed study, melatonin supplements did not relieve symptoms of jet lag (3), and only a few small studies suggest that these supplements can relieve jet lag symptoms (4-5), indicating that clinical trial results are inconsistent.

Standard dosage is not established and ranges from 0.5 to 5 mg po taken 1 h before usual bedtime on the day of travel and 2 to 4 nights after arrival. Evidence supporting use of melatonin as a sleep aid in adults and children with neuropsychiatric disorders (eg, pervasive developmental disorders) is less strong.

Adverse effects

Hangover drowsiness, headache, and transient depression may occur. Melatonin may worsen depression. Theoretically, prion infection caused by products derived from neurologic tissues of animals is a risk.

Drug interactions

Evidence suggests that melatonin may increase the effects of warfarin, increasing the risk of bleeding.

Melatonin references

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