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melatonin

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 Uses: 1) insomnia [5]* 2) effective for jet lag [14] 3) anti-aging agent - potentially anti-amyloidogenic - may have protective effect against Alzheimer's disease [23] 4) adjunct agent in combination with chemotherapy for breast cancer 5) weight gain in patients taking atypical antipsychotics [10] 6) 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] Dosage: - 0.3-5 mg QHS [4]; 2-12 mg QHS has been used for up to 4 weeks [18] * 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: 1) may impair efficacy of some calcium channel blockers - diminishes efficacy of nifedipine (Procardia XL) 2) may increase effects of fluvoxamine (Luvox) - no interaction noted [11] 3) may interact with SSRI & SNRI [11] 3) antiplatelet agents [9] - no interaction noted [11] 4) anticoagulants [9] - no interaction noted [11] 5) may diminish effects of hypoglycemic agents [9] - no interaction noted [11] 7) may enhance effects of tamoxifen [11] 8) 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

Related

melatonin receptor

General

pineal hormone tryptamine

Properties

References

  1. Prescriber's Letter 7(8):46 2000
  2. Prescriber's Letter 7(11):59 2000
  3. Prescriber's Letter 8(5):29 2001
  4. Prescriber's Letter 8(11):62 2001
  5. Journal Watch 24(5):43, 2004 Leger D et al, Am J Med 116:91, 2004 PMID: 14715322
  6. 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: 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: 16473858 Free PMC Article - Herxheimer A, Does melatonin help people sleep? It's a misapplied but probably safe miracle drug. BMJ 2006; 332372 PMID: 16484240
  7. Zeiter JM et al, Plasma melatonin rhythms in young and older humans during sleep, sleep deprivation, and wake. Sleep 2007, 30:1437 PMID: 18041478
  8. 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#: 260508 (subscription needed) http://www.prescribersletter.com
  9. Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
  10. 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 PMID: 24636483 http://onlinelibrary.wiley.com/doi/10.1111/bdi.12196/abstract
  11. Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
  12. 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: 20712869 Free PMC Article
  13. Jansen SL, Forbes DA, Duncan V, Morgan DG. Melatonin for cognitive impairment. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD003802. Review. PMID: 16437462
  14. Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev. 2002;(2):CD001520. Review. PMID: 12076414 Similar articles
  15. Liu J, Zhong R, Xiong W, Liu H, Eisenegger C, Zhou X. Melatonin increases reactive aggression in humans. Psychopharmacology (Berl) 2017 Jul 21; PMID: 28733812
  16. Marshall L As Melatonin Use Rises, So Do Safety Concerns. Medscape - Nov 13, 2018. https://www.medscape.com/viewarticle/904828
  17. 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: 31595489
  18. 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: 35103775 PMCID: PMC8808329 (available on 2022-08-01) https://jamanetwork.com/journals/jama/article-abstract/2788539
  19. WebMD: Melatonin https://www.webmd.com/vitamins/ai/ingredientmono-940/melatonin
  20. Melatonin (Herb/Suppl). Medscape Drugs & Diseases https://reference.medscape.com/drug/n-acetyl-5-methoxytryptamine-pineal-hormone-melatonin-melatonin-344545
  21. 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: 36950769
  22. 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: 37097362 PMCID: PMC10130950 Free PMC article https://jamanetwork.com/journals/jama/fullarticle/2804077
  23. Zhang Z, Xue P, Bendlin BB et al Melatonin: A potential nighttime guardian against Alzheimer's. Mol Psychiatry. 2024 Aug 11. PMID: 39128995 Review. https://www.nature.com/articles/s41380-024-02691-6

Component-of

5 oh tryptophan/melatonin 5-OH tryptophan/magnesium oxide/melatonin/pyridoxine gamma aminobutyrate/melatonin/valeriana officinalis melatonin/pyridoxine melatonin/tryptophan