THE CASE
As a preface, I would like it on record that I have no bias, either pro or con melatonin.
Melatonin is a naturally occurring substance found in virtually all living organisms. It is an antioxidant and is also associated with maintaining the daily biological clock. Advocates of melatonin suggest it may be beneficial for a wide variety of conditions including jet-lag, shift-work, fertility, ADHD, depression and Alzheimer's Disease. Most of these are unproven, but do have some biochemical rationale.
Because of a legislative loophole, melatonin is not considered to be a drug in the US, it is therefore freely sold in supermarkets. In most other countries including Australia, it has not been approved for sale either as a drug or as a complementary medicine.
The Mayo Clinic has issued an analysis of the side effects of melatonin:
There is some evidence that the doses of melatonin in some supplements, 3 mg to 5 mg is too high. It appears to be most effective with doses of 0.1 mg to 0.5 mg.
Because melatonin influences the production of other hormones, it may interfere with normal sexual development. Therefore it shouldn't be used by children or by women who are trying to conceive, pregnant or breastfeeding. In males, gynaecomastia and oligospermia have been reported reported.
Melatonin may interact with the following drugs: antidepressants, benzodiazepines and other sedatives, blood pressure treatments, corticosteroids, immunosuppressants particularly cyclosporin, insulin, kava and valerian.
If you live in one of the countries where melatonin is not legally available, don't purchase one of the homeopathic products instead (eg Melatonin 6X), you are just wasting your money. There is not enough (if any at all) melatonin in them to be biologically active. Don't buy melatonin from biological sources (watch for the words "natural" or "organic"), it may contain scary biological contaminants, synthetic melatonin is much safer.
The sleep drug ramelteon (Rozerem), apparently mimics melatonin. The manufacturer Takeda was criticised for specifically marketing it to children. (Ramelteon is not available in Australia at the time of writing this blog.)
MY VERDICT
On balance there does not seem to be any problems in healthy adults taking melatonin, for a couple of days to get over jet-lag. It is particularly useful for travellers moving across five or more time zones. For undetermined reasons Australian authorities continue to resist legalising it, although millions of doses have, seemingly safely, been sold in the US. It certainly seems to be safer than zolpidem.
As a preface, I would like it on record that I have no bias, either pro or con melatonin.
Melatonin is a naturally occurring substance found in virtually all living organisms. It is an antioxidant and is also associated with maintaining the daily biological clock. Advocates of melatonin suggest it may be beneficial for a wide variety of conditions including jet-lag, shift-work, fertility, ADHD, depression and Alzheimer's Disease. Most of these are unproven, but do have some biochemical rationale.
Because of a legislative loophole, melatonin is not considered to be a drug in the US, it is therefore freely sold in supermarkets. In most other countries including Australia, it has not been approved for sale either as a drug or as a complementary medicine.
The Mayo Clinic has issued an analysis of the side effects of melatonin:
The hormone melatonin helps control your natural sleep-wake cycle. In fact, natural levels of melatonin in the blood are highest just before bedtime. If you're struggling with insomnia, melatonin supplements may help you fall asleep or stay asleep. However, there are no guarantees. Most studies show melatonin to be only minimally effective for insomnia. Melatonin may play a stronger role in fighting jet lag.
Melatonin side effects may include daytime sleepiness, dizziness, headaches and abdominal discomfort. Confusion, sleepwalking or nightmares also are possible. Some studies suggest that melatonin increases the risk of seizures, but others disagree. Melatonin may interact with various medications.
The optimal dose of melatonin isn't certain, and the long-term effects are unknown. Talk to your doctor before taking melatonin, especially if you have any underlying health conditions. If you decide to take melatonin, make sure the supplements are manufactured in a lab, not derived from animals.
There is some evidence that the doses of melatonin in some supplements, 3 mg to 5 mg is too high. It appears to be most effective with doses of 0.1 mg to 0.5 mg.
Because melatonin influences the production of other hormones, it may interfere with normal sexual development. Therefore it shouldn't be used by children or by women who are trying to conceive, pregnant or breastfeeding. In males, gynaecomastia and oligospermia have been reported reported.
Melatonin may interact with the following drugs: antidepressants, benzodiazepines and other sedatives, blood pressure treatments, corticosteroids, immunosuppressants particularly cyclosporin, insulin, kava and valerian.
If you live in one of the countries where melatonin is not legally available, don't purchase one of the homeopathic products instead (eg Melatonin 6X), you are just wasting your money. There is not enough (if any at all) melatonin in them to be biologically active. Don't buy melatonin from biological sources (watch for the words "natural" or "organic"), it may contain scary biological contaminants, synthetic melatonin is much safer.
The sleep drug ramelteon (Rozerem), apparently mimics melatonin. The manufacturer Takeda was criticised for specifically marketing it to children. (Ramelteon is not available in Australia at the time of writing this blog.)
MY VERDICT
On balance there does not seem to be any problems in healthy adults taking melatonin, for a couple of days to get over jet-lag. It is particularly useful for travellers moving across five or more time zones. For undetermined reasons Australian authorities continue to resist legalising it, although millions of doses have, seemingly safely, been sold in the US. It certainly seems to be safer than zolpidem.
1 comments:
Thank you for this very valuable information. My pediatician actually told me to give 1mg per night to my 3 year old son to help him sleep, and to get him into a natural sleep pattern becasuse he was not sleeping throught he night and would wake 2 -4 time nightly. However, my son has been havinf headaches, vomiting and muscle pain intermittently and has been linked back to the melatonin. Since I stopped giving him melatonin which was HELL, he actually went through withdraw symptoms. He has been good. He sleeps approximately 8 hours a night but because he was on the melatonin for 4 month every night it built up in his systom and caused an overdose. PARENTS< PEOPLE beware, this is NOT for children, I dont care if your pediatrician tells you its safe, dont listen!!
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