Each week, many peer-reviewed articles are published on melatonin.
Below are select articles chosen and reviewed by our team.
Article Title Our Takeaway
The efficacy of exogenous melatonin supplement in ameliorating irritable bowel syndrome severity: A meta-analysis of randomized controlled trials
This article supports the emerging literature on melatonin’s mechanism of action through the GI tract, along with its antioxidant activities. Enterochromaffin cells in the gut contain approximately 400 times more melatonin than what is produced in the pineal gland. This release of melatonin in the gut increases gastric mucosa and gut motility and has been shown to have a protective effect on the GI tract via its antioxidant activities. The data from the 4 RCTs provide a foundation to consider melatonin as a therapy for patients with IBS. A clinician should carefully assess the individual and make recommendations according to their personalized needs. Three of the four studies included the dose of 3 mg melatonin at bedtime, which aligns with other studies reported in a review article. Read more
The effect of treatment with melatonin on primary school aged children with difficulty in initiation and maintenance of sleep.
The use of melatonin in children for sleep concerns is a topic we have routinely examined, reported on, and reviewed as literature becomes available. We agree that other approaches, especially sleep hygiene, should be addressed first prior to melatonin therapy considering that endogenous production of melatonin is high in this age group. This short-term study does support existing literature that demonstrates the safety profile of melatonin in children, with a maximum dose of 3 mg for children and 5 mg for adolescents, in those who need it. The use of melatonin for children should always be discussed with the child’s physician before starting supplementation. Read more
Based on the data presented in this article, combined with other articles our team has reviewed, we contend that the research on melatonin for PMS and PMDD is an emerging area to monitor. At present, clear clinical guidelines for the dose and timing of melatonin for this specific health concern have not yet been established, however, based on preliminary data, it appears promising and aligns with other research...
Article Title Our Takeaway
Coping with Oxidative Stress in Reproductive Pathophysiology and Assisted Reproduction: Melatonin as an Emerging Therapeutical Tool.
This narrative review has provided a comprehensive summary of the multitude of ways melatonin is beneficial for fertility, whether conceiving naturally or using assisted reproductive techniques, with key points that can be shared with patients in a clinical setting. Additionally, for women with endometriosis or PCOS, a dose of 3 mg melatonin per day has been demonstrated to improve multiple aspects of hormonal health that may improve fertility outcomes. In clinical practice, our team has used 5 mg of melatonin for PCOS.
Current Insights into the Risks of Using Melatonin as a Treatment for Sleep Disorders in Older Adults.
This narrative review summarized current evidence and reported that melatonin is a safe therapy for sleep disorders in older adults, with non-statistical significance in reported adverse effects, of which the most common are headaches, daytime fatigue, and dizziness. It is best used at the lowest therapeutic dose (<1 mg), administered 30-60 minutes before bed. Since older adults are more likely to have other health conditions and take one or more prescription medications, it is prudent for clinicians to check for possible drug interactions and monitor patients after starting melatonin therapy. Aspects of monitoring include but are not limited to, blood pressure, daytime fatigue, labs (i.e., prothrombin time for those on warfarin), and sleep quality.
This article provides a comprehensive summary of the possible mechanisms for action, each of which could be explored in greater detail in future human studies. While specific dosing of melatonin is not described in this review article, the clinical usefulness of understanding the possible mechanisms of action allow clinicians to implement this knowledge to consider melatonin as an option for the management of anxiety disorders.
Role of Melatonin in the Management of Sleep and Circadian Disorders in the Context of Psychiatric Illness.
This review provides an overview of the use of melatonin for sleep disorders in psychiatric illnesses and it may provide guidance to clinicians on possible doses of melatonin for select conditions.
We appreciate the details on the possible abnormalities in sleep and circadian rhythms and believe this can help to further guide research in the future. Further, we agree with the author’s notation that a dose of 0.3 mg melatonin is well evidenced and has “the largest impact on sleep efficiency.” Therefore, given this current evidence, along with other well-established evidence, we would consider 0.3 mg of melatonin a safe and effective dose to aid in sleep disturbances and restoring circadian rhythm dysfunction.
A phase II, single-center, double-blind, randomized placebo-controlled trial to explore the efficacy and safety of intravenous melatonin in surgical patients with severe sepsis admitted to the intensive care unit. Read More