Melatonin : Part 3

by MedlinePlus

(Page 3 of 6)

Preoperative sedation / anxiolysis

A small number of controlled studies has compared melatonin with placebo and standard drugs (benzodiazepines) for sedation and anxiety reduction (anxiolysis) prior to general anesthesia for surgery. Results are promising, with similar results reported for melatonin as for benzodiazepines such as midazolam (Versed®), and superiority to placebo.There are also promising reports using melatonin for sedation/anxiolysis prior to magnetic resonance imaging (MRI). However, due to weaknesses in the design and reporting of the available research, better studies are needed before a clear conclusion can be drawn.Melatonin has also been suggested as a treatment for delirium following surgery, although there is little evidence in this area.

REM sleep behavior disorder

Limited case reports describe benefits in patients with REM sleep behavior disorder who receive melatonin. However, better research is needed before a clear conclusion can be drawn.

Rett syndrome

Rett syndrome is a presumed genetic disorder that affects female children, characterized by decelerated head growth and global developmental regression. There is limited study of the possible role of melatonin in improving sleep disturbance associated with Rett syndrome. Further research is needed before a recommendation can be made in this area.

Schizophrenia (sleep disorders)

There is limited study of melatonin for improving sleep latency (time to fall asleep) In patients with schizophrenia. Further research is needed in this area before a clear conclusion can be reached.

Seasonal affective disorder (SAD)

There are several small, brief studies of melatonin in patients with SAD. This research is not well designed or reported, and further study is necessary before a clear conclusion can be reached.

Seizure disorder (children)

The role of melatonin in seizure disorder is controversial. There are several reported cases of children with intractable seizures or neurologic damage who improved with regular nighttime melatonin administration. Limited animal research also suggests possible anti-seizure effects. However, there has also been a report that melatonin may actually lower seizure threshold and increase the risk of seizures. Better evidence is needed in this area before a clear conclusion can be drawn regarding the safety or effectiveness of melatonin in seizure disorder.

Sleep disturbances due to pineal region brain damage

Several published cases report improvements in sleep patterns in young people with damage to the pineal gland area of the brain due to tumors or surgery. Due to the rarity of such disorders, controlled trials may not be possible. Consideration of melatonin in such patients should be under the direction of a qualified healthcare provider.

Sleep in asthma

Based on preliminary study, melatonin may improve sleep in patients with asthma. Further studies looking into long-term effects of melatonin on airway inflammation and bronchial hyper-responsiveness are needed before melatonin can be recommended.

Smoking cessation

A small amount of research has examined the use of melatonin to reduce symptoms associated with smoking cessation, such as anxiousness, restlessness, irritability, and cigarette craving. Although preliminary results are promising, due to weaknesses in the design and reporting of this research, further study is necessary before a firm conclusion can be reached.

Stroke

It has been proposed that melatonin may reduce the amount of neurologic damage patients experience after stroke, based on antioxidant properties. In addition, melatonin levels may be altered in people immediately after stroke, and it has thus been suggested that melatonin supplementation may be beneficial, although this has not been shown in humans. At this time, the effects of melatonin supplements immediately after stroke are not clear.

Tardive dyskinesia

Tardive dyskinesia (TD) is a serious potential side effect of antipsychotic medications, characterized by involuntary muscle movements. Limited small studies of melatonin use in patients with TD report mixed findings. Additional research is necessary before a clear conclusion can be drawn.

Thrombocytopenia (low platelets)

Increased platelet counts after melatonin use have been observed in patients with decreased platelets due to cancer therapies (several studies reported by the same author). Stimulation of platelet production (thrombopoeisis) has been suggested but not clearly demonstrated. Additional research is necessary in this area before a clear conclusion can be drawn. Cases of idiopathic thrombocytopenic purpura (ITP) treated with melatonin have been reported.

Ultraviolet light skin damage protection

Several small, randomized trials have examined the use of melatonin in protecting human skin against UV-light damage. It has been proposed that antioxidant properties of melatonin may be protective. Although this preliminary research reports reductions in erythema (skin redness) with the use of melatonin, further study is necessary before a clear conclusion can be drawn about clinical effectiveness in humans.

Work shift sleep disorder

There are several studies of melatonin use in people who work irregular shifts, such as emergency room personnel. Results are mixed, with some studies finding no significant benefits, and others reporting benefits in sleep quality compared to placebo. Because most published trials are small, with incomplete reporting of design or results, additional research is necessary before a clear conclusion can be drawn.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acetaminophen toxicity, acute respiratory distress syndrome (ARDS), aging, aluminum toxicity, amikacin-induced kidney damage, asthma, beta-blocker sleep disturbance, cachexia, cancer prevention, cardiac syndrome X, cognitive enhancement, colitis, contraception, coronary artery disease, critical illness/ICU sleep disturbance, cyclosporin-induced kidney toxicity, depression, edema, erectile dysfunction, fibromyalgia, gastroesophageal reflux disease (GERD), gentamicin-induced kidney damage, glaucoma, heart attack prevention, hyperpigmentation, immunostimulant, interstitial cystitis, intestinal motility disorders, itching, lead toxicity, melatonin deficiency, memory enhancement, multiple sclerosis, neurodegenerative disorders, noise-induced hearing loss, pancreatitis, polycystic ovarian syndrome (PCOS), postmenopausal osteoporosis, post-operative adjunct, post-operative delirium, prevention of post-lung transplant ischemia-reperfusion injury, rheumatoid arthritis, sarcoidosis, sedation, sexual activity enhancement, schistosomiasis, sudden infant death syndrome (SIDS) prevention, tachycardia, tinnitus, toxic kidney damage, toxic liver damage, tuberculosis, tuberous sclerosis, ulcerative colitis, withdrawal from narcotics, wound healing.

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