Melatonin

Melatonin is a neurohormone produced by the pineal gland, primarily responsible for regulating the circadian rhythm and sleep-wake cycles. As a dietary supplement, exogenous melatonin is widely utilized to address sleep disorders, jet lag, and certain circadian rhythm disruptions. Its chronobiotic properties make it a pivotal agent in non-pharmacological sleep management, offering a physiological approach to sleep induction and maintenance without the dependency risks associated with conventional hypnotics.

Features

• Synthetic formulation identical to endogenous melatonin
• Available in immediate-release, extended-release, and sublingual forms
• Typically dosed between 0.5 mg to 10 mg per unit
• Rapid absorption with an elimination half-life of approximately 20–50 minutes
• Non-habit forming with no evidence of withdrawal syndrome
• Often combined with complementary ingredients like magnesium or L-theanine in specialized formulations

Benefits

• Facilitates faster sleep onset by reducing sleep latency
• Helps realign disrupted circadian rhythms, such as in shift work or jet lag
• May improve overall sleep quality and architecture, including REM sleep
• Provides a non-addictive alternative to prescription sleep aids
• Supports antioxidant activity and immune modulation at physiological levels
• Can be used adjunctively in certain neurological and psychiatric conditions

Common use

Melatonin is most frequently used for the short-term management of insomnia, particularly sleep onset insomnia. It is also widely employed to mitigate jet lag following transmeridian travel and to assist individuals with delayed sleep-wake phase disorder (DSWPD) or non-24-hour sleep-wake rhythm disorder. Shift workers often use melatonin to adapt to irregular schedules. Off-label, it is sometimes used in supportive care for migraine prophylaxis, tinnitus, and as an adjunct in autistic spectrum disorders.

Dosage and direction

Dosage should be individualized based on the indication and patient response. For insomnia, 1–5 mg taken 30–60 minutes before bedtime is typical. Jet lag management often involves 0.5–5 mg taken close to the target bedtime at the destination, starting several days before travel. Sublingual formulations allow for quicker absorption. Higher doses (up to 10 mg) may be used under medical supervision for specific conditions. Long-term use should be periodically reevaluated.

Precautions

Use with caution in individuals with autoimmune disorders, due to melatonin’s immunomodulatory effects. Those with hepatic impairment may experience altered metabolism. Melatonin may exacerbate symptoms in patients with depression or seizure disorders. Avoid activities requiring alertness, such as driving, after ingestion. Not recommended for use during pregnancy or lactation without medical consultation. Discontinue use two weeks prior to elective surgery due to potential effects on coagulation and anesthesia.

Contraindications

Melatonin is contraindicated in individuals with known hypersensitivity to melatonin or any excipients in the formulation. It should not be used by patients undergoing immunosuppressive therapy or those with severe allergic conditions. Avoid in patients with Hodgkin’s lymphoma, leukemia, or myeloma unless under specialist supervision.

Possible side effects

Common side effects include daytime drowsiness, headache, dizziness, and nausea. Less frequently reported effects include vivid dreams, irritability, mild anxiety, and transient hypotension. Hypothermia and reduced sperm motility have been noted in high-dose or long-term studies. Most side effects are dose-dependent and reversible upon discontinuation.

Drug interaction

Melatonin may interact with anticoagulants (e.g., warfarin), increasing bleeding risk. It can potentiate the sedative effects of CNS depressants, including benzodiazepines, opioids, and alcohol. Concurrent use with fluvoxamine or other CYP1A2 inhibitors may elevate melatonin levels. It may reduce the effectiveness of antihypertensive medications and immunosuppressants. Caution is advised with diabetes medications due to potential impacts on glucose metabolism.

Missed dose

If a dose is missed, it should be skipped entirely. Do not double the next dose. Take the next scheduled dose at the usual time. Consistency in timing is more critical than compensating for missed doses, particularly for circadian rhythm applications.

Overdose

Symptoms of overdose may include severe drowsiness, confusion, disorientation, and hypothermia. There is no known antidote; treatment is supportive and symptomatic. Gastric lavage or activated charcoal may be considered if ingestion is recent. Medical attention should be sought immediately for suspected overdose, especially in children.

Storage

Store in a cool, dry place away from light and moisture. Keep the container tightly closed. Do not refrigerate or freeze. Keep out of reach of children and pets. Discard any product that has passed its expiration date or shows signs of degradation.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Melatonin is a dietary supplement and is not intended to diagnose, treat, cure, or prevent any disease. Individual responses may vary. Always consult a healthcare professional before starting any new supplement, especially if you have pre-existing medical conditions or are taking other medications.

Reviews

Clinical studies and user reports generally support melatonin’s efficacy in reducing sleep onset latency and improving sleep quality. Many users report subjective improvements in sleep without next-day grogginess. Criticisms often relate to variability in product quality and individual response. Higher-quality trials note its benefit in jet lag and shift work disorder, though effect sizes can be modest. Long-term safety data remain limited but reassuring in the short-to-medium term.