Melatonin: myths vs. A good number of people turn to melatonin, an over-the-counter sleep aid for help. But is it safe? Like many prescription medications, melatonin makes you fall asleep. Melatonin is not addicting. If a person takes melatonin, they should take it for a long time. The highest dose of melatonin is the most effective dose. Melatonin is safe for children. Melatonin can be used for other conditions other than sleep cycle disruptions. Related Blog Posts. Feng et al[ 84 ] also examined the effects of melatonin on morphine-induced behavioural sensitisation and reported that pre-treatment with melatonin prevented the development of morphine-induced behavioural sensitisation and analgesic tolerance; effects which were dose-dependent[ 84 ].
Li et al[ 95 ] also reported that protracted opiate withdrawal in rats was associated with the disruption of the circadian rhythm of hormones adrenocorticotropin, orexin and corticosterone , leading to the induction of neurobiological changes which may worsen the risk of relapse[ 95 ]. Feng et al[ 84 ] examined the ability of melatonin to militate against the deleterious effects of opiate addiction and reported that melatonin was able to reverse morphine induced mitochondrial dysfunction and oxidative stress, in cultured cells.
They also demonstrated that melatonin reversed morphine-induced autophagy and changes in mitochondrial DNA copy number in cultured cells and neurons[ 84 ]. In vivo studies using a mouse model of morphine addiction demonstrated that melatonin also counteracted morphine—induced autophagic effects and decrease in mitochondrial DNA copy number in the hippocampus[ 84 ].
Sleep and circadian rhythm disorders have been well-defined in a number of substances use disorders, including those of marijuana[ ], alcohol[ 52 , , ], nicotine[ ], benzodiazepines[ 86 , ] and cocaine[ 51 ]. Treatment options for insomnias in drug addiction are limited, largely because traditional hypnotics that target benzodiazepine receptors are associated with abuse potential, withdrawal effects, and the potential for overdose.
Melatonin supplement has been found particularly valuable in the management of circadian rhythm disorders[ ], in the treatment of insomnias in subjects with chronic schizophrenia[ ], in the elderly[ , ], and among children with sleep onset insomnia[ ]. Its use in alcohol addicts have been supported by studies that have reported low plasma melatonin levels in this group of substance users[ 66 , ]. Other studies have examined the efficacy of melatonin analogs in militating addiction-related sleep disorders.
Brower et al[ ] examined the ability of the melatonin receptor agonist ramelteon to attenuate insomnia in recovering alcoholics, and reported an improvement in sleep quality and quantity.
Another study using agomelatine a melatonergic agonist at MT1 and MT2 receptors, and a 5-HT2C antagonist approved for use as an antidepressant reported improved sleep in alcohol-dependent subjects with insomnia; with participants reporting improved subjective sleep quality after 6 wk of administration[ ].
To date, melatonin and its analogs have continued to show promise in the management of drug addiction. However, the use of melatonin may be limited by its short half-life and an additive sedative effect when used alongside BDZs and other drugs such as morphine; also, its safety in the younger age groups are still being debated. Despite these, evidences from both animal and human studies continue to show the potentials of melatonin and its analogs in the management of drug addiction.
Therefore, research must continue to focus on the applications of melatonergic agents in drug addiction management, especially, beyond their established use for associated sleep disorders.
Conflict-of-interest statement: None. Manuscript source: Invited manuscript. Peer-review started: April 3, First decision: May 2, Article in press: May 10, Specialty type: Psychiatry. Country of origin: Nigeria. Peer-review report classification. Grade A Excellent : 0. Grade B Very good : B, B. National Center for Biotechnology Information , U.
Journal List World J Psychiatry v. World J Psychiatry. Published online Jun Author information Article notes Copyright and License information Disclaimer.
Author contributions: Onaolapo AY and Onaolapo OJ contributed to writing sections of the review article, were also both responsible for the critical revision, editing, and the final approval of the final version Correspondence to: Dr.
Published by Baishideng Publishing Group Inc. All rights reserved. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. This article has been cited by other articles in PMC. Abstract Melatonin is a pleiotropic signalling molecule that regulates several physiological functions, and synchronises biological rhythms. Neurobiological and neurochemical basis of drug addiction Substance dependence can be described as a disorder which involves the motivational systems of the brain[ 25 ].
MELATONIN Melatonin is an endogenously-produced indolamine that is predominantly secreted by the pineal gland, and widely recognised as a regulator of several physiological functions. Melatonin receptors and drug addiction Melatonin exerts its effects on behaviours and physiological functions largely via the melatonin MT receptors 1 and 2[ 74 , 75 ].
Melatonin, addiction-related behavioural sensitisation, neuroplasticity and neurotoxicity Chronic intermittent use of cocaine and a number of other psychostimulants have been associated with the development of a progressive, long-lasting enhancement of psychomotor effects which have been referred to as cocaine or psychostimulant sensitisation.
Melatonin in the management of drug-addiction related sleep and circadian rhythm disorders Sleep and circadian rhythm disorders have been well-defined in a number of substances use disorders, including those of marijuana[ ], alcohol[ 52 , , ], nicotine[ ], benzodiazepines[ 86 , ] and cocaine[ 51 ].
Footnotes Conflict-of-interest statement: None. References 1. Sex differences in drug addiction and response to exercise intervention: From human to animal studies. Front Neuroendocrinol. Wakefield JC. DSM-5 substance use disorder: how conceptual missteps weakened the foundations of the addictive disorders field. Acta Psychiatr Scand. Gardner EL. Addiction and brain reward and antireward pathways. Adv Psychosom Med. A review of pharmacogenetic studies of substance-related disorders.
Drug Alcohol Depend. Burns L. Drug Alcohol Rev. J Neuroimmune Pharmacol. Jadidi N, Nakhaee N. Etiology of drug abuse: a narrative analysis. J Addict. N Engl J Med. Volkow ND, Morales M. The Genetics, Neurogenetics and Pharmacogenetics of Addiction.
Curr Behav Neurosci Rep. Volkow ND, Muenke M. The genetics of addiction. Hum Genet. Circadian rhythms and addiction: mechanistic insights and future directions. Behav Neurosci. A role for the circadian genes in drug addiction. Dim light melatonin onset in alcohol-dependent men and women compared with healthy controls.
Chronobiol Int. Gene profiling the response to repeated cocaine self-administration in dorsal striatum: a focus on circadian genes. Brain Res. Circadian timing of ethanol exposure exerts enduring effects on subsequent ad libitum consumption in C57 mice. Alcohol Clin Exp Res. Webb IC. Curr Psychiatry Rep.
Patterns of cocaine self-administration in rats produced by various access conditions under a discrete trials procedure. Cocaine sensitization and reward are under the influence of circadian genes and rhythm. Circadian discrimination of reward: evidence for simultaneous yet separable food- and drug-entrained rhythms in the rat. Methamphetamine and dopamine receptor D1 regulate entrainment of murine circadian oscillators.
PLoS One. Melatonin reduces motivation for cocaine self-administration and prevents relapse-like behavior in rats. Psychopharmacology Berl ; — World Health Organization. Neuroscience of psychoactive drug use and dependence. WHO, Geneva Switzerland; pp. Carter A. Neurobiological research on addiction: A review of the scientific, public health and social policy Implications for Australia; pp.
Neural mechanisms of addiction: the role of reward-related learning and memory. Annu Rev Neurosci. Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. Am J Psychiatry. Drug abuse: hedonic homeostatic dysregulation.
Avoid drinking alcohol or smoking while taking melatonin. These stop the medicine working as well as it should. Melatonin is also known by the brand name Circadin. To make sure melatonin is safe for you, tell your doctor if you: have had an allergic reaction to melatonin or any other medicines in the past have liver or kidney problems have rheumatoid arthritis , multiple sclerosis or lupus , or any other autoimmune condition.
Follow the instructions that come with your medicine if you're taking melatonin to: prevent headaches treat jet lag If your child is prescribed melatonin, follow the doctor's instructions carefully.
For sleep problems in adults Your doctor will prescribe 2mg slow-release or prolonged-release tablets. How to take it For sleep problems in adults, the usual dose is one 2mg tablet.
Take melatonin after food. Swallow the tablet whole. Do not crush or chew it. What if I forget to take it? What if I take too much? Urgent advice: Get advice from now if:. Most people will not have any side effects when taking melatonin. Common side effects These common side effects happen in more than 1 in people. Talk to your doctor or pharmacist if these side effects bother you or do not go away: feeling sleepy or tired in the daytime headache stomach ache or feeling sick nausea feeling dizzy feeling irritable or restless dry mouth dry or itchy skin pains in your arms or legs strange dreams or night sweats Serious side effects Serious side effects are rare and happen to less than 1 in 1, people.
Speak to a doctor as soon as possible if you: start feeling low or sad — this could be a sign of depression get blurry vision or your eyes become more watery than usual feel faint or pass out start feeling confused or dizzy, or things seem to be spinning around you vertigo have any bleeding that does not stop, unexplained bruising or blood in your urine get psoriasis.
Serious allergic reaction In rare cases, it's possible to have a serious allergic reaction anaphylaxis to melatonin. Information: These are not all the side effects of melatonin. What to do about: feeling sleepy or tired in the daytime — do not drive, cycle or use tools or machinery if you're feeling this way. Do not drink any alcohol as this will make you feel more tired. If this does not help, talk to your doctor as melatonin may not be the right medicine for you.
Do not drink too much alcohol. Ask a pharmacist to recommend a painkiller. Talk to a doctor if headaches last longer than a week or are severe. It can help to eat and drink slowly and have smaller and more frequent meals.
Do not drive, cycle or use tools or machinery if you're feeling dizzy. Do not drink alcohol as it will make you feel worse. Try using an oil-free face moisturiser for sensitive skin. Non-urgent advice: Tell a doctor if you're:. Speak to a doctor or pharmacist before taking melatonin if you take any of the following: antidepressants such as fluvoxamine or imipramine blood pressure lowering medicines nonsteroidal anti-inflammatory medicines NSAIDs such as ibuprofen , naproxen or diclofenac oestrogens used in contraceptives and hormone replacement therapy opiate agonists or antagonists for drug addiction psoralens for skin disorders such psoriasis quinolones or rifampicin types of antibiotic carbamazepine for epilepsy cimetidine for stomach problems such as ulcers thioridazine for schizophrenia tryptophan supplements for insomnia warfarin a blood thinner zaleplon, zolpidem or zopiclone for insomnia Mixing melatonin with herbal remedies and supplements Do not take any herbal remedies that make you feel sleepy while taking melatonin.
Important Tell a doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements. How does melatonin work? How long will it take to work? Melatonin takes around 1 to 2 hours to work. How long will I take it for to treat insomnia? You'll usually be prescribed melatonin for 1 to 4 weeks.
In some cases it can be prescribed for up to 13 weeks. See a doctor again if these tips do not help. How does melatonin work for jet lag? You can use melatonin for up to 5 nights in a row. For adults, the standard dose ranges from one to ten milligrams.
It is best to start with a low dose and move up carefully if you see success. Also, speak to a medical professional before you attempt to increase your dose. Since melatonin is a hormone the body produces, many people are comfortable using it over extended periods. Alcohol and melatonin, when taken at the same time, causes various side effects. Some of these include redness in the face, increased irritability, and swelling of the hands or feet. Beyond these disorienting symptoms, there are more serious ones.
When taken together, alcohol and melatonin can cause elevated heart rates, fatigue, drowsiness, difficulties in breathing, and sudden unconsciousness. Being susceptible to passing out could put you in extreme danger, especially if you operate heavy machinery, are driving, or are walking outside or in potentially hazardous situations.
You might find yourself in a collision or another serious accident. The safest dose for this sleep aid is the lowest one effective in helping you fall asleep. Start with a dose between 0. Dose strength depends on your age, your sensitivity to the supplement, and your body weight. Too much melatonin is counterproductive since it produces the opposite effect to its intended purpose.
Using too much could make sleeping more difficult since it could disrupt your circadian rhythms. Overdosing could also cause you to feel groggy during the day and cause you to experience vivid dreams or nightmares. Aside from feeling the side effects mentioned above, you could also develop joint pain and feelings of anxiety from too much melatonin.
0コメント