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Melatonin

 

Natural Standard Monograph, Copyright © 2014 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified health care professional before making decisions about therapies and/or health conditions.

Related Terms

  • 5-Methoxy-N-acetyltryptamine, 6-sulfatoxymelatonin, acetamide, agomelatine, aMT6s, beta-methyl-6-chloromelatonin, BMS-214778, CAS 73-31-4, hypnotic, indole, luzindol, luzindole, mel, MEL, melatonia, melatonine, Melaxen®, melaxene, MLT, MT, N-2-(5-methoxyindol-3-ethyl)-acetamide, N-acetil-5-metoxitriptamina (Spanish), N-acetyl-5-methoxytryptamine, neurohormone, ramelteon (CAS 196597-26-9, TAK-375), tryptophan.
  • Brand names: Accurate Release®; Appleheart Melatonin®; Circadin®; Inspired by Nature®; Mel®; Melatonin Controlled Release®; Melatonin Olympian Labs®; Melatonin Tablets®; Melatonin Time Release®; Melatonin-BioDynamax®; Melatonin-Metabolic Response Modifier®; Melatonin-New Hope Health Products®; Melatonin-Optimum Nutrition®; Melaxen®; Nature's Bounty®; Puritan's Pride®; Rozerem®; Twinlab® Melatonin; Valdoxan®.
  • Combination product examples: Melatonex® (vitamin B6); Melatonin Forte® (Piper methysticum, kavalactones, valerian); Melatonin PM Complex® (vitamin B6, vitamin B2, vitamin B3); Melatonin spray® (gamma-aminobutyric acid, pyridoxal-5-phosphate); Super Snooze with Melatonin® (valerian root, hop, skullcap, chamomile, passionflower).

Background

  • Melatonin is a hormone produced in the brain by the pineal gland from the amino acid tryptophan. The production and release of melatonin are stimulated by darkness and decreased by light, suggesting that melatonin is involved in circadian rhythm (the internal body clock) and regulation of diverse body functions. Levels of melatonin in the blood are highest prior to bedtime.
  • The most common use of melatonin is to aid in sleep. The strongest evidence supporting the use of melatonin is for delayed sleep phase syndrome, insomnia in children and the elderly, jet lag, and sleep problems in people with behavioral, developmental, or mental disorders. The weakest evidence in support of melatonin is for work shift sleep disorder. Good evidence in support of melatonin for other uses is lacking.
  • New drugs that block the effects of melatonin are being developed. These include BMS-214778 and luzindole, and they may have uses in various disorders.

Evidence

 

Uses based on scientific evidence 

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare professional.

Grade* 

Delayed sleep phase syndrome (DSPS) 

Delayed sleep phase syndrome is a condition that results in delayed sleep onset despite normal sleep patterns and duration. Studies report that melatonin may help improve the amount of time it takes to fall asleep. More research is needed before further conclusions can be made.

B 

Insomnia (children) 

According to human research, melatonin may benefit children with insomnia. Melatonin has been studied for sleep-wake disorders in children and adolescents. More well-designed studies that focus on safety are needed in this population.

B 

Insomnia (elderly) 

The production and elimination of melatonin from the body may be lower in older people with insomnia. Several human studies report that supplementing with melatonin may improve insomnia in the elderly. More research is needed before further conclusions can be made.

B 

Jet lag 

Several human trials suggest that melatonin taken by mouth, started on the day of travel (close to the target bedtime at the destination) and continued for several days, reduces the number of days needed to begin a normal sleep pattern, shortens the time it takes to fall asleep, improves alertness, and reduces daytime fatigue. More trials are needed to confirm these findings, determine the most effective dosing, and study the use of melatonin together with prescription sleep aids.

B 

Sleep disorders (people with behavioral, developmental, and mental disorders) 

Studies have looked at the use of melatonin in children with mental and nervous system disorders, including mental retardation, autism, vision loss, or epilepsy (seizure disorder). More research is needed before further conclusions can be made.

B 

Sleep enhancement in healthy people 

People who have insomnia appear to have lower melatonin levels, and supplementing with melatonin may offer some benefit. Most human studies have been small and brief in duration. However, evidence does suggest that melatonin decreases the time it takes to fall asleep, as well as increases sleepiness and sleep duration. Melatonin may also help promote daytime sleep. More research is needed before firm conclusions can be made.

B 

Age-related macular degeneration (vision loss with age) 

Melatonin may have antioxidant effects, which may contribute to its eye health benefits. Research suggests that melatonin may play a role in protecting the retina to delay macular degeneration. Well-designed clinical trials are needed before a conclusion can be made.

C 

Aging (body temperature regulation) 

Melatonin may help regulate age-dependent changes in body temperature rhythm. More well-designed trials are needed before a conclusion can be made.

C 

Alzheimer's disease/ cognitive decline 

Limited research has looked at the effects of melatonin on cognitive disorders. Some studies suggest a possible benefit. In elderly people with mild cognitive impairment, a combination treatment containing melatonin improved cognitive function scores and sense of smell, as well as speech fluency. More well-designed trials are needed before a conclusion can be made.

C 

Anti-inflammatory 

According to limited human research, melatonin may be an effective anti-inflammatory; however, results are conflicting. Well-designed clinical trials are needed before a conclusion can be made.

C 

Benzodiazepine withdrawal 

A small amount of research has looked at the use of melatonin to assist with withdrawal from benzodiazepines (antianxiety drugs) such as diazepam (Valium®) or lorazepam (Ativan®). Melatonin has been studied for this purpose in people with schizophrenia. Although early results are promising, further research is needed before a firm conclusion can be reached.

C 

Cancer treatment 

Early human studies have looked at melatonin use in people with different types of late-stage cancer, including cancer of the brain, breast, colon, rectum, stomach, liver, lung, pancreas, testicles, immune system, skin, kidney, and soft tissues. Melatonin has been used together with many other agents and therapies. Some promising results have been found in non-small cell lung cancer and breast cancer. However, no clear conclusion can currently be made in this area. There is not enough evidence to support the use of melatonin for any type of cancer, for affecting other cancer therapies, or for reducing chemotherapy side effects.

C 

Chronic fatigue syndrome 

Limited research has been conducted on the effects of melatonin in people with chronic fatigue syndrome. Early results suggest a lack of effect. Further research is needed in this area before a clear conclusion can be reached.

C 

Chronic obstructive pulmonary disease 

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that makes it difficult to breathe. Early research showed that melatonin reduced oxidative stress and shortness of breath. Changes in lung function were lacking. Further research is needed.

C 

Circadian rhythm sleep disorders (people with and without vision problems) 

In people with vision problems, light and dark signals are not received by the eye to trigger melatonin release and sleep. Some studies found inconclusive results for melatonin use in visually impaired children with sleep disorders. Others reported improvement in the time it takes to fall asleep and sleep duration in visually impaired people. Currently, research suggests that melatonin given in the evening may correct circadian rhythm (the internal body clock). Further research is needed before a conclusion can be made.

C 

Delirium 

Melatonin has been studied for delirium (confusion and changes in brain function) in people with a hip fracture and was found to reduce delirium in elderly people. More research is needed in order for conclusions to be drawn.

C 

Depression 

Melatonin has been suggested as a possible treatment for depression. However, human research remains inconclusive. More evidence is needed before a conclusion can be made.

C 

Diabetes (additional therapy) 

Melatonin used with zinc may improve blood sugar control after meals in people with type 2 diabetes. However, results are inconsistent. More evidence is needed before a conclusion can be made.

C 

Exercise performance 

Taking melatonin during the day may not affect jumping ability and strength. More research is needed before a conclusion can be made.

C 

Fertility 

Melatonin may not affect fertilization and pregnancy in people undergoing in vitro fertilization (IVF). A combination treatment containing melatonin improved both egg quality and fertilization rates in women who failed to conceive in previous IVF cycles. Further well-designed research is needed.

C 

Fibromyalgia 

Early studies suggest that melatonin may improve symptoms of fibromyalgia (chronic body-wide pain). Further research is needed.

C 

Glaucoma 

High doses of melatonin may increase eye pressure and the risk of glaucoma, age-related eye disease, nearsightedness, or retinal damage. However, early evidence suggests that melatonin may decrease eye pressure and may treat glaucoma. Further research is needed. People with glaucoma who are taking melatonin should be monitored by a healthcare professional.

C 

Headache 

Studies have looked at the use of melatonin for migraine, cluster, tension-type headaches, and other headache syndromes (in people who suffer from regular headaches). Melatonin has also been studied for nighttime headaches and for primary headaches in children. Limited research suggests possible benefits, but high-quality studies are needed before a firm conclusion can be made.

C 

Heart disease 

A combination treatment for heart disease that included melatonin was found to improve chest pain and have antioxidant, blood flow-improving, and blood pressure-lowering effects. Further high-quality research is needed.

C 

High blood pressure 

Studies report that melatonin may lead to small reductions in blood pressure. Melatonin may also improve cholesterol and reduce oxidative stress in people with metabolic syndrome. A combination treatment for heart disease that included melatonin was found to have blood pressure-lowering effects. Melatonin has been studied with other agents for high blood pressure in elderly people. Further research is needed.

C 

High cholesterol 

Early research found that melatonin used with zinc and the diabetes drug metformin may improve diabetes-related complications. Melatonin may improve blood pressure and cholesterol and reduce oxidative stress in people with metabolic syndrome. Melatonin has been studied with other agents for high blood pressure in elderly people. However, there is evidence that melatonin both increases and decreases cholesterol levels. More research is needed to clarify these mixed results.

C 

HIV/AIDS 

There is a lack of evidence to support or recommend against the use of melatonin for AIDS. Melatonin should not be used in place of more proven therapies. People who have HIV/AIDS should be treated under the supervision of a medical doctor.

C 

Liver inflammation 

Early research found that melatonin may improve liver function in people with nonalcoholic steatohepatitis (liver inflammation caused by fat buildup in the liver). Further research is needed.

C 

Memory 

Early research suggests that melatonin may improve memory in certain stressful situations. Further research is required before a conclusion can be made.

C 

Menopause 

Evidence is mixed with respect to the use of melatonin for menopause symptoms. Further research is needed before a conclusion can be made.

C 

Pain 

In infants requiring intubation (a tube in the mouth or nose to improve breathing), melatonin may reduce pain. Further research is needed to determine the effects of melatonin in other populations with various types of pain.

C 

Parkinson's disease 

There is limited research on the use of melatonin as a treatment for Parkinson's disease. Melatonin has been described as being well tolerated, but side effects may include skin flushing, diarrhea, stomach cramps, daytime sleepiness, vision changes, and headaches. Early research suggests that melatonin may improve sleep in people with Parkinson's disease. More research is needed before a firm conclusion can be made in this area.

C 

Periodic limb movement disorder 

There is limited study for the use of melatonin as a treatment for periodic limb movement disorder (repetitive limb movements during sleep). Although early research suggests possible benefits, further studies are needed before conclusions can be made in this area.

C 

REM sleep behavior disorder 

Melatonin has been suggested as a treatment for rapid eye movement (REM) sleep behavior disorder (acting out dreams during sleep), in which a person acts out vivid dreams through behaviors such as kicking, punching, and yelling. Early research describes benefits in people with this condition. However, better research is needed before a clear conclusion can be drawn.

C 

Restless leg syndrome 

Early research suggests that melatonin may affect motor symptoms associated with restless leg syndrome. However, evidence remains inconclusive. Further research is required in this field.

C 

Rett's syndrome 

Rett's syndrome is a genetic disorder that affects female children, causing slow head growth and development problems. There is limited research on the use of melatonin for improving sleep problems associated with Rett's syndrome. Further research is needed before conclusions can be made in this area.

C 

Ringing in the ears 

Melatonin has been suggested as a treatment for ringing the ears; this use has been supported by some early research. However, further research is needed before a conclusion can be made.

C 

Sarcoidosis 

Early research suggests that melatonin may be safe and effective for chronic sarcoidosis (chronic widespread inflammation) when other treatments fail or cause side effects. More research is needed before a conclusion can be made.

C 

Schizophrenia 

Early research suggests that melatonin may improve sleep, daytime function, and mood in people who have schizophrenia. Further research is needed.

C 

Seasonal affective disorder (SAD) 

Melatonin has been studied for symptoms of SAD. However, more high-quality research is needed before a clear conclusion can be reached.

C 

Seizure disorder 

There is controversy on the role of melatonin in seizure disorder. Melatonin has been studied in children with intractable seizures (seizures that do not respond to treatment), nervous system damage, febrile seizures (seizures triggered by a fever), and epilepsy. It has been suggested that melatonin may protect against oxidative stress and damage, as well as improve sleep quality and seizure control. However, there are reports that melatonin may actually increase the risk of seizures. Better evidence is needed in this area before a conclusion on the safety or effectiveness of melatonin can be made.

C 

Skin sun damage 

Several human studies have looked at the use of melatonin in protecting skin from sun damage. Although early results report reduced skin redness, further research is needed before a clear conclusion can be made.

C 

Sleep disturbance 

Melatonin may improve sleep disturbances in many people, including those in intensive care or those with Alzheimer's disease, mental disorders, and end-stage kidney disease. Several studies report improved sleep patterns in young people with brain damage caused by tumors or surgery. Melatonin has been proposed as a therapy for disease caused by exposure to light during the nighttime, as well as for sleep disorder in elderly people with dementia. Early research suggests that melatonin may also be useful for people with asthma and depression; however, results are limited and/or inconclusive for those with Parkinson's disease, bipolar disorder, and schizophrenia, or those undergoing in vitro fertilization (IVF). Depending on the condition, melatonin may or may not be an effective sleep aid.

C 

Smoking 

Limited research has looked at the use of melatonin for symptoms of smoking withdrawal, including anxiety, restlessness, irritability, and cigarette craving. Although early results are promising, further research is necessary before a firm conclusion can be reached.

C 

Stomach disorders (and intestine disorders) 

Early research suggests that melatonin may benefit people with indigestion and acid reflux disease. When used with traditional therapy, melatonin may reduce inflammation in people with Crohn's disease and ulcerative colitis (inflammatory bowel diseases that affect the intestines). Melatonin has also been studied for irritable bowel syndrome. More research is needed in this field.

C 

Stroke 

Melatonin has been proposed as a treatment for nervous system damage after a stroke, based on its antioxidant effects. Melatonin levels may also be changed following a stroke, and it has been suggested that supplementing with melatonin may have benefits. However, human evidence is lacking at this time.

C 

Surgery 

Limited studies have compared melatonin to standard drugs for anxiety before surgery. Melatonin has also been suggested as a treatment for delirium (confusion) following surgery. However, evidence is mixed, and further research is needed before a clear conclusion can be drawn.

C 

Tardive dyskinesia 

Tardive dyskinesia (involuntary muscle movements) is a serious potential side effect of medications for mental disorders. Limited studies report mixed findings on melatonin use in people with TD. Further research is needed before a clear conclusion can be drawn.

C 

Thrombocytopenia (low platelets) 

Thrombocytopenia is a condition in which platelets (parts of the blood that help promote clotting) are low. Higher platelet counts have been seen after melatonin use in people with low platelets due to cancer therapies. Stimulation of platelet production has been suggested but not proven. More research is needed in this area before a clear conclusion can be drawn.

C 

Ulcers 

Early evidence suggests that melatonin may aid in the healing of ulcers. Further well-designed research is needed.

C 

Urination (waking up at night to urinate) 

Melatonin may benefit elderly people who wake up during the night to urinate, but not teens and adolescents. Early research has produced conflicting results. More research is needed before a conclusion can be made.

C 

Work shift sleep disorder 

Several studies have looked at melatonin use in people who work irregular shifts, such as emergency room personnel. Results are mixed. Further research is necessary before a clear conclusion can be drawn.

D 

 

*Key to grades: 

A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

For full grading rationale, click here.

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 health care professional

Acetaminophen toxicity (painkiller overdose), acute respiratory distress syndrome (a severe lung condition causing difficult breathing), adaptogen (reduces sensitivity to stress), addiction, adrenal gland stimulation, aging (general), amenorrhea (lack of menstrual period), amyotrophic lateral sclerosis (disease of nerve cells that control muscle movement), antioxidant, anxiety, arthritis, ataxia (muscle control problem), atopic dermatitis (scaly, itchy rashes), attention deficit hyperactivity disorder (ADHD), autoimmune diseases, beta-blocker sleep disturbance, bipolar disorder, birth control, bladder disorders, bone diseases, bone healing, brain injuries, cachexia (weight loss/wasting from some diseases), cataracts, chemotherapy side effects, colic, dental conditions, dry skin, Duchenne muscular dystrophy (progressive muscle weakness), eating disorders, eczema (chronic skin inflammation), endometriosis (uterine cells growing in other body parts), erectile dysfunction, esophagitis (esophagus inflammation), exercise recovery, food uses, fragile X syndrome (genetic disorder causing mental disability), growth (growing pains), hair loss, hormone related problems, immune function, infant development / neonatal care, interstitial cystitis (chronic bladder inflammation), intestinal worms, ischemia-reperfusion injury protection (tissue damage caused by lack of oxygen), itching, jaundice, jellyfish stings, kidney protection, liver protection, lung inflammation, malaria, melatonin deficiency, mental disorders, metabolic disorders (sugar breakdown disorder), mouth and throat inflammation, movement disorders, multiple sclerosis, nervous system disorders, nitrate tolerance (reduced effectiveness of nitrate treatment), noise-induced hearing loss, osteoporosis, ovarian disorders, pancreatitis (pancreas inflammation), parasite infection, phenylketonuria (amino acid breakdown disorder), polycystic ovarian syndrome (female sex hormone imbalance), poisoning (including heavy metals and alcohol), pregnancy support, premenstrual dysphoric disorder (PMDD), pulmonary fibrosis (scarring of the lungs), radiation protection, retinal protection, scalds, sepsis (severe response to infection), shock, skin pigmentation disorders, sleep apnea (breathing pauses during sleep), spinal cord injury, spine problems (abnormal curving), stress, sudden infant death syndrome (SIDS) prevention, sun protection, swelling, testicular damage, tuberculosis (bacterial infection of lungs), uterine disorders, weight loss, Wilson's disease (high copper levels), withdrawal from narcotics, wound healing.


Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy. Consult a healthcare professional immediately if you experience side effects.

Allergies

  • Avoid with known allergy or sensitivity to melatonin or related products. Melatonin has been linked to allergic skin reactions and autoimmune hepatitis (liver inflammation caused by immune cells attacking the liver).

Side Effects and Warnings

  • Melatonin is likely safe when taken by mouth in commonly studied doses for up to three months, typically 1-20 milligrams. In children, melatonin is likely safe for long-term use in recommended doses.
  • Melatonin may cause abnormal heartbeat, aggression, amnesia, bedwetting (in children), body pain, changes in body temperature or feeling cold, changes in cholesterol levels, changes in the immune system, chest pain, confusion, decreased sperm count, delusions, disorientation, dizziness, eye damage or glaucoma (increased eye pressure), fatigue or irregular sleep-wake schedule, fogginess, hallucinations, headache, hormonal effects, hyperactivity, increased heart rate, increased seizure risk (particularly in children), inflammation, insomnia, irritability, mood changes, muscle control problems or weakness, musculoskeletal disorders, nightmares, nighttime awakening, poor sleep quality, psychotic symptoms, skin reactions (flushing, itching, painful lumps, paleness, and rash), sleepwalking, slow reaction time, stomach or intestinal disorders (changes in appetite, cramping, diarrhea, esophagus inflammation, nausea, odd taste in the mouth, stomach pain, and vomiting), vivid dreaming, weakness, worsened behavior, and yawning.
  • Melatonin may affect blood pressure. Caution is advised in people taking drugs, herbs, or supplements that affect blood pressure.
  • Melatonin may affect blood sugar levels. Caution is advised in people with diabetes or low blood sugar and those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
  • Melatonin may affect the risk of clotting. Caution is advised in people with bleeding or clotting disorders and those taking drugs that may affect bleeding. Dosing adjustments may be necessary.
  • Drowsiness or sedation may occur. Use caution in people who are driving or operating heavy machinery (including aircraft) and those taking depressants, stimulants, or sedatives.
  • Melatonin may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system.
  • Use cautiously in people who have or are at risk of changes in hormone levels, eye disorders, frequently feeling cold, genital or urinary disorders (including children with a history of bedwetting), heart disease, hyperactivity, immune disorders, inflammatory disorders, mental disorders, muscle control problems, nervous system disorders, seizures, skin disorders, and stomach and intestinal problems.
  • Use cautiously in people taking agents that affect the immune system, anti-inflammatory agents, or hormonal agents.
  • Use cautiously in breastfeeding women, due to a lack of safety information.
  • Avoid in women who are pregnant or trying to get pregnant. Melatonin may decrease sex drive, increase the risk of developmental disorders, and reduce ovarian function.
  • Avoid in people with known allergy or sensitivity to melatonin or related products.

Pregnancy and Breastfeeding

  • Overall, there is a lack of high quality scientific evidence on the use of melatonin during pregnancy or breastfeeding.
  • Use cautiously in breastfeeding women, due to a lack of safety information.
  • Avoid in women who are pregnant or trying to get pregnant. Melatonin may decrease sex drive, increase the risk of developmental disorders, and reduce ovarian function.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy.

Interactions with Drugs

  • Note: This section discusses both melatonin in the body and melatonin from other sources, and the effects of other agents on melatonin and when taken with melatonin. Many drugs may lower natural melatonin levels in the body. These include nonsteroidal anti-inflammatory drugs (NSAIDs, including ibuprofen [Motrin®, Advil®] or naproxen [Naprosyn®, Aleve®]), beta-blocker blood pressure medications (including propranolol [Inderal®], atenolol [Tenormin®], and metoprolol [Lopressor®, Toprol®]), and agents that lower levels of vitamin B6 in the body (including birth control, hormone replacement therapy, loop diuretics, hydralazine, and theophylline). Other agents that may affect melatonin levels include caffeine, diazepam, estradiol, somatostatin, temazepam, verapamil, and vitamin B12.
  • Melatonin may affect the risk of clotting. Caution is advised in people with bleeding or clotting disorders and those taking drugs that may affect bleeding or clotting. Dosing adjustments may be necessary.
  • Melatonin may affect blood sugar levels. Caution is advised when using medications that may also affect blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Melatonin may affect blood pressure. Caution is advised in people taking drugs that affect blood pressure.
  • Melatonin may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be altered in the blood and may cause altered effects or potentially serious adverse reactions. People using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
  • Melatonin may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
  • Melatonin may also interact with ACE inhibitors, agents passed by the kidneys, agents that affect blood vessel width, agents that affect GABA, agents that affect the immune system, agents that affect the nervous system, agents that harm the liver, agents that increase seizure risk, agents that increase urine flow, agents that protect against radiation, agents that regulate body temperature, agents that treat Parkinson's disease, agents that treat seizures, alcohol, Alzheimer's agents, anesthetics, antiaging agents, antiarthritis agents, antiasthma agents, anticancer agents, anti-inflammatory agents, antiparasite agents, antipsychotic agents, antiulcer agents, antivirals, anxiety agents, birth control, caffeine, calcium channel blockers, cholesterol-lowering agents, cognitive agents, dental agents, dextromethorphan, ear agents, epithalamin, estrogens, exercise performance agents, eye agents, fertility agents, flumazenil, genital and urinary disorder agents, glaucoma agents, headache agents, heart agents, heart rate-regulating agents, hormonal agents, isoniazid, lithium, lung agents, magnetic fields, methamphetamines, methoxamine, musculoskeletal agents, neuromuscular blockers, opioids, osteoporosis agents, pain relievers, remifentanil, sevoflurane, skin agents, stomach agents, tacrine, thyroid hormones, vaccines, valproic acid, and weight loss agents.

Interactions with Herbs and Dietary Supplements

  • Note: This section discusses both melatonin in the body and melatonin from other sources, and the effects of other agents on melatonin and when taken with melatonin. Many drugs may lower natural melatonin levels in the body. These include nonsteroidal anti-inflammatory drugs (NSAIDs, including ibuprofen [Motrin®, Advil®] or naproxen [Naprosyn®, Aleve®]), beta-blocker blood pressure medications (including propranolol [Inderal®], atenolol [Tenormin®], and metoprolol [Lopressor®, Toprol®]), and agents that lower levels of vitamin B6 in the body (including birth control, hormone replacement therapy, loop diuretics, hydralazine, and theophylline). Other agents that may affect melatonin levels include caffeine, diazepam, estradiol, somatostatin, temazepam, verapamil, and vitamin B12.
  • Melatonin may affect the risk of clotting. Caution is advised in people with bleeding or clotting disorders and those taking herbs and supplements that may affect bleeding or clotting. Dosing adjustments may be necessary.
  • Melatonin may affect blood sugar levels. Caution is advised when using herbs or supplements that may also affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
  • Melatonin may affect blood pressure. Caution is advised in people taking herbs or supplements that affect blood pressure.
  • Melatonin may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may alter in the blood. It may also alter the effects that other herbs or supplements possibly have on the cytochrome P450 system.
  • Melatonin may increase the amount of drowsiness caused by some herbs or supplements.
  • Melatonin may also interact with 5-HTP, ACE inhibitors, Alzheimer's herbs and supplements, anesthetics, antiaging herbs and supplements, antiarthritis herbs and supplements, antiasthma herbs and supplements, anticancer herbs and supplements, antidepressants, anti-inflammatory herbs and supplements, antioxidants, antiparasite herbs and supplements, antipsychotic herbs and supplements, antiulcer herbs and supplements, antivirals, anxiety herbs and supplements, birth control, caffeine-containing herbs and supplements, chasteberry, cholesterol-lowering herbs and supplements, cognitive herbs and supplements, dental herbs and supplements, DHEA, ear herbs and supplements, echinacea, exercise performance herbs and supplements, eye herbs and supplements, fertility herbs and supplements, folate, GABA, genital and urinary disorder herbs and supplements, glaucoma herbs and supplements, headache herbs and supplements, heart herbs and supplements, heart rate-regulating herbs and supplements, herbs and supplements passed by the kidneys, herbs and supplements that affect blood vessel width, herbs and supplements that affect GABA, herbs and supplements that affect the immune system, herbs and supplements that affect the nervous system, herbs and supplements that increase seizure risk, herbs and supplements that increase urine flow, herbs and supplements that protect against radiation, herbs and supplements that regulate body temperature, herbs and supplements that treat Parkinson's disease, herbs and supplements that treat seizures, hormonal herbs and supplements, light therapy, lithium, liver herbs and supplements, lung herbs and supplements, magnetic fields, meditation, musculoskeletal herbs and supplements, music therapy, neuromuscular blockers, osteoporosis herbs and supplements, pain relievers, phytoestrogens, skin herbs and supplements, stomach herbs and supplements, thyroid hormones, and weight loss herbs and supplements.

Authors

Selected References

Natural Standard developed the above evidence-based information based on a systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Arushanian EB. [Comparative evaluation of epiphyseal melatonin and benzodiazepine anxiolytics]. Eksp.Klin.Farmakol. 2012;75(3):35-40.
  2. Boyko Y, Ording H, and Jennum P. Sleep disturbances in critically ill patients in ICU: how much do we know? Acta Anaesthesiol.Scand. 2012;56(8):950-958.
  3. Dijk DJ, Duffy JF, Silva EJ, et al. Amplitude reduction and phase shifts of melatonin, cortisol and other circadian rhythms after a gradual advance of sleep and light exposure in humans. PLoS.One. 2012;7(2):e30037.
  4. Etain B, Dumaine A, Bellivier F, et al. Genetic and functional abnormalities of the melatonin biosynthesis pathway in patients with bipolar disorder. Hum.Mol.Genet. 9-15-2012;21(18):4030-4037.
  5. Forbes-Robertson S, Dudley E, Vadgama P, et al. Circadian disruption and remedial interventions: effects and interventions for jet lag for athletic peak performance. Sports Med. 3-1-2012;42(3):185-208.
  6. Gitto E, Aversa S, Salpietro CD, et al. Pain in neonatal intensive care: role of melatonin as an analgesic antioxidant. J.Pineal Res. 2012;52(3):291-295.
  7. Gonciarz M, Gonciarz Z, Bielanski W, et al. The effects of long-term melatonin treatment on plasma liver enzymes levels and plasma concentrations of lipids and melatonin in patients with nonalcoholic steatohepatitis: a pilot study. J.Physiol Pharmacol. 2012;63(1):35-40.
  8. Morganti P, Fabrizi G, Palombo P, et al. New chitin complexes and their anti-aging activity from inside out. J.Nutr.Health Aging 2012;16(3):242-245.
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