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Melatonin for Sleep Shows Promise Yet Lacks Evidence in Context of Psychiatric Illness
Although melatonin shows promise for helping with sleep and circadian abnormalities in patients with psychiatric disorders, hard evidence supporting its use overall is scarce, according to a review article published in Current Psychiatry Reports.
“Several recent studies suggest that melatonin is a safe and well-tolerated treatment option to correct sleep and circadian rhythm disturbances, but studies evaluating the efficacy of melatonin as a complementary treatment in psychiatric disorders are too limited for conclusion,” researchers advised.
Recent studies have confirmed the presence of dysregulated sleep and circadian rhythms in several psychiatric and neurocognitive disorders, including schizophrenia and bipolar disorder, according to the review. Melatonin appears indicated to correct the dysfunction; nevertheless, few well-designed trials have investigated its use in patients with psychiatric disorders. Robust evidence exists only in patients with attention-deficit/hyperactivity disorder (ADHD), autism, and neurocognitive disorders.
At this point, evidence of its usefulness is preliminary at best in the presence of schizophrenia, bipolar disorder, depressive disorders, anxiety disorders, and eating disorders.
“This topic has mainly not been of interest for recent work,” researchers wrote, “and well-designed trials with objective circadian parameters are few.”
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Nevertheless, melatonin has demonstrated usefulness in improving sleep onset latency, sleep efficiency, and sleep quality and, while not evidence-based, may offer help for patients. To maximize its efficacy, finding the optimal dosage and dosing time based on an individual patient’s sleep and circadian rhythm abnormalities is important.
“The knowledge base is sufficient to propose well-designed, larger trials with circadian parameters as inclusion and outcome criteria,” researchers advised. “Based on the partly fragmentary information, we propose testing efficacy in disorders with neurocognitive etiopathology with later and higher dosing, and affective and anxiety disorders with lower and earlier dosing of melatonin.”
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