Melatonin safety

[squideast]

My 8 year old son was diagnosed with ADD over a year ago, and prescribed Concerta. His mother and I are divorced. I learned that she is giving him Melatonin at night to 'help him sleep'. This was not prescribed by the pediatrician; it is over-the-counter. I do not give him any sleep aids when he is with me. He has no sleep issues in my home. He falls asleep within 15 minutes of being put to bed. I have researched and see that some pediatricians recommend Melatonin to help with sleeplessness in children with certain neurological disorders. That is fine and well, but I do not agree with giving my child a medication that I don't see he needs and his pediatrician has not ordered.

So here's my question: is it unsafe for a child to *intermittently* take Melatonin? There are many drugs out there that are not OK to 'start and stop'. Is Melatonin one of them? If it's 'harmless', my ex and I can just agree to disagree. If this is harmful to him, however, we cannot continue to have this 'difference' in each home.

Thanks for your time.

[squideast]

Thanks for the info (and I won't tell! lol).

I can't even discuss with the ex whether or not he should be taking it *at all*. It's like talking to a brick wall. I'm firmly of the belief he does not need it, and am none too thrilled that he's taking it at any time unnecessarily.

My concern is the intermittent administration of it. While I do *not* want to administer this supplement to him in the absence of a need for it or doctor's order, I also don't want to cause our son any medical harm, or discomfort from withdrawals, by *not* giving it to him in my home. I just want to do what's best for him on my end.

I did find the following, which leads me to not worry, since I know our son doesn't have 'sleep disturbances' to begin with:

http://www.healthy.net/scr/article.aspx?Id=1233

"When deciding to stop the use of melatonin or any sleeping medicine, it is best to taper off over a period of 1 to 2 weeks to avoid any sleep disturbances...Only a small percentage of people feel any withdrawal symptoms."

But I thought I'd ask the question on this site to double check.

[Sandman2]

      Well, it certainly should help him fall asleep sooner - which may be her idea.  It sounds like you have researched this pretty well.  I don't think our opinion is going to matter much to your ex.  I think you will need to find a professional for that.  
      I was able to find one report from consumers union which I am posting here as you need the paid subscription to read it.  (don't tell).   Hope this helps.

  

Melatonin
Natural therapy
Hormone that controls your body clock.
Treatment Rating
(Do benefits outweigh harms?)

Likely
More info




Benefits likely outweigh harms


Giving your child a pill or capsule of melatonin before bedtime may help them sleep sooner and for longer. But there's a risk of side effects. Also, because melatonin is not sold as a medication, it's hard to know how pure and safe the melatonin you buy may be.
Melatonin is a hormones
Hormones are chemicals that are made in certain parts of the body. They travel through the bloodstream and have an effect on other parts of the body. For example, the female sex hormone estrogen is made in a woman's ovaries. Estrogen has many different effects on a woman's body. It makes the breasts grow at puberty and helps control periods. It is also needed to get pregnant.

hormone. Hormones are chemicals your body makes naturally to control some of the things it does. For example, hormones can tell your body how to use energy, or when to go to sleep.
Melatonin is the hormone that controls your body clock. Normally, your brain produces melatonin during the night to help you sleep. Your body starts to make melatonin when it gets dark, and stops when it gets light. The melatonin that's sold as a treatment is a man-made version of this hormone.
We found one good-quality study a
randomized controlled trial), which looked at how well melatonin worked for children ages 6 through 12 years who had sleep problems. The children took melatonin before going to bed.

Source:
Smits MG, Nagtegaal EE, van der Heijden J, et al.
Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial.
Journal of Child Neurology. 2001; 16: 86-92.





The study found that the children:

    * Went to bed one hour earlier on average
    * Slept about half an hour longer.

But the study also found that the children:

    * Took just as much time to get to sleep after going to bed
    * Woke up just as early.

Another study found children slept better if they took 5 milligrams of melatonin before bedtime.

Source:
Smits MG, van Stel HF, van der Heijden K, et al.
Melatonin improves health status and sleep in children with idiopathic chronic sleep-onset insomnia: a randomized placebo-controlled trial.
Journal of the American Academy of Child and Adolescent Psychiatry. 2003; 42: 1286-1293.





But this research may not be reliable because there were problems with how the study was done.
There hasn't been much research on the best dose of melatonin for children to take. For some children, high doses of melatonin don't help. Melatonin may be more helpful if your child has only a low dose.

Source:
Brzezinski A, Vangel MG, Wurtman RJ, et al.
Effects of exogenous melatonin on sleep: a meta-analysis.
Sleep Medicine Reviews. 2005; 9: 41-50.



Source:
Jan JE, Freeman RD.
Melatonin therapy for circadian rhythm sleep disorders in children with multiple disabilities: what have we learned in the past decade?
Developmental Medicine and Child Neurology. 2004; 46: 776-782.

We found two small studies that looked at children with epilepsy, and one study that looked at children with attention deficit hyperactivity disorder (ADHD for short). Taking melatonin didn't make much difference to how well the children slept overall.
Source:
Gupta M, Aneja S, Kohli K.
Add-on melatonin improves sleep behaviour in children with epilepsy: randomized, double-blind, placebo-controlled trial.
Journal of Child Neurology. 2005; 20: 112-115.










Source:
Gupta M, Gupta YK, Aneja S, et al.
Effects of add-on melatonin on sleep in epileptic children on carbamazepine monotherapy: a randomized placebo controlled trial.
Sleep and Biological Rhythms. 2004; 2: 215-219.










Source:
Weiss MD, Wasdell MB, Bomben MM, et al.
Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia.
Journal of the American Academy of Child and Adolescent Psychiatry. 2006; 45: 512-519.





We don't know how safe melatonin is for children, or how safe it is to take it regularly for a long time. There hasn't been enough research to say.
The studies we looked at found that children did have some side effects. Some of the children who took melatonin felt cold or dizzy or they had a low mood. Some children also didn't feel hungry and had mild headaches.
Source:
Smits MG, Nagtegaal EE, van der Heijden J, et al.
Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial.
Journal of Child Neurology. 2001; 16: 86-92.


Source:
Smits MG, van Stel HF, van der Heijden K, et al.
Melatonin improves health status and sleep in children with idiopathic chronic sleep-onset insomnia: a randomized placebo-controlled trial.
Journal of the American Academy of Child and Adolescent Psychiatry. 2003; 42: 1286-1293.
There's also some evidence that children may get epilepsy or worse
seizures if they take melatonin, but we don't know this for sure. In one study we looked at, one child had mild epilepsy after four months of taking melatonin.
Source:
Smits MG, Nagtegaal EE, van der Heijden J, et al.
Melatonin for chronic sleep onset insomnia in children: a randomized placebo-controlled trial.
Journal of Child Neurology. 2001; 16: 86-92.

  
In another study, 4 in 6 children with epilepsy had more seizures when they took melatonin.
Source:
Sheldon SH.
Pro-convulsant effects of oral melatonin in neurologically disabled children.
Lancet. 1998; 351: 1254.

And they got seizures less often when they stopped taking the supplement.
Some studies also suggest melatonin could delay the start of puberty

Source:
Arendt J.
Safety of melatonin in long-term use.
Journal of Biological Rhythms. 1997; 12: 673-681.

Source:
Weaver DR.
Reproductive safety of melatonin: a 'wonder drug' to wonder about.
Journal of Biological Rhythms. 1997; 12: 682-689.


You can buy melatonin from pharmacies and health food stores. But melatonin isn't sold as a medication. It's sold as a supplement, a bit like vitamin pills and cod liver oil. This means that, like all supplements, it may not be made to the same standards as medications. You can't be sure how good-quality it is. Because melatonin may cause harm, it's important to speak with your child's pediatrician before giving melatonin to your child.

This information was last updated on Jan 07, 2011