In this Article

• What is insomnia and what causes it?
• What are non-drug treatments for insomnia?
• What over-the-counter (OTC) medicines are there for insomnia treatment?
• Antihistamines
• Melatonin
• What prescription medicines are there for insomnia treatment?
• What stimulant products are available OTC?
• Caffeine
• Sleep Aids And Stimulants Glossary
• Sleep Aids And Stimulants Index

Melatonin

Melatonin (for example, Melatonex) is the only hormone available OTC for insomnia. Melatonin is a hormone that is produced by the pineal gland. Melatonin helps regulate the body's clock or sleep-wake cycle. The secretion of melatonin is increased by darkness and decreased by light. The exact mechanism of how melatonin induces sleep has not been determined. Melatonin also decreases mental alertness and body temperature.

Melatonin is sold as a dietary supplement and is, therefore, not regulated by the FDA. It is commonly used for jet lag, insomnia, and sleep disturbances related to working the late night shift. Some limited evidence suggests that melatonin may be useful for treating sleep disturbances.

In 2005, MIT released the results of a meta-analysis of 17 peer-reviewed studies using melatonin. It showed that melatonin was effective in helping people fall asleep at doses of 0.3 milligrams (mg). Larger doses of melatonin seem to be less effective after only a few days use.

If you'd like to try melatonin tablets, check first with your healthcare provider.

Dosing: There is no established dose or time of administration. Individuals should follow the product labeling for dosing and administration.

Pregnancy and Lactation: The use of melatonin during pregnancy or lactation has not been studied adequately. At high doses (more than 300 mg), melatonin may affect contraception (birth control) and increase levels of prolactin in the body. Based on past experience with other agents and the possibility of unknown risks to the fetus, melatonin should be avoided during pregnancy or lactation until more information is available.

Children: The use of melatonin in children should be avoided until more information about safety is available.

Drug Interactions: Although melatonin is sold as a dietary supplement, it should be thought of as a drug. It has side effects and may have drug interactions that have not been identified. The level of melatonin that the body produces is increased by certain drugs, such as selective serotonin reuptake inhibitor antidepressants [for example, fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil)] and monoamine oxidase inhibitors [for example, tranylcypromine (Parnate), phenelzine (Nardil)]. The interaction between these antidepressants and melatonin that is used as a sleeping aid has not been assessed.

Side Effects: The most common adverse effect of melatonin is drowsiness. Therefore, tasks that require alertness (for example, driving) should be avoided for four to five hours after taking melatonin. Melatonin also may also cause itching, abnormal heartbeats, and headaches. Long-term side effects of melatonin have not been studied.

Melatonin is either derived from animal sources or synthesized in a laboratory. Melatonin obtained from animal sources has a higher likelihood of contamination, which can cause allergic reactions and viral transmission, than synthetic melatonin.

Melatonin may stimulate the immune system. Therefore, people with severe allergies or other disorders that may be caused by an overactive immune system (for example, systemic lupus erythematosus, rheumatoid arthritis) should avoid using melatonin.

Other herbal products: Natural herbal supplements such as valerian, chamomile, kava kava, and others have been touted as remedies for insomnia. However, the safety or effectiveness of these products has not been documented and it is important to consult your physician if you are taking or plan to take any herbal supplements to treat your insomnia.

From the Doctors at MedicineNet.com

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