Sleep Aids And Stimulants (cont.)
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.
Next: What prescription medicines are there for insomnia
treatment? »
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