Info about Melatonin

[Mayleng]

Somebody posted this on another site and I thought the info might be useful here.

www.medscape.com/viewarticle/448467 - One study of 20 children with developmental disabilities found that children given melatonin fell asleep significantly more quickly, but did not experience overall longer sleep durations or wake less frequently. A second slightly larger study of 46 children with neurodevelopmental disorders found that sleep improved in 34 of the children and none experienced side effects. Only a very few studies have examined the use of this hormone in children without disability. For example, a study of 40 elementary school children without neurologic problems who were experiencing delayed sleep onset found that over the duration of the 4-week study, melatonin was relatively safe and significantly more effective than placebo in advancing sleep onset and increasing sleep. Of note, tests that examined attention span in these children found that, even in those whose sleep improved, measures of attention did not change.

www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12069468&dopt=Abstract - Melatonin may provide an alternative to conventional sedation regimes and GA for uncooperative children undergoing an MRI examination.

www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8989717&dopt=Abstract - Melatonin, which benefitted slightly over 80% of our patients, appears to be a safe, inexpensive, and a very effective treatment of sleep-wake cycle disorders. The oral dose of fast release melatonin taken at bed-time ranged from 2.5 mg to 10 mg. Side effects or the development of tolerance have not been observed.

www.keepkidshealthy.com/medicine_cabinet/melatonin_sleep_problems.html - They found that the melatonin significantly improved almost all aspects of sleep in most of the children and around 93% recorded significant benefits. The average number of hours sleep that the children had each week increased by around 10%, from 54 hours/week before taking the melatonin to 66 hours/week while taking the melatonin. The number of interruptions to sleep each week decreased by 50% from an average of seven interruptions per week before taking the melatonin, to 3.5 interruptions while taking the drug. Also, the number of hours of interrupted sleep decreased by 45%, from nine hours awake each week during a sleep interruption pre melatonin, to five hours per week while taking melatonin. There were no major side effects from the medication in any of the children and importantly there was no change in the frequency or severity of seizures in children with epilepsy. Boys and girls were equally likely to respond well to melatonin. The visually impaired children were the most likely to have success with melatonin, but around three-quarters of the fully sighted children also responded very well.

www.keele.ac.uk/depts/mm/MTRAC/ProductInfo/verdicts/M/MELATONINv.html - The limited clinical data suggest that melatonin is well tolerated in children.

www.autism.org/melatonin.html - "the fact that melatonin can stabilize and promote normal sleep and daily bodily rhythms is presently certain." (this article includes instructions for giving it to autistic children and other kids who have sleep disorders and other sleep problems)

www.gsdl.com/assessments/finddisease/autism/melatonin.html - some studies have observed that nightly melatonin supplementation in children ... appears to improve sleep patterns in up to 80% of these children.6 In one Japanese study, utilizing melatonin to improve the sleep habits of autistic children also reduced the amount of emotional and behavior problems in the children.7

www.healthy.net/asp/templates/article.asp?PageType=Article&ID=194 - A recent report described the use of melatonin to treat sleep disorders in hyperactive and neurologically compromised children: small nightly doses corrected the sleep problems, and investigators noticed improved mood and more stable and sociable dispositions tended to accompany the use of melatonin with these children.

www.melatonin.com/melatonin-faq1.htm - "Although long-term, high-dose melatonin supplementation might interfere with puberty and reproductive cycles, your teenage children - and even younger kids - might be happier, healthier travelers if they re-set their clocks quickly with help from melatonin supplements." (MAAH, pg. 112-113)

www.gsdl.com/assessments/finddisease/sleep/melatonin.html - Melatonin therapy was found to benefit over 80% of these children, and was lauded as a "safe, inexpensive, and very effective treatment of sleep-wake cycle disorders."

www.my.webmd.com/content/drugs/3/4046_2063?bn=Melatonin - There is no information available regarding the use of melatonin by children.


www.cps.ca/english/statements/PP/pp02-03.pdf -Melatonin is a powerful antioxidant with immunological and neuroprotective effects. It has been successful in treating sleep problems in children with ADHD (59,60). Side effects include reduced daytime alertness, increased fatigue, sleepiness, headache and irritability with high doses.

[Mayleng]

For those who can't get the article in Medscape, here it is:

The Use of Melatonin in Children With Sleep Disturbances
Posted 11/26/2003

Marcia L. Buck, Pharm.D., FCCP

The administration of exogenous melatonin has been used in a variety of clinical settings, most frequently in the management of sleep disturbances, including insomnia and jet lag. Although considered a dietary supplement and not regulated by the Food and Drug Administration (FDA), melatonin was classified as an orphan drug by the FDA in November 1993 for the entrainment of circadian rhythm in blind people. In children, melatonin has been used for chronic insomnia, as well as in the management of sleep disturbances associated with vision disturbances, attention deficit/hyperactivity disorder (ADHD), and neurologic injury.[1- 3]

Pharmacology
Melatonin (N-acetyl-5-methoxytryptamine) is a chronobiotic, a neurohormone involved in the regulation of the sleep-wake cycle. It is produced in the pineal gland through the conversion of tryptophan, first to serotonin, then N-acetylserotonin, and finally to melatonin. Melatonin is normally secreted during darkness, in response to the release of norepinephrine from retinal photoreceptors and the resulting activation of the retino-hypothalamic-pineal system. Levels begin to rise at nightfall, with peak serum concentrations typically occurring between 2 and 4 AM in adults. Secretion during daylight is minimal.[3]

Melatonin promotes sleep through regulation of the activity of the suprachiasmatic nucleus (SCN), located within the anterior hypothalamus above the optic chiasm. Impairment of melatonin production, secretion, or binding within the SCN may lead to chronic disturbances in both sleep onset and duration. In these patients, exogenous melatonin may be beneficial to regulate the sleep-wake cycle. Exogenous melatonin was first synthesized over two decades ago. It produces the same effects and is metabolized in the same manner as the endogenous neurohormone.[1- 3]

Pharmacokinetics
After oral administration of exogenous melatonin, peak concentrations are achieved within 60 minutes. Melatonin is hepatically metabolized, with 80 to 90% converted to sulphatoxymelatonin (aMT6), an inactive compound which is excreted in the urine. The average elimination half-life of melatonin in adults is 20 to 50 minutes. The administration of exogenous melatonin does not appear to affect endogenous production or secretion.[2]

Use in Children
Since the first case report by Palm and colleagues in 1991,[4]there have been over two dozen papers describing the use of melatonin in children with sleep disturbances. Several studies have been published by Jan and colleagues of the Children's Hospital Visually Impaired Program at British Columbia's Children's Hospital. In 1994, they published a study of 15 children (ages 6 months to 14 years) given melatonin for sleep disturbances.[5]All of the subjects had failed to respond to traditional therapy, including nonpharmacologic measures to improve sleep hygiene. Nine of the patients had mental retardation, and two had ADHD. Nine children had either ocular or cortical vision impairment. The study was a double-blind crossover randomized design, with each child receiving melatonin at a dose of 2.5 to 5 mg or placebo at bedtime for a period of 7 to 10 days, then switching to the alternative arm after a 4 to 5 day wash-out period. Sleep diaries were maintained by the subjects' careproviders. Patients responding to therapy remained on melatonin after completion of the study and were followed at three and six months.

Thirteen of the 15 children had a favorable response to melatonin, with improvement in sleep duration. All of the subjects experienced clinical benefit, with improved daytime mood and behavior. Children with delayed sleep onset experienced the greatest response. The effective dose ranged from 2.5 to 10 mg; higher doses or the administration of a second dose during the night produced no additional benefit. Ten of the patients continued on therapy after conclusion of the study, for periods up to a year. No adverse effects related to melatonin were reported.

Building on their initial case report, Palm and colleagues published the results of an open study of melatonin in eight blind children and young adults in 1997.[6]The patients ranged in age from 3 to 23 years of age, and all had significant sleep disturbances. Serum and urine concentrations of melatonin were evaluated in five patients prior to treatment, revealing delays in the time of peak concentrations (range 03:00 to 12:00). Administration of melatonin in doses of 0.5 to 4 mg produced improvement in all patients. Benefit was maintained long-term, up to six years in some patients. No adverse effects were reported.

Further support for the use of melatonin was added by Pillar and colleagues in their 1998 case report.[7]The patient was a 13 year old girl with psychomotor retardation and a one year history of an irregular sleep-wake cycle. Serial measurements of urine aMT6 were abnormally low, with no time-related differences indicating nocturnal release of melatonin. Actigraph recordings revealed no discernible night/day differentiation in sleep patterns. Administration of 3 mg melatonin nightly produced an immediate improvement in her sleep-wake cycle with an increase in total nocturnal sleep from an average of 5.5 to 7.7 hours and a reduction in daytime sleep from 4.4 to 2.8 hours. Urine nocturnal aMT6 levels measured one month after starting therapy showed a distinct increase at night, with a peak at 22:00.

During 2001, two studies of melatonin were published in the Journal of Child Neurology.[8,9]In February, Smits and coworkers reported their randomized, placebo-controlled trial of melatonin in 40 children (6 to 12 years of age) with chronic insomnia.[8]The children were randomized to receive either 5 mg melatonin or placebo, given nightly at 6 PM over a 4 week treatment period. At the conclusion of the study, patients could be continued on therapy if desired by the parents. Both sleep diaries and actigraph recordings were used to assess efficacy. Sleep onset and duration were significantly improved in the melatonin group, but showed no difference in the placebo group. Sleep latency, wake-up times, and sustained attention reaction times were not affected. Two children had headaches for the first two days of melatonin treatment. After 18 months, 13 of the 38 children evaluated had discontinued therapy without the return of insomnia. In one child, melatonin was stopped due to lack of effect. One child developed generalized epilepsy 4 months into the study, but causality with melatonin was not suggested.

Later that year, Dodge and Wilson published an additional randomized, double-blind, placebo-controlled, cross-over trial of melatonin in 20 children with developmental disabilities.[9]The melatonin dose was 5 mg in all children. In 18 of the subjects, time to sleep onset was significantly shorter with melatonin than placebo. The duration of sleep was greater than baseline values during melatonin treatment, but the difference between the melatonin treatment period and placebo was not statistically significant. The authors also failed to find a difference in the number of nighttime awakenings. They reported no adverse effects.

In 2002, Ross and colleagues published an observational study of melatonin administration in 49 children with neurodevelopmental disorders.[10]The patients ranged in age from 1 to 13 years, and the most frequent underlying illness was epilepsy. Patients less than 5 years of age were started on a dose of 2.5 mg nightly, while older children were started on 5 mg. Doses were increased by 2.5 mg increments at 3 day intervals until the desired effect on sleep patterns was achieved or the patients reached the maximum dose (7.5 mg in patients less than 2 years or 10 mg in older children). Of the 46 patients with evaluable sleep diaries or case notes, 34 (69%) showed improvement after receiving melatonin. In the 28 children with complete diaries, total sleep, nighttime sleep, duration and number of interruptions, and time of sleep onset improved with melatonin. The median sleep time increased from 54 to 65.5 hours/week after treatment. The median number of interruptions in sleep decreased from 7 to 3.5.

Melatonin appears to be beneficial in the management of the delayed sleep onset and frequent awakenings observed with other neurologic illnesses as well. Additional papers have noted the efficacy of melatonin in sleep disturbances associated with Rett syndrome and tuberous sclerosis, as well as in a child with a pineal tumor.[11- 13]In a double-blind, placebo-controlled cross-over study of nine girls with Rett syndrome, melatonin in doses of 2.5 to 7.5 mg nightly produced significant benefits in sleep characteristics.[11]Sleep latency decreased from 42.1±12.0 (mean+SE) to 19.1±5.3 minutes during the first three weeks. Total sleep duration also improved, but the difference from baseline was not statistically significant.

In the January/February 2003 issue of Clinical Pediatrics, Ivanenko and colleagues from Kosair Children's Hospital Research Institute at the University of Louisville published a retrospective review of 32 children treated with melatonin in their program.[1]All had been referred to their sleep program after failure to benefit from conventional treatments. The children ranged in age from 2 to 18 years (mean 9.6±4.5 years). Several children had comorbidities, including ADHD (in 44% of subjects), anxiety (25%), affective disorders (9%), and mild developmental delay (9%).

Twenty-nine (90.6%) of the children experienced benefit from melatonin, with improvement in sleep onset and/or sleep maintenance. Average time to sleep onset, based on caregiver journals, declined from 90±52.5 to 25.4±11 minutes, and nocturnal awakenings declined from 18.7±15 to 1.2±2 times per week. The patients were treated with an average melatonin dose of 2.0±1.2 mg (range 0.3 to 6 mg), given one hour before bedtime. There was a positive relationship between patient age and dose, with the 2 to 6 year old group requiring an average dose of 1.4±0.6 mg and the 12 to 18 year olds requiring 2.8±1.4 mg. Although many caregivers reported clinical improvement within days of the initiation of therapy, normal sleep patterns were usually achieved within 1 to 2 weeks. The average duration of follow-up was 2 months, with the longest follow-up at 10 months. Melatonin was stopped in three patients due to lack of sustained response. No adverse effects were noted.

Earlier this month, Smits and colleagues published another study of melatonin for pediatric insomnia.[14]Building on the positive response in behavior reported by parents in their earlier study, the authors conducted a similar randomized, double-blind placebo-controlled trial in 62 children (6 to 12 years in age). Patients received either 5 mg melatonin or placebo at 7 PM for 4 weeks. In addition to standard measurements of sleep characteristics, health status was evaluated with the RAND General Health Rating Index (RAND-GHRI) and Functional Status II (FS-II) questionnaires. Total scores for both measures improved significantly more in the melatonin group than with placebo. The standardized response means for the RAND-GHRI were 0.69 in the melatonin group versus 0.07 in the controls, with FS-II scores of 1.61 versus 0.64. Melatonin advanced sleep onset by an average of 57 minutes, and salivary measurement of melatonin production showed an onset occurring an average of 82 minutes earlier during melatonin administration.

Drug Interactions
Melatonin has been reported to interfere with the antihypertensive effect of extended-release nifedipine.[2]The mechanism of this interaction has not been determined.

Adverse Effects
Exogenous melatonin appears to be well tolerated. In most clinical trials and case series, no adverse effects have been noted. Headache, excessive sedation, and transient depression have been reported, most often with doses greater than 8 mg/day. Isolated cases of rash, a psychotic episode, gynecomastia, and autoimmune hepatitis have also been reported after melatonin use, but in none of these cases has melatonin been identified as the cause.[1- 3]

In a 1998 study published in Lancet, melatonin administration to six children with underlying seizure disorders produced a worsening of seizures in three.[15]Although this finding has not been reported in other papers, the benefit to risk ratio of melatonin in patients with seizures should be carefully weighed before initiation of therapy. Because melatonin may also play a role in immune function, it is not recommended for patients with autoimmune disorders.[2]

Dosing
Based on the case series and clinical trials published to date, melatonin should be initiated at a dose of 2.5 to 5 mg in children with sleep disturbances. The dose should be administered in the evening, approximately 30 to 60 minutes before bedtime. Dose titration should be based on response.[1- 14]Some authors have noted that children with neurologic injury may require higher doses. In patients with nighttime awakenings, a controlled release dosage form may be more effective than standard immediate release products.[16]

Availability and Cost
Melatonin is available at most pharmacies and health food stores. It is manufactured as both immediate release and controlled release tablets and capsules. The most commonly available dosage strengths are 300 mcg, 1, 3, and 5 mg. In the Charlottesville area, the cost of a 60-tablet bottle (3 mg tablets) ranges from $3 to $8.

Melatonin is not considered a drug product, and is not regulated by the FDA. Patients and their families should be instructed to purchase only synthetic melatonin, rather than the bovine-derived product, in order to avoid potential exposure to infectious agents. In addition, careproviders should be aware of the potential for variation in content among brands, as well as the presence of contaminants. A voluntary verification program has been developed by the United States Pharmacopeia (USP) to provide consumers with information on the quality of dietary supplements such as melatonin. The "USP verified" symbol on these products, while not a guarantee of efficacy or safety, indicates compliance with accepted manufacturing practices and standardization of contents.

Summary
Endogenous melatonin plays an important role in the regulation of the sleep-wake cycle. In children with sleep disturbances, the administration of exogenous melatonin appears to reduce the time to sleep onset and minimize nighttime awakenings. Melatonin is generally well tolerated, with few reports of adverse effects. In patients for whom traditional pharmacologic and nonpharmacologic therapies to improve sleep have failed, melatonin may be a useful adjunctive therapy.

If you have comments or suggestions for future issues, please contact us at Box 800674, UVA Health System, Charlottesville, VA 22908 or by e-mail to [e-mail]. This newsletter is also available at www.healthsystem.virginia.edu/internet/pediatrics/pharma-news/home.cfm

[Mayleng]

Here's another study:

Melatonin Helps ADHD Insomnia

Natural Hormone Helps Kids With ADHD Go to Sleep Faster By Staff Writer
WebMD Medical News Reviewed By Michael Smith, MD
on Tuesday, October 21, 2003



Oct. 21, 2003 -- Attention deficit hyperactivity disorder medications (ADHD) commonly cause insomnia. But the natural sleep hormone melatonin may actually help put children with ADHD to sleep faster.


Children with ADHD often have trouble sleeping this usually stems from stimulant medications --such as Ritalin and Adderall -- that they take for their condition.


Results of a new study testing melatonin's effects on ADHD insomnia were presented at the American Academy of Child and Adolescent Psychiatry meeting this week.


Kids Fall Asleep Faster


Researcher Melissa Bomben, MSc and colleagues studied the effect of melatonin in nine children with ADHD -- seven boys and two girls from 7 to 13 years old. These children had severe ADHD that was interfering with their daily functioning. On average, it was taking these kids about 1½ hours to fall asleep at night.


In order to help fully evaluate the effects of melatonin on ADHD insomnia, the children were given either melatonin or placebo on different nights. Neither the researchers nor the study participants were aware if the children were taking the melatonin treatment or placebo.


Based on sleep logs completed by parents, study results showed that the children fell asleep significantly faster when taking melatonin -- more than 30 minutes faster. While taking melatonin, it took an average of 51 minutes to fall asleep, compared with 88 minutes while taking the placebo.


The greatest improvement in ADHD insomnia was seen in children who had the most severe cases of insomnia before the study. Therefore, the beneficial effect of melatonin may be lessened in children who have less trouble with insomnia.


The researchers continued to watch the children for an additional three months and found that the melatonin continued to improve ADHD insomnia.


Melatonin Safety


No significant side effects were seen during the study, and melatonin is generally very well tolerated, Bomben tells WebMD. Bomben is a project manager of the Mental Health Research Unit at the University of British Columbia in Vancouver.


The children were given melatonin at a dose of 6 milligrams per night, which some doctors may consider to be high, says Bomben.


"However, clinical practice at British Columbia's Children's Hospital has yielded a 20-year history of adequate doses for children in the 2.5 milligrams to 10 milligrams range. Doses in excess of 10 milligrams are not uncommon."


"Since melatonin is in an unusual category, being an unpatentable hormone, considered in the U.S. to be a 'nutritional supplement' that is unregulated by the FDA, and since there is evidence that some brands contain substances other than 'pharmaceutically pure' melatonin, evidence of safety and efficacy is of great importance to clinicians," Bomben says.


Importance of Sleep Hygiene


Parents were encouraged to establish consistent bed and waking times, but it was not required to continue in the trial. Children whose sleep hygiene was not consistent from day to day had less improvement with melatonin treatment. Sleep hygiene refers to the practices, habits, and environmental factors that are critically important for sound sleep.


In the current study, the researchers did not screen the children to see who was taking stimulant ADHD medications and which types. But the investigators are currently conducting a larger trial involving only children with ADHD who are taking stimulant medications and who have resulting ADHD insomnia. Results of this trial are expected next summer.


Strattera, the first nonstimulant ADHD medication, was approved in November of 2002, so none of the children in this study were taking this medication. Strattera does not appear to cause wakefulness, although sleeping problems have been reported with the drug. Strattera's manufacturer, Eli Lilly and Company, is a WebMD sponsor.


With reporting by Laurie Barclay, MD.

[Mayleng]

Rest easy: MIT study confirms melatonin's value as sleep aid
Elizabeth A. Thomson, News Office
March 1, 2005


A new study by MIT scientists and colleagues confirms that melatonin is an effective sleep aid for older insomniacs and others. Misuse of the hormone had led some to question its efficacy, but the latest work (published in the February issue of Sleep Medicine Reviews) could jump-start interest in the dietary supplement and help more people get a good night's sleep.

In earlier research, scientists led by Professor Richard Wurtman, principal investigator for the current study, showed that only a small dose of melatonin (about 0.3 milligrams) is necessary for a restful effect. Taken in that quantity, it not only helps people fall asleep, but also makes it easier for them to return to sleep after waking up during the night--a problem for many older adults.

The researchers also found, however, that commercially available melatonin pills contain 10 times the effective amount. And at that dose, "after a few days it stops working," said Wurtman, director of MIT's Clinical Research Center and the Cecil H. Green Distinguished Professor. When the melatonin receptors in the brain are exposed to too much of the hormone, they become unresponsive.

As a result of these inadvertent overdoses, "many people don't think melatonin works at all," said Wurtman, who is also affiliated with the Department of Brain and Cognitive Sciences. This belief, coupled with potentially serious side effects related to high doses such as hypothermia, has earned the hormone a bad reputation in some quarters--"and something that could be very useful to a lot of people isn't," said Wurtman, who said that he and his wife have been taking melatonin every night for about a year now.

To determine conclusively whether melatonin works or not, the scientists in the current study analyzed 17 peer-reviewed scientific papers about the hormone. To be included in this study, or meta-analysis, the experiments reported in each paper had to satisfy specific criteria. For example, each had to be placebo-controlled and include objective measurements on at least six adult subjects.

"A meta-analysis essentially tells 'yes' or 'no'--that a treatment does or does not have a significant effect," Wurtman said. "When a meta-analysis says 'yes,' there should no longer be any controversy about whether the treatment works."

The melatonin meta-analysis delivered a definitive "yes."

Wurtman notes that some of the 17 studies included in the analysis involved very high doses of the hormone over long periods, a "situation where we know it's not going to work." Yet the meta-analysis still showed that the hormone's positive effects on sleep "are statistically significant."

When Wurtman first discovered the efficacy of small doses of melatonin, he and MIT patented its use for dosages up to one milligram. Because the FDA defined the hormone as a dietary supplement, however, manufacturers were free to sell it in much higher dosages, "even though we knew they wouldn't work," Wurtman said.

As a result, until recently the hormone was commercially unavailable to the public in small doses. "People who knew that small doses were best often bought the high-dose pills, then divided them with a knife," Wurtman said. "But that's not very accurate."

The company Nature's Bounty has since licensed the work, and now the hormone is easily available in the effective dosages.

Wurtman's colleagues in the meta-analysis work are Amnon Brzezinski of Hadassah-Hebrew University Medical Center in Israel; Mark G. Vangel, a visiting scientist at the Clinical Research Center; Gillian Norrie and Ian Ford of the University of Glasgow in Scotland; and Irina Zhdanova of the Boston University School of Medicine.

The work was supported by the National Institutes of Health, the Center for Brain Sciences and Metabolism Charitable Trust, and the Womens' Health Center of Hadassah-Hebrew University Medical Center.


A version of this article appeared in MIT Tech Talk on March 9, 2005 (download PDF).

[baysmommy]

After reading this, and consulting with DD's GP I gave her 300mcgs. of melatonin last night about 1 1/2 hours before bedtime.
All I can say is WOW, she went to bed with little trouble because she was sleepy, and was in a MUCH MUCH better mood this morning.We rarely have a morning without some kind of issue. We will definetely continue the Melatonin as long as she is on stims.

[Mayleng]

Works well for my son too. He only takes 0.5mgs.

[ambersmom]

Is this safe with the supplements also, i give my kids omega 3, vit e and then mag at nite.
just recently since i started giveing my son the mag at night he says hes haveing trouble sleeping. I thought the mag helped with calming so im wondering if i should give this to him at in the morning or just add something like the melatonin also at night.
thanks

[alyssasmom]

Hi all! Due to changing around Alyssa's seizure meds, we have hit a patch of insomnia. Poor thing didn't sleep last night until after 11. I bought some Melatonin, and am not sure of the dosage that she should take. I bought pills that are 300 mcg. When I look at some of the dosing charts, they are in milligrams. Alyssa is about 115 lbs. and 4' 8". When I have done a conversion chart, it says that she isn't even getting one full milligram unless she takes 4 of these pills, and that doesn't seem right to me.

I gave her one last night since that is what is on the bottle. It didn't do a thing for her... Other meds that she takes at night are 100 mgs. of Lamictal and 300 mgs. of Trileptal. Anyone that could help me, it would be appreciated.

[Mayleng]

300mgs is very little. Try giving 2 pills that should be close enough to 0.5mgs which is what my son takes. However, since she is on so many meds and has seizures, pls check with the doctor before using melatonin.

[barktra]

I have been giving my son 5 mg of melatonin for several months and it works quite well. I have done some recent reading that concerns me though regarding safety over long term use. it seems that much of the research says to use for a few weeks then discontinue and that there might be long term negative side effects. does anyone have any knowledge of long term concerns? Also, there seems to be a wide range in the dosing level. What do most people give for adolecents??

[Mayleng]

There really hasn't been any long term studies done that I am aware of. My son has been on 0.5mg of melatonin for the last 4 to 5 yrs, and at this small amount it has been effective for him. Have you tried giving your son a smaller amount. If you read the study in Reply #3, you will see that they believe that the smaller dosages are more effective. I know studies have used up to 9mgs, but I am generally more cautious and started my son on a lower dose 0.25mg (quarter the 1mg pill) and then raised it to 0.5mg when that did not work. So far 0.5mg has been working for the last 4 to 5 yrs for him. He does not take it when he does not take his metadate cd ie. on weekends and vacations.

[Mayleng]

Here's another article on Melatonin from the University of Maryland Medical Center. www.umm.edu/altmed/articles/melatonin-000315.htm