The short-term and long-term adverse effects of melatonin treatment in children and adolescents: a systematic review and GRADE assessment

Händel, Mina Nicole; Andersen, Henning Keinke; Ussing, Anja; Virring, Anne; Jennum, Poul; Debes, Nanette Mol; Laursen, Torben; Baandrup, Lone; Gade, Christina; Dettmann, Jette; Holm, Jonas; Krogh, Camilla; Birkefoss, Kirsten; Tarp, Simon; Bliddal, Mette; Edemann-Callesen, Henriette

doi:10.1016/j.eclinm.2023.102083

Cited by 12 publications

(8 citation statements)

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“…The adverse effects appear to be minor and include headaches, drowsiness, dizziness, stomach cramps, irritability, and diarrhea [ 40 ]. One systematic review of the outpatient use of melatonin for pediatric chronic insomnia found no serious adverse events after the short- or long-term administration of melatonin to children and adolescents, but the authors did note increased non-serious events such as headaches, nausea, behavior changes, or fatigue/drowsiness [ 41 ]. Furthermore, these non-serious adverse events were not affected by patient age and gender or by the melatonin duration or dose [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…One systematic review of the outpatient use of melatonin for pediatric chronic insomnia found no serious adverse events after the short- or long-term administration of melatonin to children and adolescents, but the authors did note increased non-serious events such as headaches, nausea, behavior changes, or fatigue/drowsiness [ 41 ]. Furthermore, these non-serious adverse events were not affected by patient age and gender or by the melatonin duration or dose [ 41 ]. Another systematic review of the pre-operative use of melatonin (as an anxiolytic) also demonstrated an “excellent safety profile” [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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Melatonin Use in Pediatric Intensive Care Units: A Single-Center Experience

Jacobson,

Tylka,

Glazer

et al. 2023

Medical Sciences

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Growing evidence indicates that altered melatonin secretion during critical illness may influence the quality and quantity of sleep, delirium, and overall recovery. However, limited data exist regarding the use of melatonin in pediatric critical illness. Data were reviewed over a 5-year period at a tertiary pediatric intensive care unit for pediatric patients (ages 0–18 years) who were prescribed melatonin with the aim of identifying the frequency of and indications for use. Data collection included the hospital day of initiation, the dose, the frequency, the duration of use, and the length of stay. The results demonstrate that melatonin was infrequently prescribed (6.0% of patients admitted; n = 182) and that the majority of patients received melatonin as continuation of home medication (46%; n = 83 of 182). This group had significantly earlier melatonin use (0.9 ± 2.3 day of hospitalization; p < 0.0001) and significantly reduced lengths of stay compared to the other groups (mean LOS 7.2 ± 9.3 days; p < 0.0001). Frequently, clear documentation of indication for melatonin use was absent (20%; n = 37). In conclusion, given that melatonin is infrequently used within a tertiary PICU with the most common indication as the continuation of home medication, and often without clear documentation for indication, this presents an opportunity to emphasize a more attentive and strategic approach regarding melatonin use in the PICU population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Melatonin Use in Pediatric Intensive Care Units: A Single-Center Experience

Jacobson,

Tylka,

Glazer

et al. 2023

Medical Sciences

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“…Concerns regarding melatonin's long-term effects on hormone levels and puberty have also been raised [ 45 ]. While melatonin use in children commonly results in non-serious adverse events, the true extent of such events and their long-term implications remain uncertain [ 46 ]. Given this knowledge gap, caution is advised against indiscriminate melatonin use in children and adolescents with insomnia [ 46 ].…”

Section: Reviewmentioning

confidence: 99%

“…While melatonin use in children commonly results in non-serious adverse events, the true extent of such events and their long-term implications remain uncertain [ 46 ]. Given this knowledge gap, caution is advised against indiscriminate melatonin use in children and adolescents with insomnia [ 46 ]. Parents and caregivers must recognize that not all melatonin supplements are equivalent in purity and strength, with significant brand variability [ 47 ].…”

Section: Reviewmentioning

confidence: 99%

A Comprehensive Review on the Role of Melatonin's Anesthetic Applications in Pediatric Care

Subhadarshini,

Taksande

2024

Cureus

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Anesthesia is critical to pediatric care, ensuring the safety and comfort of children undergoing medical procedures. With a growing interest in alternative anesthetic agents, melatonin has emerged as a promising candidate due to its sedative, analgesic, anti-inflammatory, and neuroprotective properties. This comprehensive review explores the potential applications of melatonin in pediatric anesthesia. We delve into the pharmacological characteristics of melatonin, its anesthetic properties, and its clinical applications in pediatric care, including preoperative sedation, adjunct to general anesthesia, postoperative pain management, and prevention of emergence delirium. Additionally, we discuss the safety profile of melatonin, potential adverse effects, and comparative analysis with traditional anesthetics. Finally, we highlight future research directions to provide insights into melatonin's role in pediatric anesthesia and its implications for clinical practice.

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“… 12 Whether or not sleep disorders are associated with ASD or ADHD as underlying conditions, it has been recommended that melatonin should only be used where sleep problems persist after non-pharmacological interventions have been implemented. 13 Melatonin appears to be relatively well tolerated, at least in the short to medium term 14 and, for children with neurodevelopmental disorders, only mild transient adverse effects, such as headache, hyperactivity, dizziness and abdominal pain, have been reported. 15 …”

Section: Introductionmentioning

confidence: 99%

Quality of melatonin use in children and adolescents: findings from a UK clinical audit

Paton,

Gringras,

Ruan

et al. 2024

BMJ Ment Health

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BackgroundMelatonin is commonly used to treat sleep disturbance in children and adolescents, although uncertainties about its optimal use remain.ObjectiveTo determine to what extent prescribing of melatonin complies with evidence-based clinical practice standards.MethodsAs part of a quality improvement programme, the Prescribing Observatory for Mental Health conducted a retrospective clinical audit in UK services for children and adolescents.FindingsData were submitted for 4151 children and adolescents up to 18 years of age, treated with melatonin: 3053 (74%) had a diagnosis of neurodevelopmental disorder. In 2655 (73%) of the 3651 patients prescribed melatonin to be taken regularly, the main reason was to reduce sleep latency (time taken to fall asleep). In 409 patients recently starting melatonin, a non-pharmacological intervention had already been tried in 279 (68%). The therapeutic response of patients early in treatment (n=899) and on long-term treatment (n=2353) had been assessed and quantified in 36% and 31%, respectively, while for review of side effects, the respective proportions were 46% and 43%. Planned treatment breaks were documented in 317 (13%) of those on long-term treatment.ConclusionsMelatonin was predominantly prescribed for evidence-based clinical indications, but the clinical review and monitoring of this treatment fell short of best practice.Clinical implicationsWith limited methodical review of melatonin use in their patients, clinicians will fail to garner reliable information on its risks and benefits for individual patients. The lack of such practice-based evidence may increase the risk of melatonin being inappropriately targeted or continued despite being ineffective or no longer indicated.

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The short-term and long-term adverse effects of melatonin treatment in children and adolescents: a systematic review and GRADE assessment

Cited by 12 publications

References 68 publications

Melatonin Use in Pediatric Intensive Care Units: A Single-Center Experience

Melatonin Use in Pediatric Intensive Care Units: A Single-Center Experience

A Comprehensive Review on the Role of Melatonin's Anesthetic Applications in Pediatric Care

Quality of melatonin use in children and adolescents: findings from a UK clinical audit

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