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Current role of melatonin in pediatric neurology: clinical recommendations

Current role of melatonin in pediatric neurology: clinical recommendations
Current role of melatonin in pediatric neurology: clinical recommendations
Background/purpose
Melatonin, an indoleamine secreted by the pineal gland, plays a key role in regulating circadian rhythm. It has chronobiotic, antioxidant, anti-inflammatory and free radical scavenging properties.

Methods
A conference in Rome in 2014 aimed to establish consensus on the roles of melatonin in children and on treatment guidelines.

Results and Conclusion

The best evidence for efficacy is in sleep onset insomnia and delayed sleep phase syndrome. It is most effective when administered 3–5 h before physiological dim light melatonin onset. There is no evidence that extended-release melatonin confers advantage over immediate release. Many children with developmental disorders, such as autism spectrum disorder, attention-deficit/hyperactivity disorder and intellectual disability have sleep disturbance and can benefit from melatonin treatment. Melatonin decreases sleep onset latency and increases total sleep time but does not decrease night awakenings. Decreased CYP 1A2 activity, genetically determined or from concomitant medication, can slow metabolism, with loss of variation in melatonin level and loss of effect. Decreasing the dose can remedy this. Animal work and limited human data suggest that melatonin does not exacerbate seizures and might decrease them. Melatonin has been used successfully in treating headache. Animal work has confirmed a neuroprotective effect of melatonin, suggesting a role in minimising neuronal damage from birth asphyxia; results from human studies are awaited. Melatonin can also be of value in the performance of sleep EEGs and as sedation for brainstem auditory evoked potential assessments. No serious adverse effects of melatonin in humans have been identified.
melatonin treatment, sleep disorders, insomnia, epilepsy, adhd, autism
1090-3798
122-133
Bruni, Oliviero
b25e21c1-672b-48cb-990e-b907ecf12546
Alonso-Alconada, Daniel
b090efce-d0e5-4729-a1b9-2c174079b462
Besag, Frank
36d48fc5-296a-4881-b7d1-671eec10acf0
Biran, Valerie
bdf174cf-1d88-41c9-9e53-d490ca22fbc2
Braam, Wiebe
d33cd7af-6a7c-451e-bfc2-45edbee852c9
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Moavero, Romina
14ceb1a1-9b6f-4835-9c27-9d0c47fb9b37
Parisi, Pasquale
a9ee1126-02e0-41d0-a97a-66d77e8b1173
Smits, Marcel
03ab333d-647b-4e9f-bed9-5e19d06ecbea
Van der Heijden, Kristiaan
c4f1abe2-203c-46e1-bb37-f5c01bf42251
Curatolo, Paolo
4a177f24-d572-442c-9609-4357d429c27e
Bruni, Oliviero
b25e21c1-672b-48cb-990e-b907ecf12546
Alonso-Alconada, Daniel
b090efce-d0e5-4729-a1b9-2c174079b462
Besag, Frank
36d48fc5-296a-4881-b7d1-671eec10acf0
Biran, Valerie
bdf174cf-1d88-41c9-9e53-d490ca22fbc2
Braam, Wiebe
d33cd7af-6a7c-451e-bfc2-45edbee852c9
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Moavero, Romina
14ceb1a1-9b6f-4835-9c27-9d0c47fb9b37
Parisi, Pasquale
a9ee1126-02e0-41d0-a97a-66d77e8b1173
Smits, Marcel
03ab333d-647b-4e9f-bed9-5e19d06ecbea
Van der Heijden, Kristiaan
c4f1abe2-203c-46e1-bb37-f5c01bf42251
Curatolo, Paolo
4a177f24-d572-442c-9609-4357d429c27e

Bruni, Oliviero, Alonso-Alconada, Daniel, Besag, Frank, Biran, Valerie, Braam, Wiebe, Cortese, Samuele, Moavero, Romina, Parisi, Pasquale, Smits, Marcel, Van der Heijden, Kristiaan and Curatolo, Paolo (2015) Current role of melatonin in pediatric neurology: clinical recommendations. European Journal of Paediatric Neurology, 19 (2), 122-133. (doi:10.1016/j.ejpn.2014.12.007).

Record type: Article

Abstract

Background/purpose
Melatonin, an indoleamine secreted by the pineal gland, plays a key role in regulating circadian rhythm. It has chronobiotic, antioxidant, anti-inflammatory and free radical scavenging properties.

Methods
A conference in Rome in 2014 aimed to establish consensus on the roles of melatonin in children and on treatment guidelines.

Results and Conclusion

The best evidence for efficacy is in sleep onset insomnia and delayed sleep phase syndrome. It is most effective when administered 3–5 h before physiological dim light melatonin onset. There is no evidence that extended-release melatonin confers advantage over immediate release. Many children with developmental disorders, such as autism spectrum disorder, attention-deficit/hyperactivity disorder and intellectual disability have sleep disturbance and can benefit from melatonin treatment. Melatonin decreases sleep onset latency and increases total sleep time but does not decrease night awakenings. Decreased CYP 1A2 activity, genetically determined or from concomitant medication, can slow metabolism, with loss of variation in melatonin level and loss of effect. Decreasing the dose can remedy this. Animal work and limited human data suggest that melatonin does not exacerbate seizures and might decrease them. Melatonin has been used successfully in treating headache. Animal work has confirmed a neuroprotective effect of melatonin, suggesting a role in minimising neuronal damage from birth asphyxia; results from human studies are awaited. Melatonin can also be of value in the performance of sleep EEGs and as sedation for brainstem auditory evoked potential assessments. No serious adverse effects of melatonin in humans have been identified.

Full text not available from this repository.

More information

Published date: 2015
Keywords: melatonin treatment, sleep disorders, insomnia, epilepsy, adhd, autism
Organisations: Clinical Neuroscience

Identifiers

Local EPrints ID: 380136
URI: https://eprints.soton.ac.uk/id/eprint/380136
ISSN: 1090-3798
PURE UUID: 41e2f18f-a1b3-469a-a098-be5c45c6b317
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075

Catalogue record

Date deposited: 19 Aug 2015 13:46
Last modified: 06 Jun 2018 12:21

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Contributors

Author: Oliviero Bruni
Author: Daniel Alonso-Alconada
Author: Frank Besag
Author: Valerie Biran
Author: Wiebe Braam
Author: Samuele Cortese ORCID iD
Author: Romina Moavero
Author: Pasquale Parisi
Author: Marcel Smits
Author: Kristiaan Van der Heijden
Author: Paolo Curatolo

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