Melatonin assessments

Hughes RJ, Sack RL, Lewy AJ. The role of melatonin and circadian phase in age-related sleep-maintenance insomnia assessment in a clinical trial of melatonin replacement. Sleep 1998 21 52-68. 

Holliman BJ, Chyka PA. Problems in assessment of acute melatonin overdose. South Med J 1997 90(4) 451-3. 

Eisenach JC, Hood DD, Curry R (2002) Preliminary efficacy assessment of intrathecal injection of an American formulation of adenosine in humans. Anesthesiology 96 29-34 El Shenawy SM, Abdel-Salam OM, Baiuomy AR, El-Batran S, Arbid MS (2002) Studies on the anti-inflammatory and anti-nodeeptive effects of melatonin in the rat. Pharmacol Res 46 ... 

Myristic acid is used in oral and topical pharmaceutical formulations. Myristic acid has been evaluated as a penetration enhancer in melatonin transdermal patches in rats and bupropion formulations on human cadaver skin. Further studies have assessed the suitability of myristic acid in oxymorphone formulations and clobetasol 17-propionate topical applications. " ... 

L. Mallory Boylan, and Judy A. Driskell Melatonin in the Promotion of Health, Ronald R. Watson Nutritional and Environmental Influences on the Eye, Allen Taylor Laboratory Tests for the Assessment of Nutritional Status, Second Edition,... 

Nervous system In a comparison of the effects of single doses of melatonin 2-6 mg and chloral hydrate on sleep electroencephalography in a randomized study of 348 children aged 1 month to 6 years, melatonin was well tolerated and associated with less drowsiness than chloral hydrate [48 ]. Two of those who took melatonin developed diarrhea and two developed agitation, but there was insufficient information to assess causality. 

Haloperidol, a dopamine receptor antagonist, was cytotoxic to mouse clonal hippocampal HT22 cells in a concentration-dependent manner and caused death by oxidative stress as assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazo-lium bromide (Post et al. 1998). The addition of haloperidol to HT22 cells led to an increase in intracellular peroxides and a rime-dependent drop in the intracellular glutathione levels. Haloperidol-induced oxidative cell death was prevented by melatonin, its precursor N-acetyl serotonin, and most effectively by a-tocopherol. 

A randomised, placebo-controlled trial examining the efficacy of immediate release melatonin (0.5-12 mg, depending on response) in treating sleep disorders in 146 children (aged 3-15 years) with neurodevelopmental disorders found melatonin caused mild improvements in total sleep but more marked improvement in latency to sleep and actigraphy results [54 ]. However, treatment was associated with earlier waking times. Only mild adverse events were reported and their occurrences were similar between the two groups— no formal statistical assessment of prevalence was conducfed. 

Melatonin is widely used for sleep disorders in patients with a range of developmental disorders and neurodisabilities who also frequently have epilepsy. The current section examines published data to assess the evidence behind melatonin and seizure control. The literature survey revealed 26 papers apparently reporting an association between melatonin and epilepsy or seizures but seven of these did not provide relevant information. Of the three double-blind, randomised, controlled trials, two showed no overall worsening or improvement in seizures, and one recent trial reported a statistically significant reduction in seizures. 

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