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insomnia in dementia, rapid eye movement behavior disorder, insomnia in [people with]
autism, and jet lag."^15 Three studies have documented decreased “sundowning” (agitation
at night) and improvements in mood, memory and sleep in persons with dementia taking
melatonin, although the sample sizes have been very small and the studies have been short
(under three months).^16
- SUGGESTED BUT UNPROVEN USES: ADJUNCTIVE USE: Many of these suggested uses would
be adjunctive to the use of other psychotropic drugs, especially antidepressants. This would
require careful monitoring of melatonin levels, since psychotropic drugs that affect
norepinephrine or serotonin levels might alter the pattern of melatonin production.
Although no dangerous interaction is known, adjunctive use of melatonin with
psychotropics should be coordinated with the prescribing physician.
- THE NATURAL STANDARD DISSENTS: Other than jet lag, the uses of melatonin approved
by Brown et al. and Mischoulon and Rosenbaum are categorized by the Natural Standard
as “C,” “unclear scientific evidence for this use,” even though in most cases there are
studies suggestive of effective use of melatonin for these conditions. These include
Alzheimer’s disease (sleep disorders), attention deficit hyperactivity disorder,
benzodiazepine tapering, bipolar disorder (sleep disturbances), circadian rhythm entraining
(in blind persons), depression (sleep disorders), insomnia (of unknown origin in non-elderly
persons), sedation, REM sleep behavior disorder, schizophrenia (sleep disorders),shift work
adjustment, tardive dyskinesia(despite the comment quoted above), and seasonal affective
disorder.
- DRUG INTERACTIONS:
Drug interactions with melatonin have not been sufficiently studied, and Mischoulon
and Rosenbaum’s discussion is essentially theoretical. However, they caution against the
potential that psychotropic drugs that affect norepinephrine or serotonin levels might
alter the pattern of melatonin production and that any drugs that might affect the
