The past year and a half haven’t been easy for us.
As some of you will know, our daughter was diagnosed with Benign Rolandic Epilepsy last year, and since then we’ve been on the roller coaster of finding the right dose of medicine, of trying to find ways to help her get the sleep she needs, and of dealing with seizures that unfortunately, have progressed to full-on tonic clonic (otherwise known as grand mal) seizures.
You may recall I wrote a post sometime last year about the possible link between seizures, melatonin and lack of sleep. If you haven’t read it you can find it here:
I have been shocked at the amount of attention that post has received (in the past few months alone, several hundred thousand people).
Given that this is still an issue with very real consequences in my life and in the life of my family, I wanted to write a follow up post to share with you the research I’ve found on the subject. Unfortunately, at this point the main thing we know is how little we know!
“There are significant limitations in the studies done to date supporting melatonin use. The small number of randomized, placebo-controlled trials and the small number of subjects in these trials limit the power of evidence in favour of melatonin treatment. As well, the lack of long-term studies limits our knowledge both of relapse risk and of long-term efficacy and safety. More research in the future would help to focus these issues.” (Source: Canadian Pediatric Society)
What does seem clear that there is some kind of relationship between melatonin and seizures. Not enough research on long-term usage has been done, however, to be able to say exactly what this relationship looks like. Questions long-term studies could help answer include:
Since I’ve spent a great deal of time scouring the internet for information related to the safety of melatonin in kids, I thought this would be helpful information to share here.
If you know of other information that’s missing, please send it to me via email and I will add it to the list.
*This information is meant as a jumping board for discussion with your physician only.
“Melatonin should not be used in most children. It is POSSIBLY UNSAFE. Because of its effects on other hormones, melatonin might interfere with development during adolescence.” (Source: Medline Plus)
“We don’t know how safe melatonin is for children, or how safe it is to take regularly for a long time. There hasn’t been enough research to say. The studies we looked at found that children did have some side effects. Some of the children who took melatonin felt cold or dizzy or they had a low mood. Some children also didn’t feel hungry and had mild headaches. There’s also some evidence that children may get epilepsy or worse fits if they take melatonin, but we don’t know this for sure. In one study we looked at, one child had mild epilepsy after four months of taking melatonin. But in another study, 4 in 6 children with epilepsy had more fits when they took melatonin. And they got fits less often when they stopped taking the supplement. Some studies also suggest melatonin could delay the start of puberty.” (Source: Boots Web MD)
“Always ask your child’s doctor before giving melatonin to a child. In fact, doses between 1 – 5 mg may cause seizures in this age group.” (Source: University of Maryland Medical Center)
“Talk to your child’s pediatrician before giving him melatonin. Although presently there is no recommended dose for melatonin supplements, many pediatricians suggest doses less than 0.3 mg per day. This is close to the amount of melatonin the body produces naturally. There is concern that higher doses between 1 mg to 5 mg may cause seizures in children, especially those with serious neurological disorders.” (Source: Livestrong)
Of special interest to me (for obvious reasons) is the effect of melatonin on kids with Epilepsy. Does it cause seizures to occur? Does long term use increase the risk of seizures starting in an otherwise healthy child? Does long term use merely increase the risk of seizures in kids who were already predisposed to it?
From spending some time reading some pretty credible sources, it appears that smaller, standard doses of melatonin may increase the likelihood of seizures, whereas mega-doses of the hormone seem to reduce the frequency of seizures.
For kids with intractable seizures – meaning seizures that aren’t responding to other interventions – research published in the Journal of Child Neurology showed that giving mega-doses (10mg) of melatonin to kids aged 9 and up with intractable seizures significantly decreased the frequency of seizures, with no major side effects or seizure aggravation.
“The hormone melatonin has been reported to exhibit anti-epileptic properties in clinical trials. However, recent animal studies have demonstrated that melatonin can have opposite effects on brain function, depending on the dose and timing of melatonin administration. In other words, while high pharmacological doses are able to decrease brain excitability and suppress seizures, smaller doses of melatonin (administered at night when melatonin levels in the brain are highest) similar in amount to what is produced by the brain can actually increase the excitability of neurons making them more susceptible to seizure activity.” (Source: Hippocampal Melatonin Receptors Modulate Seizure Threshold)
I hope I don’t actually have to say this, but please do not give your child mega-doses of melatonin except as prescribed by a physician!
It also appears highly likely that melatonin usage does have an impact on kids with seizures:
“In a 1998 study published in Lancet, melatonin administration to six children with underlying seizure disorders produced a worsening of seizures in three.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.” (Source: Pediatric Pharmacology, 2003)
Much of the research that has been done to date on melatonin use in children has been in populations with conditions such as ADHD, Autism, visual impairments, Cerebral Palsy, and developmental disabilities. In many cases where a child has sleep issues related to one of these conditions, a doctor will prescribe melatonin. The research seems to show positive outcomes in these kids, perhaps because meds used to treat these conditions may reduce natural melatonin levels.
“Melatonin has been used in pediatrics for over 20 years. An article in the Annals of Neurology in 1991 reported that melatonin successfully corrected the sleep-wake cycle of a blind child with multiple disabilities. Since then, numerous studies, mostly short-term and involving special-needs children, have shown positive results. Doctors say the supplement can be critical in regulating the sleep patterns of children with neurodevelopmental disorders like autism, with few, if any, side effects.” (Source: Wall Street Journal
“The results of this study support the efficacy and tolerability of melatonin treatment for sleep problems in children with ASD and FXS. We conclude that melatonin can be considered a safe and effective pharmacologic treatment in addition to behavior therapies and sleep hygiene practices for the management of sleep problems in children with ASD and FXS.” (Source: Journal of Clinical Sleep Medicine)
Again, please keep in mind that I’m not a physician. I’m just a mom who likes to know what she’s up against, and who wants to help other parents to do the same.
Before starting your child on melatonin, or stopping melatonin, please first consult your child’s physician.
From the research I’ve seen on melatonin use in kids, I have no doubt that melatonin works to help kids fall asleep. The evidence seems overwhelmingly clear: kids who take melatonin fall asleep easier. That’s why we gave it to our daughter for YEARS.
It worked, and we never heard even a hint that it may be unsafe.
The problem is that melatonin is not, as some would have you believe, simply just another natural supplement. Melatonin is a hormone, and the long-term effects on children have not been studied sufficiently.
A number of major news outlets have published articles over the past year or so discussing the use of melatonin in kids. To read what people are saying, check out these articles:
Parents use melatonin to get kids to sleep: Is it safe? (source: CBS News)
If I send my kid to bed with melatonin will it hurt him? (source: Globe and Mail)
I’m so glad this issue is ‘getting out there’ so parents and physicians can at least grapple with the issue, rather than assuming melatonin is completely safe.
What do you think? Do you give your kids melatonin? Will you continue to, given what you’ve read?
PLEASE NOTE: I realize this is a contentious issue. Please ensure your comments are thoughtful and respectful – feel free to disagree with me or a commenter, but I have no problem deleting comments that aren’t respectful.
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