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Adverse events associated with oral administration of melatonin: A critical systematic review of clinical evidence
Abstract
While melatonin was once thought of simply as a sleep-inducing hormone, recent research has resulted in development of a deeper understanding of the complex physiological activity of melatonin in the human body. Along with this understanding has come widespread, increasing use of melatonin supplementation, extending beyond its traditional use as a sleep aid into novel fields of application. This increased use often involves off-label and self-prescription, escalating the importance of safety data. In order to examine the current knowledge relating to safety of the exogenous neurohormone, we conducted a comprehensive, critical systematic review of clinical evidence. We examined controlled studies of oral melatonin supplementation in humans when they presented any statistical analysis of adverse events. Of the fifty articles identified, twenty-six found no statistically significant adverse events, while twenty-four articles reported on at least one statistically significant adverse event. Adverse events were generally minor, short-lived and easily managed, with the most commonly reported adverse events relating to fatigue, mood, or psychomotor and neurocognitive performance. A few studies noted adverse events relating to endocrine (e.g. reproductive parameters, glucose metabolism) and cardiovascular (e.g. blood pressure, heart rate) function, which appear to be influenced by dosage, dose timing and potential interactions with antihypertensive drugs. Oral melatonin supplementation in humans has a generally favourable safety profile with some exceptions. Most adverse effects can likely be easily avoided or managed by dosing in accordance with natural circadian rhythms. Further research is required to explore the potential for melatonin to interact with endogenous hormones and pharmaceuticals.
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“Oral melatonin is mostly perceived as safe based on published reports, even in higher doses [300]; however, there can be specific instances that may necessitate further diligence and clinical oversight.”
From Is Melatonin the “Next Vitamin D”?: A Review of Emerging Science, Clinical Uses, Safety, and Dietary Supplements (2022) · cites this paper as [300]
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Rechciński, T., Uznańska‐Loch, B., Trzos, E., Wierzbowska-Drabik, K. A., Krzemińska‐Pakuła, M., Kasprzak, J. D., & Kurpesa, M. (2012) · PubMed · Cited by 7
Influence of Melatonin on Sleep in Humans
Cramer, H., Kendel, K., & Beck, U. (2015) · Sleep · doi:10.1159/000428116 · Cited by 5
[Melatonin in combined therapy of patients with stable angina and arterial hypertension].
Rm, Z., Shcherban', E. A., & Logvinenko, S. I. (2008) · PubMed · Cited by 4
Cheng, C., Gooneratne, N. S., Payton, C., Keith, S. W., & Hafycz, J. (2016) · Hypertension · doi:10.1161/hyp.68.suppl_1.p308 · Cited by 1
Flagged first, then by citations
3 of the 107 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Hawthorne, 2017, Jetlag drug remains prescription-only in Australia, Aust Med, 29, 11
Cited by
Sorted by citations
Melatonin in Cancer Treatment: Current Knowledge and Future Opportunities
Talib, W. H., Alsayed, A. R., Abuawad, A., Daoud, S., & Mahmod, A. I. (2021) · Molecules · doi:10.3390/molecules26092506 · Cited by 235
Sleep and Diet: Mounting Evidence of a Cyclical Relationship
Zuraikat, F. M., Wood, R. A., Barragán, R., & St‐Onge, M. (2021) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-120420-021719 · Cited by 230
Minich, D. M., Henning, M., Darley, C., Fahoum, M., Schuler, C. B., & Frame, J. (2022) · Nutrients · doi:10.3390/nu14193934 · Cited by 176
Besag, F., Vasey, M. J., Lao, K. S. J., & Wong, I. C. K. (2019) · CNS Drugs · doi:10.1007/s40263-019-00680-w · Cited by 170
Safety of higher doses of melatonin in adults: A systematic review and meta-analysis
Menczel Schrire, Z., Phillips, C. L., Chapman, J. L., Duffy, S. L., Wong, G., D’Rozario, A. L., Comas, M., Raisin, I., Saini, B., Gordon, C. J., et al. (2022) · Journal of Pineal Research · doi:10.1111/jpi.12782 · Cited by 133
Metadata
- Authors
- Foley, H. M., & Steel, A. E.
- Affiliations
- Endeavour College of Natural Health (AU)
- Corresponding author
- Foley, Hope M.
- Venue
- Complementary Therapies in Medicine
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 42
- Pages
- 65-81
- ISSN
- 0965-2299 (ISSN-L)
- OpenAlex
- W2898688630
- Cited by
- 144
- References
- 107
- Citations by year
- 2026: 11 · 2025: 22 · 2024: 21 · 2023: 17 · 2022: 20 · 2021: 25 · 2020: 20 · 2019: 8
- FWCI
- 1.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Complementary Therapies in Medicine (publishedVersion)
- PubMed (publishedVersion)
- OPUS - Open Publications of UTS Scholars (University of Technology Sydney) (submittedVersion)
- Funders
- Complementary Medicines Australia
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- melatonin, oral supplementation, adverse events, drug safety, sleep aids, off-label drug use, self-prescription, fatigue, mood, neuropsychological performance, cardiovascular effects, glucose metabolism, reproductive parameters, antihypertensive drug interactions, endocrine interactions
- MeSH terms
- Administration, Oral, Animals, Humans, Melatonin, Drug-Related Side Effects and Adverse Reactions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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