International Expert Opinions and Recommendations on the Use of Melatonin in the Treatment of Insomnia and Circadian Sleep Disturbances in Adult Neuropsychiatric Disorders
Year: 2021
Type: review
Abstract: Introduction: Insomnia and circadian rhythm disorders, such as the delayed sleep phase syndrome, are frequent in psychiatric disorders and their evaluation and management in early stages should be a priority. The aim of this paper was to express recommendations on the use of exogenous melatonin, which exhibits both chronobiotic and sleep-promoting actions, for the treatment of these sleep disturbances in psychiatric disorders. Methods: To this aim, we conducted a systematic review according to PRISMA on the use of melatonin for the treatment of insomnia and circadian sleep disorders in neuropsychiatry. We expressed recommendations for the use of melatonin in psychiatric clinical practice for each disorder using the RAND/UCLA appropriateness method. Results: We selected 41 studies, which included mood disorders, schizophrenia, substance use disorders, attention deficit hyperactivity disorders, autism spectrum disorders, neurocognitive disorders, and delirium; no studies were found for both anxiety and eating disorders. Conclusion: The administration of prolonged release melatonin at 2–10 mg, 1–2 h before bedtime, might be used in the treatment of insomnia symptoms or comorbid insomnia in mood disorders, schizophrenia, in adults with autism spectrum disorders, neurocognitive disorders and during sedative-hypnotics discontinuation. Immediate release melatonin at <1 mg might be useful in the treatment of circadian sleep disturbances of neuropsychiatric disorders.
Source: Frontiers in Psychiatry
Authors: Laura Palagini, Raffaele Manni, Eugenio Aguglia, Mario Amore, Roberto Brugnoli, Stéphanie Bioulac, Patrice Bourgin, Jean-Arthur Micoulaud Franchi, Paolo Girardi, Luigi Grassi, Régis Lopez, Claudio Mencacci, Giuseppe Plazzi, Julia Maruani, Antonino Minervino, Pierre Philip, Sylvie Royant Parola, Isabelle Poirot, Lino Nobili, Giovanni Biggio, Carmen M. Schroder, Pierre A. Geoffroy
Institutions: University of Pisa, University of Catania, Ospedale Policlinico San Martino, University of Genoa, Azienda Ospedaliera Sant'Andrea, Sapienza University of Rome, Centre National de la Recherche Scientifique, Université de Bordeaux, Hôpital Pellegrin, Sommeil, Addiction et Neuropsychiatrie, Institut des Neurosciences Cellulaires et Intégratives, Hôpitaux Universitaires de Strasbourg, University of Ferrara, Inserm, Université de Montpellier, Hôpital Gui de Chauliac, ASST Fatebenefratelli Sacco, University of Modena and Reggio Emilia, Istituto delle Scienze Neurologiche di Bologna, Assistance Publique – Hôpitaux de Paris, Hôpital Bichat-Claude-Bernard, Groupe Hospitalo-Universitaire Paris Nord, Centre Hospitalier Universitaire de Lille, Istituto Giannina Gaslini, University of Cagliari, National Research Council, Université Paris Cité, GHU Paris psychiatrie & neurosciences, NeuroDiderot
Language: English
Subfield: Endocrine and Autonomic Systems
Field: Neuroscience
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $2,950
OpenAlex ID: W3167915831