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Reflections on melatonin: focus on child mental health

Adult, Child and Adolescent Services, Lagos University Teaching Hospital, Lagos, Nigeria, and presently Consultant Child and Adolescent Psychiatrist, Northumberland Tyne and Wear NHS Trust, 10 Bailffgate, Ainwick, NE66 1LU, UK, email: fam2005lag{at}yahoo.com

Abiodun O. Adewuya, Psychiatrist

Child and Adolescent Psychiatric Research Unit, Faculty of Health Sciences, Obafemi Awolowo University, Osun State, Nigeria

Declaration of interest

None.

Abstract

AIMS AND METHOD

To examine the propriety of the use of melatonin in child and adolescent psychiatry based on findings retrieved from multiple electronic databases including the Cochrane Library resource, covering 1950–2007.

RESULTS

There is evidence for the effectiveness of melatonin in the initiation of sleep in children with a variety of neurodevelopmental disorders but its value in improving quality of sleep is doubtful. Like hormones in general, melatonin has multifarious action sites and hence potential for many side-effects. Posological issues and long-term side-effects are yet to be validly determined.

CLINICAL IMPLICATIONS

Sleep hygiene should be a major component of the routine intervention programme for insomnia and melatonin judiciously prescribed until the safety of long-term use is known.