Melatonin controlled release caplet quick guide to effects –part 1

Melatonin is a hormone related to the physiological clock, also known as the body's "timing factor", and is often used to regulate sleep.

What is controlled release melatonin?

Melatonin, a hormone produced in the pineal gland and also found in plants and microorganisms, was discovered and named by American dermatologist Aaron Lerner in 1958 CE and is primarily associated with circadian rhythms and seasonal reproductive regulation.

In most animals, melatonin is synthesized and secreted mainly at night (converted from tryptophan), but it is also synthesized in many tissues and cells, including the retina, bone marrow cells, platelets, gastrointestinal tract, skin, or lymphocytes.

Melatonin receptors are scattered throughout the body and appear to be versatile physiological signals involved in the control of many physiological processes, thus affecting responses such as sleep, reproduction, molting, immune response, energy balance and behavior.

In addition, it has direct and indirect antioxidant properties, and this compound counteracts the harmful effects of reactive oxygen and nitrogen species in different systems.

What are the empirical effects of slow release melatonin?

1. Control weight

Obesity has become one of the most important public health problems worldwide and is strongly associated with type 2 diabetes, myocardial infarction, stroke, osteoarthritis, obstructive sleep apnea, depression, and several types of cancer such as breast, ovarian, prostate, liver, kidney, and colon cancers.

A systematic literature review and meta-analysis of 23 randomized controlled trials showed that melatonin supplementation (at doses ranging from 3 to 10 mg per day and intervention durations ranging from 3 weeks to 48 weeks) reduced body weight compared to placebo, but had no significant effect on BMI or waist circumference.

2. Relieve anxiety related to surgery

Surgery (surgical) is an invasive treatment that is often associated with the risk of bleeding, pain, or death, so patients admitted to the hospital for surgery usually experience some degree of anxiety.

Patients with high levels of anxiety require greater doses of anesthetic induction agents and recover less well. Prolonged anxiety can cause stress, which may delay patient recovery.

A Caucus Blue systematic review (Cochrane Database of Systematic Reviews, containing 27 randomized controlled trials of 2319 patients undergoing any surgical procedure requiring the use of anesthesia) noted that melatonin as a premedication (tablet or sublingual) may reduce preoperative anxiety in adults compared to placebo (administered 50 to 120 minutes after administration).

3. Adjunctive COVID-19 treatment

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly worldwide. The virus can cause a wide range of clinical manifestations, from mild symptoms (e.g., fever, cough, and myalgia) to moderate symptoms (pneumonia and local inflammation) requiring hospitalization, with critical symptoms that may lead to death.

A single-center, double-blind, randomized clinical trial (14 days in 74 patients hospitalized with confirmed mild to moderate COVID-19) noted that patients in the intervention group (standard care plus melatonin) had significantly improved clinical symptoms such as cough, dyspnea, malaise, and CRP levels and lung damage compared to the control group (receiving standard care).

4. Beneficial autism in children

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder.

Its etiology is often thought to be related to heterogeneous genetic influences. It is estimated that up to 89% of patients have sleep problems, and the presence of sleep disorders may have a negative prognosis.

A systematic review of the literature and a meta-analysis of 5 randomized, double-blind, placebo-controlled studies in children with autism suggested that melatonin use may help improve sleep parameters (including sleep duration and sleep onset latency).

In addition, melatonin appears to improve daytime behavior in autistic patients with few side effects.

5. Improve postoperative pain and opioid use

More than 230 million people worldwide undergo surgery each year. Surgery often causes postoperative pain, which should be relieved as soon as possible to reduce pain, facilitate the healing process and recovery, and prevent complications.

Traditionally, opioid analgesic therapy has been the mainstay of treatment for acute postoperative pain. However, the recent rise in morbidity and mortality associated with opioid abuse has led to the need for additional efforts to develop pain management strategies.

A systematic literature review and pooled analysis (Meta-analysis, including 15 randomized controlled studies with 1,102 participants) noted that melatonin use slightly reduced postoperative pain scores (trial sequence analysis = conclusive), reduced postoperative opioid consumption (trial sequence analysis = inconclusive), reduced the number of patients requiring analgesics, and did not increase or reduction in the incidence of adverse events (dizziness, headache, nausea, and sensory abnormalities).

6. Improve migraine

The word migraine comes from the Greek word "hemicrania" meaning "half of the head" and represents one of the most distinctive features of the disease (the pain affects only half of the head). Most migraine attacks are severe or at least moderate, and between 10% and 20% of migraineurs experience aura symptoms 48 hours before the migraine attack, including visual abnormalities, tingling and numbness (usually spreading to the hand, arm, face, lips and tongue on one side of the body), while weakness and difficulty swallowing are less common.

A meta-analysis of the literature suggests that oral melatonin may help improve the frequency of migraine attacks. Furthermore, considering the improvements in migraine attack frequency, response rate, withdrawal rate, and adverse event rate, oral melatonin 3 mg (immediate-release/instant-release tablets) at bedtime was the optimal pharmacological intervention with the best magnitude of improvement among all investigated interventions.