Verywell Health6 Serious Side Effects of Melatonin

This consumer health article reviews melatonin’s side effect profile based on available research, addressing commonly reported adverse effects and contraindications. The content provides practical guidance for safe supplementation while acknowledging limitations in long-term safety data.

⚕️ Key Clinical Considerations ⚕️

• Dose-dependent effects: Side effects increase significantly above 10mg daily, with optimal adult dosing at 4mg taken 3 hours before bedtime according to recent meta-analysis.
• Drug interactions require monitoring: Warfarin increases bleeding risk, SSRIs elevate melatonin levels, and diabetes medications may cause hypoglycemia when combined.
• Vulnerable populations need special consideration: Pregnant/breastfeeding women, patients with bleeding disorders, kidney/liver disease, depression, and immunocompromised individuals require careful evaluation.
• Long-term safety data limited: Most research focuses on short-term use, with one study suggesting increased fracture risk and potential hormonal effects in children.
• Common side effects predictable: Headaches, daytime drowsiness, dizziness, and nausea occur more frequently with higher doses and can impact daily functioning.

🎯 Clinical Practice Impact 🎯

• Patient Communication: Counsel patients on appropriate dosing (0.5-5mg range), timing of administration, and recognition of side effects. Emphasize that “more is not better” regarding efficacy and safety.
• Practice Integration: Develop screening protocols for contraindications, drug interactions, and patient-specific risk factors before recommending melatonin supplementation.
• Risk Management: Monitor patients taking warfarin, diabetes medications, or those with cardiovascular conditions. Document discussions about long-term use limitations and alternative sleep interventions.
• Action Items: Consider sleep specialist referral for patients requiring nightly use beyond 3-6 months. Establish follow-up protocols for side effect monitoring and efficacy assessment.

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