Gelfand and colleagues reported that 10 mg of melatonin was superior to placebo in the treatment of cluster headaches.
Editor who approved publication: Melatonin N-acetylmethoxytryptamine has been discovered as a hormone secreted by the pineal gland, even though it is also synthetized in various other organs, tissues, and cells.
The circadian rhythm of melatonin is often used as an indicator phase position since it is a well-defined, high-amplitude rhythm controlled by the hypothalamic suprachiasmatic nuclei. Melatonin production is controlled by this endogenous circadian timing system. It peaks during the night and is suppressed by daylight.
Mood spectrum disorders, including bipolar disorder BDmajor depressive disorder MDDand seasonal affective disorder SADhave been observed to be accompanied by circadian dysregulation as well as dysregulation in melatonin secretion. These findings suggested that altered circadian rhythms might be biological markers of these disorders.
However, the available evidence is controversial. This review summarizes the data published so far about reliable evidence on the role of melatonin in affective disorders. Secondary sources are retina, gut, skin, platelets, bone marrow, and other structures. The first is the metabolization of l-tryptophan to serotonin or 5-hydroxytryptamine.
The physiological regulation of SNAT, with its sharp increase in activity at night, is considered the major regulatory step in melatonin synthesis. Its lipophilicity contributes to its easy passive diffusion across cell membranes as well as through cell layers. The 6-hydroxymelatonin is then conjugated and excreted in urine.
The stimulation of the sympathetic nerves on the pineal gland is strictly connected to the environmental light—dark cycle. Their activation leads to the inhibition of the adenylate cyclase with subsequent decrease of intracellular cyclic adenosine monophosphate which, in turn, provokes the inhibition of protein kinase A and of CREB protein phosphorylation.
The most commonly used circadian melatonin phase marker is the dim light melatonin onset DLMO. The present review aims to provide an overview of data published so far about the potential role of melatonin in affective disorders.
A selectively targeted literature review of English language studies was carried out. No time restrictions were placed on the electronic search covering the period up to January To be included in the review, studies were required to investigate the circadian melatonin pattern eg, its alterations in the affective disorders BD, MMD, or SAD.
All studies not focusing on these specific topics were properly excluded, including animal studies; studies referring to melatonergic drugs; studies on population without a diagnosis of an affective disorder; studies on pregnant women, healthy subjects, or subjects affected with comorbid organic pathologies eg, neuromuscular diseases ; studies focusing on jet lag, sleep disorders, or bright light therapy.
The search was performed independently by the authors. Data were compared and discrepancies were settled, if needed. Finally, data were then ranked in three macrocategories, eg, those pertaining to role of melatonin in MMD, those referring to BD, and, finally, those regarding SAD.
With the initial set of keywords, some 1, studies were identified. Out of the remaining studies, were excluded because they were duplicated or were not consistent with the aims of this review, leaving a total of 80 documents to be considered for inclusion in this review.
Table 1 Melatonin circadian pattern in MDD: Table 2 Melatonin circadian pattern in BD: Table 3 Melatonin circadian pattern in SAD: The role of melatonin in major depressive disorder Alteration of circadian rhythms in major depression, particularly unipolar depression, were first described more than 30 years ago.
In particular, the most consistent findings have been lower nocturnal melatonin levels, 53 — 5559 — 72 phase advance 6263707173 — 76 of melatonin onset 77 or peak, 6263 a delay in the peak, 727577 — 80 onset, 638182 or offset 78 of melatonin secretion, as well as a longer duration of aMT6s excretion.
The role of melatonin in bipolar disorder Chronobiological models have contributed to a better understanding of the pathophysiology of BD. Some studies reported phase disturbances 8286, in the melatonin secretion in BD whilst others reported no phase variations.A case study of a ten-year-old boy with refractory bipolar disorder demonstrated that melatonin treatment brought rapid relief in insomnia and also prevented a mania episode.
Continuing the treatment for 15 months reduced both insomnia and mania.
Case Study: The Use of Melatonin in a Boy With Refractory Bipolar Disorder. J Am Acad Child Adolesc Psychiatry.
; 36 (6): Anderson, G., Maes, M. Melatonin: an overlooked factor in schizophrenia and in the inhibition of anti-psychotic side effects. Metab Brain Dis. ; 27 (2): Morera-Fumero AL, Abreu-Gonzalez P.
The authors describe the clinical course of a year-old boy with bipolar disorder diagnosed at age 5 years. Lithium, carbamazepine, and valproic acid were ineffective or caused intolerable side.
Case study: the use of melatonin in a boy with refractory bipolar disorder - JM Robertson, PE Tanguay - Journal of the American Academy of Child & , - Elsevier [timberdesignmag.com] Case—control study of neurocognitive function in euthymic patients with bipolar disorder: an association with mania - JTO Cavanagh, M Van Beck, W Muir.
The function of melatonin is not fully established, but recent studies suggest that it plays a role in the regulation of sleep. Thus, physiological doses of melatonin given to healthy volunteers decreased the time taken to fall asleep,1 and the incidence of insomnia in the population rises during.
Apr 20, · Valproate in Bipolar Disorder: Case Examples From a Family Practice J. Sloan Manning, M.D. From the Department of Family Medicine, University of Tennessee, Memphis.