Question: Melatonin for ADHD?
11 Jan, 08 | by Bob Phillips
Does melatonin improve sleep pattern in children with Attention Deficit Hyperactivity Disorder?
Adam is an 8 year old boy with Attention Deficit Hyperactivity Disorder (ADHD) who you see with his mother in your paediatric outpatient clinic. She explains that life is being made increasingly stressful for the whole family as Adam is having difficulty getting off to sleep. It often takes him several hours to calm down and go to sleep, and the day after he gets angry and seems to be tired all the time. She has seen a recent TV programme that suggested that melatonin may be helpful for children with ADHD.
Are the television producers correct? If melatonin is prescribed for Adam, will it be harmful or helpful in improving his sleep?
Sarah Snowden, SpR inYorkshire, has asked this question and searched for a good quality answer. Melatonin certainly seems to help people go to sleep, in my experience, but so does a warm malted milk drink, and watching Neighbours. Is Melatonin any better than placebo, or a homeopathic tablet?
As always, comments and debate welcome.
Acknowledgement. Image taken from Phillipe Rahm’s architectural exhibition - a room designed to stimulte maximum endogenous melatonin production. Visit here to read more.
Not sure how it is for ADHD but I have a son with Autism and
it has been amazing. He usually falls asleep within 30 mins of
taking it. Before it would take 2-4 hours.
Kevin
January 12th, 2008 at 7:13 am
An article just published in the Feb 2007 Journal of the American Academy of Child and Adolescent Psychiatry examines the roll of melatonin in ADHD children with “chronic sleep onset insomnia”. Children in the study were ages 6-12, taking either 3mg or 6mg of melatonin depending on body weight. Results showed that melatonin helped kids both fall asleep sooner and stay asleep longer. Give the melatonin half an hour before bedtime. Most kids like the orange flavored type, some unflavored brands taste chalky.
Recent research also shows that the glowing screen of TV and possibly computers depresses melatonin production, so should be minimized, particularly in the hours leading up to bedtime.
Kids who have consistent, calming bedtime routines and set schedules also fall asleep more easily, including kids with ADHD.
Dr. Laura Markham
January 12th, 2008 at 6:25 pm
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Question: Melatonin for ADHD? at adhd advice.net
January 14th, 2008 at 5:24 pm
My own 10 year old with ADHD had a really bad reaction to by mouth melatonin - she went to sleep fine, but her body doesn’t seem to break it down again effectively and by 3 - 4.30 the next day, she would look desperately ill (huge black circles under eyes) and feel very low and run down. After a seasonal pattern (over 3 years) emerged in her ADHD, with winter much worse, we invested in a SAD light,and was able to reduce her Ritalin by 1/3. I don’t think we know enough about the way this stuff works to mess with it too much!
sandiehobley
January 16th, 2008 at 6:33 pm
There are surely two additional issues here:
- is there evidence of harm, in the context of the testimonial type of evidence from parents here and elsewhere
- can UK (or other) paediatricians be in a position to make a fixed recommendation about a “medicine” which is not properly regulated - ie there are a variety of forms available for purchase, with differing bio-availability and thus efficacy. Some parents I’ve talked with talk of accidental swaps from “real” melatonin to “diet” melatonin - although of course the packing doesn’t mention either of these; you just get pot luck. I mean, imagine recommending paracetamol to parents to treat their children’s headaches if you didn’t know exactly what the child would be getting in terms of dose and therefore presumed effect.
Ian Wacogne
January 23rd, 2008 at 10:05 am
The article is definitely interesting and important in day to day practice especially in community. Unfortunately melatonin is not classed as a drug in USA and is not licensed in UK. So this is imported from USA. Nobody knows who makes melatonin and how is is prepared. To add to this as it is not a drug therefore it is unlikely to have various studies looking at the effectiveness, side effects etc. Clinicians should be careful in prescribing melatonin and it should be explained to the parents / carers that this is not a sleeping pill.
Dr Somnath Banerjee
March 20th, 2008 at 8:16 pm
Hello all parents with children with ADHD and sleep disorders. I am an Occupational Therapist and also a mom of a child who had ADHD and Sensory Issues. I have had several mom’s tell me that Melatonin has changed their children drastically. So I finally decided to try it with my own child. We have been using it for only two weeks now and I am pleasantly surprised! She is only about 40 pounds so we are only giving her a half of a milligram, about an hour before we want her to go to bed.
It used to take her sometimes two hours to fall asleep, jumping on the bed, talking…… Tonight, she told me ” I do not want to watch TV or a book.” “I am tired”! I said WOW! She was out in five minutes.
The best part is that she seems better in the daytime as well. Less cranky when I wake her up in the AM. A better attitude and much more tolerable.
Luckily we have not seen any side effects. We started by giving her a small dose!
For more information about children with ADHD and sensory issues please visit my website!
http://www.sensationalsensorykids.com
Shelby
MissGrand
May 17th, 2008 at 3:47 am
I note all the comments on melatonin use with interest. I started using it 4 years ago,in a teenager with a chromosomal deletion and sleeping problems. He has been on a decreasing dose(having started it on 10 mgs) with very good effects. Currently he is on 1 mg at night.No one else at work had any experience of using it.It was started after a lengthy discussion with the family and other colleagues.It would have been very useful to have some evidence base for this but so far i haven’t come across anything.
shyla jehangir
July 7th, 2008 at 12:13 pm
Im rather surprised there have not been more comments from parents with children diagnosed with ADHD, as melatonin is quite often used in the UK for sleep problems from what I hear.Our son (12) has been using melatonin for a number of years, now at a 3mg long acting dose, without any problems or side effects.
GregB
September 7th, 2008 at 10:33 pm
Melatonin has seemed very effective for a number of children I know who have been prescribed this drug/dietary supplement (depending on which side of the Atlantic you live.)As it is “off label” it is one of the very few prescriptions I have to write up on a regular basis (GPs tend to write most repeat prescriptions)and it seems many parents are very happy with the results in “normalising” sleep pattern. I have also seen children with ADHD like behaviour who have benefited from Melatonin, and sometimes quite dramatically, with improved school performance. However it is not a panacea, and should be used with other methods to improve sleep pattern. I am pleased to say that a clinical study is currently underway in the UK.
Dr Mark Bagott
January 21st, 2009 at 4:00 pm
Hi.Melatonin has really worked for my 10 year old child.
He has been diagnosed with Dyspraxia {OCD] possibly Aspergers.His dad’s side of the family has various language disabilities i.e. Dyslexia but are still well paid professionals.
My side of the family has a history of Biopolar Disorder with Dyspraxia and ADHD in early childhood.Our I.Q.’s are great[ish]but our ability to lead normal lives has been diminished.
None of this was relevant until our beautiful wee boy started school.Then the problems kicked in.
In short…the not sleeping at night could no longer be solved by night-time massages,meditation C.D.’s and stories.He literally bounced of walls,much to our neighbours frustration.
Whoah!…that imagination.The stories going on inside his head that I was too tired to listen to.
With much trepidation[bad spelling sorry]I decided to try Melatonin.My husband and I had long split up[he doesn't agree]but it worked.
These poor wee things do benefit from this drug It’s lovely to see him drift of to sleep like a ‘normal’child.
It may not work in every case but I certainly would recommend it.
J.Alexander
Jane Alexander
August 4th, 2009 at 3:00 am