In our never-ending quest fora restful night’s sleep, melatonin often presents itself as a promising solution. Produced naturally by the pineal gland, this essential hormone orchestrates our body’s circadian rhythm, regulating our sleep and wake cycles. The growing interest in melatonin as a potential treatment for sleep disorders has prompted a great deal of discussion and research, particularly into its interactions with other drugs, its use in pregnant women, and its effectiveness in managing night-time awakenings.
Finally, in this article we address the crucial question of whether it is safe to take melatonin and sleeping pills at the same time
Drug interactions and precautions to be taken with melatonin
Although melatonin is a natural hormone, it is not free from potential drug interactions. In fact, there are over 300 possible interactions with different drugs. These interactions may be particularly notable with alcohol or other drugs that induce drowsiness or dizziness. The concomitant use of melatonin with these substances should be approached with caution, or even avoided.
Medicines that may interact with melatonin
- Sedatives and hypnotics Benzodiazepines: Commonly used to treat anxiety and sleep disorders, these drugs may increase the sedative effect of melatonin.
- Sedative antihistamines: Drugs such as diphenhydramine (Benadryl) are known to cause drowsiness and may interact with melatonin.
- Opioid analgesics: Used to treat pain, these drugs can also increase the sedative effects of melatonin.
- Muscle relaxants: These drugs, often prescribed to relieve muscle spasms, may increase the drowsiness induced by melatonin.
- Other Herbs and Supplements : Certain supplements such as 5-HTP, kava, and St. John‘s Wort may also increase sedation when taken with melatonin.
Risk of cognitive and coordination problems
The elderly must be particularly vigilant when using melatonin. This population may experience impaired thinking, judgement and motor coordination.
Risk of bleeding
Melatonin may interact with anticoagulants such as warfarin, potentially increasing the risk of bleeding. It is essential to consult a doctor before combining melatonin with warfarin or other blood-thinning drugs.
Signs and symptoms of bleeding to watch out for when taking Melatonin with other treatments
- Unusual bleeding or bruising: An increased tendency to bleed may be a sign of drug interaction.
- Dizziness or Vertigo: These symptoms may indicate an increased risk of internal bleeding.
- Black or tarry stools: This may indicate bleeding in the gastrointestinal tract.
- Coughing or vomiting blood: The presence of blood resembling coffee grounds in vomit may be a sign of internal bleeding.
- Severe Headache: An unusual or severe headache may be a sign of cerebral haemorrhage.
- General Weakness: Sudden weakness may indicate severe internal bleeding.
Which medicines affect the action of melatonin?
Melatonin, although beneficial for regulating sleep, requires particular care when taken in conjunction with certain medications. These interactions can not only affect the effectiveness of melatonin, but also increase the risk of side effects.
Medications affecting the sedative effect of melatonin
It is important to note that many medicines can intensify or reduce the sedative effects of melatonin. This is why, before taking melatonin, it is essential to inform your doctor or pharmacist if you are taking any of the following medicines:
- Antidepressants: Drugs such as fluvoxamine or amitriptyline can interact with melatonin.
- Benzodiazepines: Medicines such as temazepam (for insomnia) or diazepam (for anxiety or muscle pain) may increase the sedative effect of melatonin.
- Hypotensive medicines: These medicines, used to lower blood pressure, may interact with melatonin.
- Non-steroidal anti-inflammatory drugs (NSAIDs ): Drugs such as ibuprofen, naproxen or diclofenac can affect the effectiveness of melatonin.
- Oestrogens: Used in contraceptives and hormone replacement therapy (HRT), these hormones can alter the effectiveness of melatonin.
- Opioids: Analgesics such as codeine or morphine, used for pain control, may increase the sedation induced by melatonin.
- Psoralens: Prescribed for skin disorders such as psoriasis, these drugs may interact with melatonin.
- Quinolones and Rifampicin: Types of antibiotics that can affect the effectiveness of melatonin.
- Carbamazepine: Used for epilepsy, this medicine can reduce the effectiveness of melatonin.
- Cimetidine: Prescribed for stomach problems such as ulcers, this medicine can affect melatonin metabolism.
- Thioridazine: Used for schizophrenia, this drug can interact with melatonin.
- Warfarin: An anticoagulant which may increase the risk of bleeding if it interacts with melatonin.
- Zaleplon, Zolpidem or Zopiclone: Drugs for insomnia which may increase the sedative effects of melatonin.
Use of melatonin in the treatment of sleep disorders
Melatonin, commonly known as the sleep hormone, plays a key role in regulating the sleep-wake cycle. Its use in the treatment of sleep disorders has grown in popularity. Not least because of its less invasive nature compared with traditional sleeping pills.
Is melatonin more effective than a sleeping pill?
The effectiveness of melatonin in treating sleep disorders is well documented. Moreover, it has proved particularly useful in specific cases. Examples include jet lag, circadian rhythm disorders and sleep disorders associated with shift work. Melatonin helps to resynchronise the body’s internal biological clock, making it easier to fall asleep at more conventional times.
Melatonin can also be beneficial for people suffering from insomnia. This is particularly true of the elderly, where the natural production of melatonin tends to decline. Its use can oftenimprove sleep quality and reduce the time it takes to fall asleep.
Sleep aid or melatonin, which should you choose?
Melatonin is generally considered to have fewer side effects than conventional sleeping pills. Sleeping pills, such as benzodiazepines or non-benzodiazepines, work by suppressing the activity of the central nervous system to induce sleep. This can often lead to dependence and side effects. These include daytime sleepiness, cognitive impairment and even poorer quality sleep.
Melatonin, on the other hand, works in harmony with the body’s natural rhythm. It is not addictive and the risk of serious side effects is relatively low. What’s more, unlike many sleeping pills, melatonin generally has no residual sleepiness the next day.
Can I take melatonin and a sleeping pill at the same time?
The combined use of melatonin and sleeping pills, such as benzodiazepines, in the treatment of sleep disorders is the subject of research and analysis in the medical field. According to a systematic review and meta-analysis published on PubMed, taking melatonin showed no significant effect on the ability of participants to stop using benzodiazepines. Secondly, the impact of melatonin on sleep quality was inconsistent. It is important to note that these results do not completely rule out the potential role of melatonin in improving benzodiazepine discontinuation or sleep quality, due to imprecise effect estimates. Larger, better designed and reported randomised controlled trials could provide more valid and precise estimates of the effect of melatonin on these outcomes.
Can melatonin be taken with prescription treatments?
Another study (3) comparing melatonin and zolpidem, a drug commonly used to treat insomnia, found that there were no significant differences in patients’ perception of sleep, sleep efficiency, sleep disturbance or side effects between the two groups. This study indicates that melatonin could be a viable alternative to zolpidem for certain patients, although further research is needed to confirm these results.
Finally, one study (2) explored the potential beneficial effects of the combined use of melatonin and morphine. It was found that the use of melatonin with morphine can reduce morphine-induced tolerance and hyperalgesia, thanks to its anti-inflammatory and antioxidant properties. This combination could be advantageous for improving patients’ quality of life and managing their pain in a variety of pathological conditions.
These studies highlight the importance of individual assessment by a healthcare professional before mixing melatonin with sleeping pills or other drugs. This is due to the complexity of possible interactions and the variable effects on different individuals.
Short-term vs long-term use of melatonin
The use of melatonin, a natural sleep-regulating hormone, varies according to whether it is used on a short-term or long-term basis. Its safety and efficacy depend on the duration of use and the individual characteristics of each user.
Short-term use
Most adults generally consider short-term use of melatonin to be safe. It is frequently used to remedy specific sleep problems. Examples include jet lag or sleep disorders associated with shift work. Its recommended period of use is generally short, ranging from a few days to a few weeks. In these cases, melatonin can be useful in helping to realign the natural rhythm of sleep.
Long-term use
On the other hand, long-term use of melatonin can present additional challenges and risks. Although there is no clear consensus on the long-term safety of melatonin, some experts suggest that prolonged use could reduce its effectiveness and impact the body’s natural production of melatonin. The long-term effects of melatonin on hormonal processes, such as puberty and the menstrual cycle, are still poorly understood. These aspects continue to be actively studied as part of scientific research. It is therefore essential to seek the advice of a health professional before starting any prolonged treatment with melatonin. This precaution is all the more important if you are taking other medications or suffering from certain medical conditions.
Recommendations for responsible use of melatonin
- Medical consultation. Before starting any melatonin treatment, whether short- or long-term, it is vital to consult a healthcare professional to assess its suitability for your particular situation.
- Dosage. Adapt the dosage of melatonin to the individual and the sleep problem encountered, starting with the lowest possible dose and adjusting it if necessary.
- Monitoring side effects. Although the side effects of melatonin are generally mild, it is important to watch out for any unusual reactions, such as headaches, dizziness or nausea.
- Beware of Drug Interactions. Melatonin can interact with certain drugs, such as anticoagulants, epilepsy medication, contraceptives, diabetes medication and blood pressure medication.
- Needs assessment. Instead of turning directly to melatonin, it may be beneficial to first examine the underlying causes of insomnia, such as anxiety or medication side-effects, and consider lifestyle changes or cognitive behavioural therapies.
Can melatonin be used for long periods?
In conclusion, melatonin, secreted naturally by the pineal gland, is essential for regulating our circadian rhythm and is crucial in the treatment of various sleep disorders, including frequent waking during the night. Although the pineal gland is the main site of production, melatonin can also be synthesised elsewhere in the body, such as in the skin and gastrointestinal tract, where it exerts its action in an autocrine or paracrine manner. However, these other sources of melatonin have a limited impact on its levels in the blood, as levels become almost undetectable after removal of the pineal gland. According to Vidal, regulations in France allow online pharmacies to market food supplements providing less than 2 mg of melatonin per day.
Melatonin is available without prescription in various forms, including tablets, oral solutions, gummies and sprays, with immediate or prolonged release options. Its metabolism takes place mainly in the liver, and its half-life varies between one and two hours, depending on the formulation. Its bioavailability fluctuates widely, making it difficult to define an optimal dosage. The doses used in studies generally range from 0.1 to 10 mg, to be taken up to two hours before bedtime.
Can sleeping pills and melatonin be combined?
As to whether melatonin and sleeping pills can be taken at the same time, it is important to note thatno addiction to melatonin has been observed. However, caution is advised when melatonin is combined with benzodiazepines or zolpidem. This is because of the risk of excessive sedation.
For pregnant women, melatonin should not be used in the absence of sufficient evidence of its safety.
In short, it is essential to consult a health professional before starting any treatment. Especially if used for long periods or in combination with other medications. Research continues to reveal its role and impact on sleep and other aspects of health.
References:
- Avis de l’Anses relatif aux risques liés à la consommation de compléments alimentaires contenant de la mélatonine
- Fundam Clin Pharmacol. 2021 Feb;35(1):25-39. doi: 10.1111/fcp.12566. Epub 2020 Jun 21.
Melatonin and morphine: potential beneficial effects of co-use - J Pharm Pract. 2021 Feb;34(1):44-50. doi: 10.1177/0897190019851888. Epub 2019 Jun 25.
Comparison of Melatonin and Zolpidem for Sleep in an Academic Community Hospital: An Analysis of Patient Perception and Inpatient Outcomes - Drugs Aging. 2015 Dec;32(12):1009-18. doi: 10.1007/s40266-015-0322-5.
The Effect of Melatonin on Benzodiazepine Discontinuation and Sleep Quality in Adults Attempting to Discontinue Benzodiazepines. A Systematic Review and Meta-Analysis
