AUTHOR=Palagini Laura , Manni Raffaele , Aguglia Eugenio , Amore Mario , Brugnoli Roberto , Bioulac Stéphanie , Bourgin Patrice , Micoulaud Franchi Jean-Arthur , Girardi Paolo , Grassi Luigi , Lopez Régis , Mencacci Claudio , Plazzi Giuseppe , Maruani Julia , Minervino Antonino , Philip Pierre , Royant Parola Sylvie , Poirot Isabelle , Nobili Lino , Biggio Giovanni , Schroder Carmen M. , Geoffroy Pierre A.
TITLE=International Expert Opinions and Recommendations on the Use of Melatonin in the Treatment of Insomnia and Circadian Sleep Disturbances in Adult Neuropsychiatric Disorders
JOURNAL=Frontiers in Psychiatry
VOLUME=12
YEAR=2021
URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.688890
DOI=10.3389/fpsyt.2021.688890
ISSN=1664-0640
ABSTRACT=Introduction: Insomnia and circadian rhythm disorders, such as the delayed sleep phase syndrome, are frequent in psychiatric disorders and their evaluation and management in early stages should be a priority. The aim of this paper was to express recommendations on the use of exogenous melatonin, which exhibits both chronobiotic and sleep-promoting actions, for the treatment of these sleep disturbances in psychiatric disorders.
Methods: To this aim, we conducted a systematic review according to PRISMA on the use of melatonin for the treatment of insomnia and circadian sleep disorders in neuropsychiatry. We expressed recommendations for the use of melatonin in psychiatric clinical practice for each disorder using the RAND/UCLA appropriateness method.
Results: We selected 41 studies, which included mood disorders, schizophrenia, substance use disorders, attention deficit hyperactivity disorders, autism spectrum disorders, neurocognitive disorders, and delirium; no studies were found for both anxiety and eating disorders.
Conclusion: The administration of prolonged release melatonin at 2–10 mg, 1–2 h before bedtime, might be used in the treatment of insomnia symptoms or comorbid insomnia in mood disorders, schizophrenia, in adults with autism spectrum disorders, neurocognitive disorders and during sedative-hypnotics discontinuation. Immediate release melatonin at <1 mg might be useful in the treatment of circadian sleep disturbances of neuropsychiatric disorders.