Melatonin as add-on treatment for epilepsy

Area of Science:

• Neurology
• Pharmacology

Background:

• Epilepsy affects many individuals, with 30% experiencing uncontrolled seizures despite available antiepileptic drugs (AEDs).
• Current polytherapy for refractory epilepsy can lead to adverse effects, highlighting the need for better-tolerated treatments.
• Melatonin has been suggested as a potential antiepileptic agent with a favorable safety profile.

Purpose of the Study:

• To evaluate the effectiveness and tolerability of melatonin as an adjunctive therapy for epilepsy.
• To synthesize evidence from randomized controlled trials on melatonin's role in seizure management.

Main Methods:

• Searched multiple databases (Cochrane, CENTRAL, MEDLINE) and contacted manufacturers for relevant studies up to January 2016.
• Included randomized controlled trials (RCTs) of any design comparing melatonin add-on therapy to placebo in individuals with epilepsy.
• Assessed outcomes including seizure reduction, seizure freedom, adverse events, and quality of life.

Main Results:

• Six studies with 125 participants were included; most were pediatric.
• Insufficient data prevented meta-analysis; narrative summary showed no significant change in seizure frequency compared to baseline.
• Limited reporting on adverse events (headache worsening) and no significant improvement in quality of life was observed.

Conclusions:

• The included studies exhibited poor methodological quality, hindering robust analysis.
• Insufficient evidence exists to conclude on melatonin's efficacy for seizure reduction or quality of life improvement in epilepsy.
• Further high-quality research is required to determine melatonin's role in epilepsy treatment.