Psychiatrists' Use of Melatonin with Children

Melatonin is gaining popularity as a sedative agent with children. This study sought to characterise this practice more precisely as well as examine aspects of its safety and efficacy in order to develop treatment guidelines.

Postal surveys of two groups of psychiatrists: generic child psychiatrists and psychiatrists who regularly treat learning disabled children.

Both groups (all of the specialists and 81% of the non-specialists) reported regular but not frequent use of melatonin in their usual practice, mostly for night-settling sleep problems refractory to behavioural modification strategies, commonly in the context of neurodevelopmental disability (especially autism). Treatment was described as being 'usually successful' and side-effects were highly infrequent and mild in nature. Variations in most prescribing practices were identified (dosage, timing).

Melatonin appears to represent a useful and relatively safe drug when used in specific circumstances; however, the evidence-base underpinning its use, particularly over the long-term, remains modest. Thus caution and clinical audit of practice is required.