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Combination Therapy With Risperidone and High-Dose Melatonin Is Effective Despite Reversible Side Effects Including

Akihiro Nakamura1

  • 1Pediatrics, Child and Parents Support Clinic, Ebina, JPN.

Cureus
|December 30, 2024
PubMed

Insights

High-dose melatonin, used for sleep disorders, may cause reversible breast budding in children. Clinicians should monitor for this side effect and adjust melatonin dosage as needed.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Pharmacology

Background:

  • Melatonin is widely prescribed for sleep disorders.
  • Melatonin is known to elevate prolactin levels.
  • Breast budding is not a recognized side effect of melatonin treatment.

Observation:

  • A 10-year-old boy with restlessness and sleep disorders was treated with risperidone and melatonin.
  • The patient developed breast budding after one month of high-dose melatonin (4 mg/day).
  • Symptoms resolved after discontinuing melatonin.

Findings:

  • High-dose melatonin administration, in conjunction with risperidone, may induce breast budding in pediatric patients.
  • The observed breast budding was reversible upon melatonin discontinuation.
  • Melatonin treatment improved daytime concentration but not complete resolution of nighttime awakenings.

Implications:

  • Clinicians should be aware of the potential for melatonin-induced breast budding in children.
  • Careful dosage adjustment and monitoring are recommended when prescribing melatonin for pediatric sleep and behavioral issues.
  • This case highlights the importance of considering medication side effects even when they are not commonly reported.

Keywords:
breast buddingmelatoninprolactinrestlessnessrisperidonesleep disorders

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