Epilepsy Talk

Epilepsy and Melatonin – Yes? No? Or Maybe So? | November 19, 2012


Most of us are familiar with melatonin and it’s purpose: To help you sleep. Or at least to help you get to sleep. In fact, melatonin is one of the most commonly used supplements in the United States. (Lots of sleepless people out there!)

Scientifically speaking, melatonin is a hormone synthesized from serotonin, the “feel good” hormone. It’s secreted from the pineal gland (a pea-sized gland, near the center of your brain) over an exact 24-hour cycle.

This cycle is an important part of our circadian rhythm, the system that regulates numerous body functions over a twenty-four hour cycle, the most obvious of which is the sleep / wake cycle.

Around bedtime, melatonin rises, so you feel sleepy. Then the secretion of melatonin falls during the night, and by morning, levels are low.

Sounds pretty good, doesn’t it?

But we haven’t introduced the epilepsy wild card. That’s where the yes…no…and maybe so…come in.

Why all the controversy? Because no one really wants to take up the gauntlet. You can’t patent melatonin (remember, it’s a natural hormone), therefore BIG Pharma has nothing to gain. As a result, clinical trials are few and far between.

But some brave souls have tried. Read the outcomes, (confusing though they may be).

YES.

It’s obvious why melatonin is important in epilepsy. Because inadequate sleep contributes to drowsiness during the day, memory problems and intractable seizures. The longer you go without adequate sleep, the greater your chances of increased or worsening seizures.

And epilepsy itself, or the antiepileptic drugs used to control epilepsy, may result in decreased melatonin levels, according to the results of a study published in the September 2010 issue of “Medical Science Monitor,” an international medical journal focusing on clinical and experimental research.

Here’s the good news: A pilot study was done to investigate melatonin’s effectiveness for treating sleep / wake cycle disturbances and the ability to decrease epileptic seizure frequency, with no long term side-effects.

The 10 patients were aged 9 to 32 years old and had intractable epilepsy. Patients were randomized to receive melatonin (10 mg daily at bedtime) followed by a placebo or a placebo followed by melatonin for 3 weeks each, with a 1-week washout period in between.

Seizure frequency was monitored by daily diaries, recordings and behavior and sleep patterns were rated by caregivers. Daytime seizures decreased significantly with melatonin compared with the placebo. No major side-effects or seizure aggravation was documented.

The scientists concluded that melatonin could be effective and safe for decreasing daytime seizure frequency in patients with intractable epilepsy.

Moreover, melatonin could significantly reduce your dose of antiepileptic drugs, and reduce their side-effects.

And it can be a potential adjunct to antiepileptic drugs, achieving a therapeutic effect at lower concentrations, therefore limiting their dose-related toxicities.

Also, melatonin supplements can have a direct anticonvulsant effect on photosensitive epilepsy and partial epilepsy. But without clinical trials, the actual usefulness of melatonin to treat seizures independently of its beneficial sleep effects is unknown.

NO.

Melatonin has been reported to exhibit antiepileptic properties in clinical trials. But, recent animal studies have demonstrated that melatonin can have the opposite effect on brain function, depending on the dose and timing of melatonin administration. (You knew there had to be a “but.”)

In other words, while high pharmacological doses are able to decrease brain excitability and suppress seizures, smaller doses of melatonin (administered at night when melatonin levels in the brain are highest), can actually increase the excitability of neurons, making them more susceptible to seizure activity.

This process may be involved with certain forms of nocturnal epilepsy. Thus, seizures can be a side-effect of melatonin.

And the relatively high doses of melatonin required to inhibit experimental seizures can also induce cognitive and motor impairments and decreased body temperature.

In addition, melatonin has been shown to cause EEG abnormalities in patients with temporal lobe epilepsy and increase seizure activity in neurologically disabled children.

The good news is that the hormone showed very low toxicity in clinical practice. The reported adverse effects (sleep disorders, nightmares and hypotension) were rare and mild.

However, more placebo-controlled, double-blind randomized clinical trials are needed to establish the usefulness of melatonin in the adjunctive treatment of epilepsy.

MAYBE SO.

The role of melatonin in seizure disorders is controversial. And so is the research. (That’s an understatement!)

Some researchers have suggested that melatonin may lower seizure threshold and increase the risk of seizures, particularly in children with severe neurological disorders. But then, multiple other studies actually report reduced seizures with regular melatonin use.  So you can see why it’s (very) confusing.

Side-effects of melatonin treatments in children haven’t yet been reported. And although test results are promising, once again, specific studies to resolve the problems of dosage, formulation, (slow or fast release) and length of treatment are necessary.

I’m sorry to sound like a broken record, but it seems like nobody really gives a hoot about melatonin except a small number of researchers and those of us who take it.

While it’s clear that it can’t and won’t replace our AEDs, it’s sure nice to get a good night’s sleep.

And if it’s friendly to your body chemistry and meds, without side-effects, that’s good news.

But before you buy and try, speak to your doc to see if melatonin might help or harm (or have no effect) on your AEDs and seizure activity.

Just because it works for me, doesn’t mean it’s the right answer for you. But I sure hope it can help. Because as far as I’m concerned, it’s a dream come true!

Another article of interest:

Melatonin May Aid in Migraine Prevention

http://www.medscape.com/viewarticle/781465

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Resources:

http://jcn.sagepub.com/content/early/2012/01/30/0883073811435916.abstract

http://www.livestrong.com/article/440335-melatonin-for-seizures/

http://curepages.com/cure-epilepsy-with-naturally-occuring-hormones-melatonin/

http://www.ncbi.nlm.nih.gov/pubmed/21441606

http://www.livestrong.com/article/517126-epilepsy-melatonin/

http://www.mayoclinic.com/health/melatonin/NS_patient-melatonin/DSECTION=evidence

http://medind.nic.in/icb/t05/i8/icbt05i8p687.pdf

http://www.ehow.com/facts_5004041_side-effects-melatonin-children.html

http://www.wellness.com/reference/herb/melatonin/dosing-and-safety

http://my.epilepsy.com/epilepsy/basic_science

http://www.lef.org/protocols/neurological/epilepsy_02.htm

http://www.res-medical.com/neuropathy/26307

http://www.hindawi.com/journals/ijped/2011/892624/

http://www.researchgate.net/publication/8629394_Modulation_of_antiepileptic_effect_of_phenytoin_and_carbamazepine_by_melatonin_in_mice


14 Comments »

  1. I take melatonin, it sure helps me to fall asleep, otherwise im awake most of night. My father suggested I try it.

    Comment by jennifer — November 19, 2012 @ 5:44 PM

  2. It sure does the trick for me. I’ve been taking it for years!

    Comment by Phylis Feiner Johnson — November 19, 2012 @ 6:34 PM

  3. It’s the amt. my Epileptologist told me. I take a lot of medication that is sedating. I use 1/4 dropper, of it if that amt. It knocks me out like a light. My sz meds, should have me sleepwalking but once in a while. I have trouble sleeping..

    Comment by Toni Robison — November 19, 2012 @ 6:59 PM

  4. Hi, I take 1 mg of Melatonin once in awhile when I cannot sleep. It works and it does not affect my epilepsy.

    Ruth

    Comment by Ruth Brown — November 19, 2012 @ 7:21 PM

  5. How fascinating – thanks for the info! I’ll talk to my dr about it.

    Comment by letizia — November 20, 2012 @ 4:47 PM

  6. Hope it’s of some help to you!

    Comment by Phylis Feiner Johnson — November 20, 2012 @ 6:51 PM

  7. I occasionally take 1mg capsule melatonin for extra deep sleep and feel pretty refreshed. I also find ear plugs as I’m sensitive to noise, dogs barking, cars, etc., and then an eye mask to block out any light coming into the room. Trying to get the best quality sleep possible, goodnight=)

    Comment by Aje — November 21, 2012 @ 3:26 AM

    • Sounds like you have all bases covered! :-)

      But you might want to consider upping your melatonin to 3mg. I know it works, at least for me, without any “hangover” or side-effects.

      Comment by Phylis Feiner Johnson — November 22, 2012 @ 11:00 AM

  8. The information would be great if the headings were clearer. Under ‘Yes’ does this mean studies indicate this information is indeed true? I believe that is what you mean. Under the heading ‘No’ do the findings indicate that the information is not true, or the studies are not valid? I’m not quite sure how to interpret the heading. For me, the headings are a bit confusing. The information is great so it would be helpful to know better how to interpret the great information that you provide.
    Thanks

    Comment by Carol — April 10, 2013 @ 10:43 AM

  9. The headline is meant to convey the fact that there are pluses and minuses to melatonin.

    For some, melatonin is a good thing. For others, it is detrimental.

    The article is meant to convey all aspects of the decision to take melatonin.

    Comment by Phylis Feiner Johnson — April 10, 2013 @ 11:01 AM

  10. My son is 12 and has moderate Autism, we started him on Melatonin a few yrs. ago. None of his Drs. objected to the use of it, a few months into it and he had his first seizure. I was told it(epilepsy) often coincides with those challenged with Autism. He was doing great on his meds and was seizure free for a yr, also I did not give him any Melatonin. Until he broke a tooth at school and was in horrific pain as a result of this and a few other dental issues. This continued for a year and half, all the while we continued the Melatonin regiment, he has started having what they call episodes and say this is something they often see in children like my son. His most recent EEG was a few weeks ago and his Dr. said it showed partial seizures before/now and now/also general seizures. I had suspected there might be a link to the Melatonin and after reading this, believe their is definitely a link. Whats so disturbing is that within the Autism community many people discuss using Melatonin for their children, however no one that I’ve heard from is pointing out the possible link to seizures. With so many children who have challenges taking Melatonin there needs to be some Drs. saying, ‘whoa hold up here maybe he/she shouldn’t be taking Melatonin.’ IDK, I’m not a Dr… I’m just a concerned parent trying to figure this out, but this is a great informative article. Thank you.

    Comment by Traci — May 27, 2013 @ 3:57 PM

  11. Thank YOU Traci for both your insight and advice!

    I don’t know if this is relevant to you Traci, but according to Science Daily, new research suggests that for children with autism, four anti-epileptic drugs: Depakene, Depakote, Eilim, (valproic acid), Lamictal, (lamotrigine), Keppra, (levetiracetam) and Zarotin (ethosuximide), were reported to most often reduce the number or lessen the severity of seizures.

    But on average, they had little positive or negative effect on the other symptoms of autism.

    http://www.sciencedaily.com/releases/2011/06/110602162822.htm

    Comment by Phylis Feiner Johnson — May 27, 2013 @ 4:18 PM


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    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I've also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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