Epilepsy Talk

Epilepsy and Melatonin – Yes? No? Or Maybe So? | October 20, 2021

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 “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 inhibit 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!

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Resources:

https://www.mayoclinic.org/drugs-supplements-melatonin/art-20363071

https://www.healthline.com/health/melatonin-and-epilepsy

https://www.nestmaven.com/sleep/health-benefits-melatonin/

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

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

https://clinicaltrials.gov/ct2/show/NCT03590197

https://www.verywellhealth.com/melatonin-benefits-uses-tips-and-more-89808

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

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

https://www.healthline.com/health/melatonin-and-epilepsyhttps://10faq.com/health/melatonin-side-effects/?utm_source=google&utm_campaign=701-717-3049-1362493182&utm_medium=cpc&utm_content=57235675351&utm_term=%2Bmelatonin&gclid=Cj0KCQjwtrSLBhCLARIsACh6RmiR_XZEk3OS6LwC25aS3OKxUOXz82BQgJuZREMtwrZEL0lGucofbzIaAv3gEALw_wcB

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