Melatonin
<p>From: 'Chronic Fatigue Syndrome, A Roadmap for Testing and Treatment' <a href="https://sites.google.com/site/cfstestingandtreatmentroadmap/home">https://sites.google.com/site/cfstestingandtreatmentroadmap/home</a>
before bed improves fatigue, concentration and motivation in ME/CFS.<a href="http://www.ncbi.nlm.nih.gov/pubmed/16420393" target="_blank" rel="nofollow" >1</a> </p>
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From: Reviving the Broken Marionette: Treatments for CFS/ME and Fibromyalgia
melatonin (Transzone, Circadin)
Melatonin is a hormone produced by the pineal gland with major effects on our circadian rhythm. It is a well–known sleep aid and used in the treatment of jet leg, but also much more than that. Though it can have side effects, it is one of the few medications that are actually good for you (in most cases). Some may find that melatonin puts them to sleep, but keeps them up at night. Different doses, slow–release preparations or the over–the–counter supplement inositol may help.
According to Dr. Andrew J. Wright over 60% of his patients with CFS/ME produce undetectable levels of melatonin.35 He prescribes a low dose of 0.5 mg, though most CFS/ME doctors use more, 3–9 mg. 3 mg is the standard dose, but the requirements appear to be highly individual—for some people 3 mg is too much and produces sedation the next day, yet others need more than that to even feel drowsy. Low doses of melatonin can sometimes be more effective than higher doses. Lucinda Bateman recommends a “pulse” treatment.36
For some reason studies of patients with CFS/ME and fibromyalgia have reported both high and low melatonin levels, but clinical efficacy has nonetheless been good. In one study melatonin improved the quality of life and functionality in CFS/ME.37 Another study found improvement in several parameters, including fatigue, using a 5 mg dose.38 A pilot study of melatonin for fibromyalgia found that melatonin not only significantly improved sleep but also pain and tender point count.39
Melatonin is a powerful antioxidant, anti–inflammatory and to some extent an immunostimulant.40 It can be useful in the treatment of immune system disorders, osteoporosis and even cancer.41 Melatonin both scavenges peroxynitrite and reduces the production of nitric oxide.42 It also has anticonvulsant action43 and increases the secretion of growth hormone.44 Not only is melatonin neuroprotective45,46, it also protects the mitochondria.47 All of these properties can be beneficial in
CFS/ME and fibromyalgia.
Melatonin has analgesic effects that appear to be mediated by increased secretion of beta endorphin.48 It can help prevent migraine and other headaches49 and ameliorate the symptoms of IBS.50 In one study melatonin helped 40% of patients with tinnitus, and when it was combined with the neuroleptic sulpiride, as many as 81% of the patients reported improvement.51
Melatonin does not cause tolerance or dependency. Some people may experience morning grogginess, which usually subsides with dose decrease. Tachycardia, tiredness, depression, headaches and orthostatic hypotension are possible but rare. Combining melatonin with an MAOI can lead to excessive sedation. Caffeine and fluvoxamine can elevate melatonin levels. There have been concerns that over–the–counter melatonin products may contain contaminants similar to those that caused the eosinophilia myalgia syndrome.52
Melatonin is available in most countries. Usually it is a prescription drug, but in the United States and Canada it is an over–the–counter supplement. Available dosages vary from 0.1 mg to 5 mg a pill. In some countries there are also over–the–counter products containing “homeopathic melatonin,” which contain insufficient quantities of the drug to be effective. Melatonin is generally inexpensive.
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