Melatonin (5-methoxy-N-acetyltryptamine): powerful antioxidant that treats abnormalities in sleep-wake cycle, jet lag, cancer, and Parkinson’s disease. Epileptic children have a higher incidence of sleep problems; epilepsy is exacerbated by sleep deprivation. Melatonin has antiepileptic activity. Mechanism may be antiexcitotoxic neuroprotection achieved by lowering lipid peroxidation and raising coenzyme Q10 within the central nervous system. In children aged 3 to 12 years seizure free on sodium valproate (10 mg/kg/day) for 6 months, fast-release 3-mg melatonin tablet 1 hour before bedtime improved attention, memory, language, anxiety, behavior, and other cognitive processes. Very high doses (up to 300 mg/day)are well tolerated in adults; slowly increasing dose beyond 3 mg gives better results.
Melatonin • Hormone manufactured from serotonin and secreted by the pineal gland. • Powerful antioxidant and treatment option for jet lag, sleep problems, and cancer. • May be protector of neuronal cells by supporting mitochondrial function and preventing apoptosis. • Directly scavenges oxidants produced during the normal metabolism and indirectly promotes activity of antioxidant enzymes SODandcatalase. • Increases activities and expression of electron transport chain complexes. Melatonin increases ATP production and promotes GSH homeostasis. It may interact with the mitochondrial genome to enhance production of proteins. Melatonin may help prevent neuronal apoptosis. • Theoretically, melatonin may actually exacerbate symptoms because of its putative interference with dopamine release. However, most studies agree that PD is caused by multiple issues of compromised mitochondrial activity in substantia nigra and loss of GSH, oxidative damage, and increased apoptosis. Clinical studies are needed to evaluate efficacy in PD. If melatonin is used, start with low dose (1 to 5 mg); gradually increase, and carefully monitor symptoms.