What is melatonin?
Melatonin is a natural hormone that regulates the sleep/wake cycle. When children have a
disturbed sleep cycle, melatonin can help restore a more natural sleep pattern. Melatonin tablets
work best in combination with good night-time routines. They are not intended to be a long-term
treatment.
Who needs melatonin?
Melatonin is mainly used for children with cerebral palsy, Attention Deficit Hyperactivity Disorder
(ADHD), autism, learning disabilities or visual impairment. Only specialist paediatricians and
psychiatrists can initiate treatment and prescribe for the first few months of treatment. The
prescribing may then be transferred to your GP. The specialist will review the continued need for
melatonin every six months. Attempts will be made to wean your child off melatonin once a good
sleep routine is established or if melatonin is no longer considered effective.
What form of melatonin will be supplied?
Melatonin is available as a modified-release tablet called Circadin®. However, this is licensed for
use only in people aged over 55. This does not mean that it is unsafe to use Circadin® in younger
people, just that the manufacturer has not applied to the Medicines Healthcare Products
Regulatory Agency for a licence. Many medicines are not licensed for use in children but are
considered safe and effective. There is much evidence to support the use of melatonin in younger
people. The specialist will give you a prescription for Circadin®. Repeat prescriptions for Circadin®
will continue to be supplied by the specialist until such time as it is considered appropriate for your
GP to take over the prescribing.
If the modified-release tablets are not suitable for your child then the specialist may prescribe
alternative forms. These are not easily available from your local chemist and will be supplied from
the pharmacy at Prospect Park Hospital. Supplies can be collected from there or sent to you in the
post.
How does my child take melatonin?
Circadin® tablets should normally be swallowed whole with a glass of water one to two hours
before bedtime. This is because they are modified (slow) release tablets which mean that the
melatonin is released over a period of time. Depending on the dose prescribed, you may need to
cut the tablets in half. Tablet-cutters are available from your chemist. Halving the tablets will not
destroy their slow-release properties. If your child has problems swallowing tablets or the specialist
wants a more immediate effect, you will be advised to crush the tablets and give with a spoonful of
milk or yoghurt. Crushing Circadin® tablets means that they will work more quickly as the slowrelease properties are destroyed. Crushed tablets should be given earlier - 30 minutes before
bedtime.
What side effects are there from melatonin?
Melatonin is generally well tolerated but long term side effects have not been evaluated. The most
common side effects reported are headache, nausea, dizziness and abnormal dreams. Rare side
effects which should be reported to your doctor include an increased heart rate and changes in fit
pattern in a child who has epilepsy.
How can I boost melatonin naturally?
Exposure to strong light in the morning and low lighting in the evening can help improve melatonin
production at night. Foods that are rich in melatonin or help the body to boost melatonin production
and include: apples, bananas, barley, beans, bread (particularly wholemeal), breakfast cereals with
milk, cheese (cottage, cheddar and parmesan), chicken, eggs, fish (cod, canned salmon and
sardines)
Adapted from: Melatonin, Information for patients and carers. Cambridgeshire and Peterborough NHS Foundation Trust