Melatonin treatment improves primary progressive multiple sclerosis: a case report

Abstract

We describe the case of a female patient who, at the age of 28, was diagnosed with symptoms of primary progressive multiple sclerosis (PPMS). Glucocorticoid treatment was immediately initiated. The disease and the demyelinating lesions progressed during the following 9 years reaching Expanded Disability Status Scale (EDSS) 8.0 (patient essentially restricted to bed, a chair or perambulated in a wheelchair). At this point, the patient began taking melatonin at doses ranging from 50 to 300 mg per day. Melatonin was her only treatment for the next 4 years; during this interval, her EDSS progressively recovered to 6.0 (the person needs intermittent or unilateral constant assistance such as cane, crutch, or brace to walk 100 meters with or without resting). This long-lasting improvement is likely due to melatonin usage since it is related in time and because of its exceptionally long duration.

Melatonin controls experimental autoimmune encephalomyelitis by altering the T effector/regulatory balance

“…Further work is needed to investigate the role of exogenous melatonin in Treg activity in the periphery and CNS, as well as the microenvironment where immunogenic cells are generated and the inflamed sites. In conclusion, according to the present and recently described (Lopez-Gonzalez et al, 2015) results we believe that a placebo-controlled study with high doses of melatonin in patients diagnosed with MS would seem to be in order.…”

“…These data suggest that melatonin may represent a possible therapeutic strategy in MS by two approaches. On one hand, our results regarding daily treatment with melatonin, together with other results recently described (Lopez-Gonzalez et al, 2015) might suggest that melatonin administration starting at MS diagnosis could be beneficial as a prophylactic treatment. On the other hand, the therapeutic action of melatonin in EAE points out a possible use of melatonin, on its own or in combination with corticosteroids, in the amelioration of the acute inflammatory exacerbations typically observed in the relapse phases of the MS.…”

“…Moreover, mutations in enzymes implicated in melatonin synthesis and in melatonin receptors are associated with an increased risk of progressive MS (Natarajan et al, 2012). Recently, we have also reported that oral administration of melatonin improved disability in a patient with the most aggressive form of the disease, primary progressive MS (Lopez-Gonzalez et al, 2015).…”

Assessing the efficacy of melatonin to curtail benzodiazepine/Z drug abuse

“…In a recent case report on a patient with primary progressive multiple sclerosis followed for 4 years with the only administration of 50 to 300 mg of melatonin per day a partial recovery of the disease was documented [134].…”

Western lifestyle and immunopathology of multiple sclerosis

“…demonstrated that melatonin can directly bind to T cells via melatonin receptor type 1A and interfere with T H 17 and IL‐10–producing T r 1 cell differentiation, thus boosting levels of T r 1 cells while suppressing the generation of T H 17 cells 191. However, so far, only one case report of a female MS patient was published in which melatonin was used as the only treatment for MS for 4 years, and the disability status improved by two points from Expanded Disability Status Scale (EDSS) 8 to EDSS 6 193. Overall, most published reports on sleep and circadian disruption in MS patients are descriptive in nature and cannot causally link the disruption to the pathogenesis.…”