Optimal Melatonin Dose in Older Adults: A Clinical Review of the Literature

Pierce, Mackenzie; Linnebur, Sunny A.; Pearson, Scott M.; Fixen, Danielle R.

doi:10.4140/tcp.n.2019.419.

Cited by 5 publications

(2 citation statements)

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“…Melatonin also causes positive effects on other physiological processes, such as for example bone formation, body mass regulation, reproduction, regulation of immune system and cardiovascular system, as well as it serves as a pharmacological agent [28]. Doses between 1 mg and 6 mg appear to be effective for improving sleep in older adults [29]. In clinical trials investigating anxiety, melatonin in doses varied from 3 to 10 mg probably reduced preoperative anxiety in adults, which is potentially clinically relevant [30].…”

Section: Introductionmentioning

confidence: 99%

Cumulative Protective Effect of Melatonin and Indole-3-Propionic Acid against KIO3—Induced Lipid Peroxidation in Porcine Thyroid

Iwan

Stępniak

Karbownik-Lewińska

2021

Toxics

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Iodine deficiency is the main environmental factor leading to thyroid cancer. At the same time iodine excess may also contribute to thyroid cancer. Potassium iodate (KIO3), which is broadly used in salt iodization program, may increase oxidative damage to membrane lipids (lipid peroxidation, LPO) under experimental conditions, with the strongest damaging effect at KIO3 concentration of ~10 mM (corresponding to physiological iodine concentration in the thyroid). Melatonin and indole-3-propionic acid (IPA) are effective antioxidative indoles, each of which protects against KIO3-induced LPO in the thyroid. The study aims to check if melatonin used together with IPA (in their highest achievable in vitro concentrations) reveals stronger protective effects against KIO3-induced LPO in porcine thyroid homogenates than each of these antioxidants used separately. Homogenates were incubated in the presence of KIO3 (200; 100; 50; 25; 20; 15; 10; 7.5; 5.0; 2.5; 1.25; 0.0 mM) without/with melatonin (5 mM) or without/with IPA (10 mM) or without/with melatonin + IPA, and then, to further clarify the narrow range of KIO3 concentrations, against which melatonin + IPA reveal cumulative protective effects, the following KIO3 concentrations were used: 20; 18.75; 17.5; 16.25; 15; 13.75; 12.5; 11.25; 10; 8.75; 7.5; 0.0 mM. Malondialdehyde + 4-hydroxyalkenals (MDA + 4-HDA) concentration (LPO index) was measured spectrophotometrically. Protective effects of melatonin + IPA were stronger than those revealed by each antioxidant used separately, but only when LPO was induced by KIO3 in concentrations from 18.75 mM to 8.75 mM, corresponding to physiological iodine concentration in the thyroid. In conclusion, melatonin and indole-3-propionic acid exert cumulative protective effects against oxidative damage caused by KIO3, when this prooxidant is used in concentrations close to physiological iodine concentrations in the thyroid. Therefore, the simultaneous administration of these two indoles should be considered to prevent more effectively oxidative damage (and thereby thyroid cancer formation) caused by iodine compounds applied in iodine prophylaxis.

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Section: Introductionmentioning

confidence: 99%

Cumulative Protective Effect of Melatonin and Indole-3-Propionic Acid against KIO3—Induced Lipid Peroxidation in Porcine Thyroid

Iwan

Stępniak

Karbownik-Lewińska

2021

Toxics

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“…All patients acutely admitted to the SU between August 1, 2018 and December 31, 2018 were treated with melatonin within the first 24 h of AIS onset (single dose of 2 mg/day at 8 p.m.) [21], according to our standard operating procedure (SOP) for PSD prevention, and were eligible for inclusion in the study. The SOP for PSD prevention was put into effect on August 1, 2018, due to the high prevalence of PSD among AIS patients and the increasing SU staff awareness of the role of early strategies for PSD prevention, complementing previous SOPs by adding prophylactic melatonin supplementation (single dose of 2 mg/day at 8 p.m.) within the first 24 h of AIS onset and until discharge from the SU in patients aged ≥55 years.…”

Section: Methodsmentioning

confidence: 99%

Delirium REduction after administration of melatonin in acute ischemic stroke (DREAMS): A propensity score–matched analysis

Mengel

Boßelmann

Brendel

et al. 2021

Euro J of Neurology

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Background and purpose Poststroke delirium (PSD) comprises a common and severe complication after stroke. However, treatment options for PSD remain insufficient. We investigated whether prophylactic melatonin supplementation may be associated with reduced risk for PSD. Methods Consecutive patients admitted to the Tübingen University Stroke Unit, Tübingen, Germany, with acute ischemic stroke (AIS), who underwent standard care between August 2017 and December 2017, and patients who additionally received prophylactic melatonin (2 mg per day at night) within 24 h of symptom onset between August 2018 and December 2018 were included. Primary outcomes were (i) PSD prevalence in AIS patients and (ii) PSD risk and PSD‐free survival in patients with cerebral infarction who underwent melatonin supplementation compared to propensity score–matched (PSM) controls. Secondary outcomes included time of PSD onset and PSD duration. Results Out of 465 (81.2%) patients with cerebral infarction and 108 (18.8%) transient ischemic attack (TIA) patients, 152 (26.5%) developed PSD (median time to onset [IQR]: 16 [8–32] h; duration 24 [8–40] h). Higher age, cerebral infarction rather than TIA, and higher National Institutes of Health Stroke Scale score and aphasia on admission were significant predictors of PSD. After PSM (164 melatonin‐treated patients with cerebral infarction versus 164 matched controls), 42 (25.6%) melatonin‐treated patients developed PSD versus 60 (36.6%) controls (odds ratio, 0.597; 95% confidence interval, 0.372–0.958; p = 0.032). PSD‐free survival differed significantly between groups (p = 0.027), favoring melatonin‐treated patients. In patients with PSD, no between‐group differences in the time of PSD onset and PSD duration were noted. Conclusions Patients prophylactically treated with melatonin within 24 h of AIS onset had lower risk for PSD than patients undergoing standard care. Prospective randomized trials are warranted to corroborate these findings.

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