The use of melatonin in Swedish children and adolescents—a register-based study according to age, gender, and medication of ADHD

Furster, Catrin; Hallerbäck, Maria Unenge

doi:10.1007/s00228-015-1866-3

Cited by 17 publications

(18 citation statements)

References 20 publications

(19 reference statements)

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“…The increasing prevalence and incidence of dispensation of melatonin prescriptions in children in our study has previously been shown in other Nordic European countries [11][12][13]27]. A Norwegian study showed an increase in prevalence for girls 1.5-7.7 per 1000 and boys 3.4-11.0 per 1000 during the time period 2004-2012 [11].…”

Section: Discussionsupporting

confidence: 82%

“…Similarly, a Danish study showed that the number of melatonin prescriptions (all off-label) increased expansively from 2006 to 2012 [13]. Another Swedish study investigating melatonin use among children and adolescents 0-19 years of age between 2006 and 2013 reported similar results [12]. Furthermore, the Swedish study stressed the importance of continuous follow-up of melatonin use in a pediatric population.…”

Section: Discussionmentioning

confidence: 84%

“…Hence, most medicines that are usually used for sleep disturbances in adults are not approved for children, and consequently, if used, are prescribed off-label [10,11]. Melatonin is the most commonly used medicine for sleep disturbances among children and adolescents [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…Among the Nordic European countries there has been an increase in prescriptions of melatonin among children and adolescents [11][12][13]. Studies among children and adolescents with attention deficit hyperactive disorder (ADHD) and other neurodevelopmental disorders indicate that melatonin can be effective in treating sleep disorders in these patient groups [6][7][8]15].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pediatric use of prescribed melatonin in Sweden 2006–2017: a register based study

Kimland

Bardage

Collin

et al. 2020

Eur Child Adolesc Psychiatry

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Sleep disturbances are common in the pediatric population and should primarily be treated non-pharmacologically. Most medicines for sleep disturbances are not approved for pediatric use and data on long-term safety is scarce. In Sweden, melatonin is classified as a prescription medicine. The aim of the present study was to characterize the prevalence and incidence of dispensed melatonin prescriptions, long-term treatment, concomitant dispensation of psychotropic medication, and psychiatric comorbidity, in children and adolescents aged 0-17 years living in Sweden during 2006-2017. Data was retrieved by linking the national population-based registers, the Swedish Prescribed Drug register and the National Patient register. In 2017, nearly 2% of the pediatric population 0-17 years was dispensed at least one prescription of melatonin, which was more than a 15-fold increase for girls and a 20-fold increase for boys, when compared to 2006. Among the children in the age group 5-9 who initiated a melatonin treatment in 2009, 15% of girls and 17% of boys were found to be continuously prescribed melatonin 8 years later. Nearly 80% of all children with dispensed melatonin had concomitant dispensations of psychotropic medications. The most common combination was melatonin together with centrally acting sympathomimetic medicines (23% of girls and 43% of boys). About half of the children (47% of girls and 50% of boys) had at least one registered diagnosis of mental or behavioral disorders. The most common diagnosis was attention deficit hyperactive disorder, across all age groups and genders. The continuous increase of use of melatonin in children, often concomitant with other psychotropic medications, together with a high proportion of younger children with prescriptions of melatonin on a longterm basis, suggests the need for further structured follow up studies, in particular of long-term use.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pediatric use of prescribed melatonin in Sweden 2006–2017: a register based study

Kimland

Bardage

Collin

et al. 2020

Eur Child Adolesc Psychiatry

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“…A long-term follow-up study by Hoebert et al (2009) in 94 children with ADHD and sleeponset insomnia indicated that melatonin discontinuation was associated with relapse of sleep-onset insomnia in 92% of cases. A register study in Sweden indicates that 50% of children prescribed melatonin were also using ADHD medications and that melatonin usage was higher in boys than girls (Furster and Hallerbäck 2015). There is little comprehensive evidence for other chronotherapeutic approaches in ADHD.…”

Section: Intervention Studiesmentioning

confidence: 99%

A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder

Coogan

McGowan

2017

ADHD Atten Def Hyp Disord

146

126

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Reports of sleep disturbances in attention deficit hyperactivity disorder (ADHD) are common in both children and adults; however, the aetiology of such disturbances is poorly understood. One potentially important mechanism which may be implicated in disrupted sleep in ADHD is the circadian clock, a known key regulator of the sleep/wake cycle. In this systematic review, we analyse the evidence for circadian rhythm changes associated with ADHD, as well as assessing evidence for therapeutic approaches involving the circadian clock in ADHD. We identify 62 relevant studies involving a total of 4462 ADHD patients. We find consistent evidence indicating that ADHD is associated with more eveningness/later chronotype and with phase delay of circadian phase markers such as dim light melatonin onset and delayed sleep onset. We find that there is evidence that melatonin treatment may be efficacious in addressing ADHD-related sleep problems, although there are few studies to date addressing other chronotherapeutic approaches in ADHD. There are only a small number of genetic association studies which report linkages between polymorphisms in circadian clock genes and ADHD symptoms. In conclusion, we find that there is consistent evidence for circadian rhythm disruption in ADHD and that such disruption may present a therapeutic target that future ADHD research might concentrate explicitly on.

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Melatonin use among children, adolescents, and young adults: a Danish nationwide drug utilization study

Bliddal

Jensen²,

Rasmussen³

et al. 2022

Eur Child Adolesc Psychiatry

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The use of melatonin in Swedish children and adolescents—a register-based study according to age, gender, and medication of ADHD

Cited by 17 publications

References 20 publications

Pediatric use of prescribed melatonin in Sweden 2006–2017: a register based study

Pediatric use of prescribed melatonin in Sweden 2006–2017: a register based study

A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder

Melatonin use among children, adolescents, and young adults: a Danish nationwide drug utilization study

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