Dr Neil Stanley Independent Sleep Expert
© Dr. Neil Stanley 2013-2019
SleepScore Labs recently promoted this web page on LinkedIn  https://www.sleepscore.com/6-of-the-biggest- questions-about-melatonin-answered/  In the webpage I noticed  a statement  “There is no such thing as a melatonin overdose,” that I believe to be incorrect and posted the following as a reply (see here) Dr. Raymann says “There is no such thing as a melatonin overdose,” perhaps he needs to do a better literature review - de Haan, M., Macnab, J., Kent, D.A. and Kennedy, J., 2005. Melatonin overdose resulting in respiratory depression and coma responsive to naloxone. Journal of Toxicology: Clinical Toxicology, 43(6), pp.759-760. Chung, C.H., 2001. An upsurge in melatonin overdose. Hong Kong Journal of Emergency Medicine, 8(3), pp.150-152. Holliman, B.J. and Chyka, P.A., 1997. Problems in assessment of acute melatonin overdose. Southern medical journal, 90(4), pp.451-453. Morera, A.L. and Henry, M., 2001. Safety in melatonin use. Actas espanolas de psiquiatria, 29(5), pp.334-337. Balentine, J., 1997. Melatonin overdose. Reactions, 671, p.4. Gül, M., Dikmetaş, C., Cander, B., Akif Önal, M., Defne Dündar, Z. and Harmankaya, A., 2012. Melatonin Poisoning: A Case Report. Journal of Academic Emergency Medicine Case Reports/Akademik Acil Tip Olgu Sunumlari Dergisi (Acil Tip Uzmanlari Dernegi), 3(4) Dr Raymann replied to my post thus “I am aware of the literature shared by you. And yes, technically you can get an overdose of melatonin, just like you can overdose water. Both in normal use, and even in when used at very high dose, there are hardly any side effects of melatonin. The meta analysis showed a very few cases of (serious and very mild) adverse effects and even the melatonin overdose study showed no acute toxicity symptoms. The level of detail you need to share is different for the audience you target. Not all publication need the level of detail as aimed for in a scientific paper.” I then replied You made a categorical statement with no caveats “And yes, technically you can get an overdose of melatonin”, (so you admit there is such thing as a melatonin overdoes, proving your statement to be false) “just like you can overdose water” (this is a false equivalence, and you know it). Both in normal use, and even in when used at very high dose, there are hardly any side effects of melatonin. (melatonin is not regulated as a medicine in the US so side effect reporting will be much lower than if it were a medicine as it is in the UK this statement is unrelated to overdose and is untrue) Common or very common-Arthralgia; headaches; increased risk of infection; pain Uncommon - Anxiety; asthenia; chest pain; dizziness; drowsiness; dry mouth; gastrointestinal discomfort; hyperbilirubinaemia; hypertension; menopausal symptoms; mood altered; movement disorders; nausea; night sweats; oral disorders; skin reactions; sleep disorders; urine abnormalities; weight increased Rare or very rare - Aggression; angina pectoris; arthritis; concentration impaired; crying; depression; disorientation; electrolyte imbalance; excessive tearing; gastrointestinal disorders; haematuria; hot flush; hypertriglyceridaemia; leucopenia; memory loss; muscle complaints; nail disorder; palpitations; paraesthesia; partial complex seizure; prostatitis; sexual dysfunction; syncope; thirst; thrombocytopenia; urinary disorders; vertigo; vision disorders; vomiting Frequency not known- Angioedema; galactorrhoea https://bnf.nice.org.uk/drug/melatonin.html#sideEffects  “The meta analysis showed a very few cases of (serious and very mild) adverse effects and even the melatonin overdose study showed no acute toxicity symptoms.” (This statement is contradicted by this paper - de Haan, M., Macnab, J., Kent, D.A. and Kennedy, J., 2005. Melatonin overdose resulting in respiratory depression and coma responsive to naloxone. Journal of Toxicology: Clinical Toxicology, 43(6), pp.759-760.) “The level of detail you need to share is different for the audience you target” (giving misleading medical information is never justified). “Not all publication need the level of detail as aimed for in a scientific paper.” (so you believe it is OK to mislead consumers?) Dr Raymann then decided to delete the thread.