Posted by SLS on January 22, 2001, at 9:41:54
In reply to Re: Melatonin - SLS, posted by Ron Hill on January 20, 2001, at 11:48:30
Dear Ron,
Thanks for the URL. I have not had the chance to look at it yet, but from your description, it sounds very logical.
To use a slower delivery system of melatonin might serve to enhance the normal rhythmic increase of endogenous melatonin by mimicking the curve of pineal secretion. To take slow-release melatonin at the early hour suggested would allow for this. Hopefully, the peak levels of melatonin will coincide with that point in the circadian clock that is scheduled for this peak.
Maybe there is a place for a rapid-delivery sublingual preparation of melatonin. Perhaps it can be used to help reinforce or reset a normal synchrony of the X and Y clocks (X=brain hypothalamic suprachiasmatic nucleus - pacemaker; Y=endocrine and organal). It might also be used to strategically phase-shift one's aberrant circadian rhythm, or be used to help quickly accommodate to jet-lag.
Scott---------------------------------------------------------
> Scott,
>
> Here is a link to the article and abstract:
>
> http://ajp.psychiatryonline.org/cgi/search?fulltext=Dolberg&sendit=Enter&volume=155&issue=8&journalcode=ajp
>
> -- Ron
> --------------------------------------------
>
> > Scott,
> >
> > I found the following study interesting and I thought you might find it worth reading (if you have not already seen it):
> >
> > •For the adjunctive treatment of insomnia† related to major depression:
> > Oral dosage (extended-release formulations):
> > Adults: 5—10 mg PO taken 1—2 hours prior to habitual bedtime. In one 4-week placebo-controlled study of 19 patients with major depressive disorder treated with fluoxetine, the sub-group of 10 patients who received concomitant slow-release melatonin at 9 pm for sleep reported significantly improved sleep quality scores versus the patients receiving fluoxetine alone. Melatonin treatment avoided the need for additional sleep medications. No differences in the rates of improvement of depressive symptoms or side effects were reported between the two groups.[2100]
> >
> > Reference [2100]:
> > Dolberg OT, Hirschmann S, Grunhaus L. Melatonin for the treatment of sleep disturbances in major depressive disorder. Am J Psychiatry 1998;155:1119—21.
> >
> > I find it interesting that this study reports positive results using *extended release* melatonin. As a layman, I would have expected the patients in this study to have experienced simillar "next day problems" as you and I both experienced using a multiple dosing trial. However, I don't know the length of time the extended release continues to provide exogenous melatonin to the subject's brain. If the extended release continues its action well into the night (i.e.; past 2:00 or 3:00 am), I don't understand how the circadian rhythm delay issues were avoided. Know what I mean? What do you think?
> >
> > -- Ron
> > >
> > > For oral preparations of melatonin, I can't see taking it after 1:00am so as to not produce a phase delay. I don't know the exact amount of time it takes for oral administration to produce a peak concentration in the target tissues. If necessary, however, I should think that sublingual administration would be alright to take up until 2:00am. I have no idea when is the optimal time to take melatonin. I have seen recommendations to take it 20 minutes before going to bed.
poster:SLS
thread:51473
URL: http://www.dr-bob.org/babble/20010122/msgs/52216.html