TY - JOUR
T1 - International Expert Opinions and Recommendations on the Use of Melatonin in the Treatment of Insomnia and Circadian Sleep Disturbances in Adult Neuropsychiatric Disorders
AU - Palagini, Laura
AU - Manni, Raffaele
AU - Aguglia, Eugenio
AU - Amore, Mario
AU - Brugnoli, Roberto
AU - Bioulac, Stéphanie
AU - Bourgin, Patrice
AU - Micoulaud Franchi, Jean Arthur
AU - Girardi, Paolo
AU - Grassi, Luigi
AU - Lopez, Régis
AU - Mencacci, Claudio
AU - Plazzi, Giuseppe
AU - Maruani, Julia
AU - Minervino, Antonino
AU - Philip, Pierre
AU - Royant Parola, Sylvie
AU - Poirot, Isabelle
AU - Nobili, Lino
AU - Biggio, Giovanni
AU - Schroder, Carmen M.
AU - Geoffroy, Pierre A.
N1 - Publisher Copyright:
© Copyright © 2021 Palagini, Manni, Aguglia, Amore, Brugnoli, Bioulac, Bourgin, Micoulaud Franchi, Girardi, Grassi, Lopez, Mencacci, Plazzi, Maruani, Minervino, Philip, Royant Parola, Poirot, Nobili, Biggio, Schroder and Geoffroy.
PY - 2021/6/10
Y1 - 2021/6/10
N2 - Introduction: Insomnia and circadian rhythm disorders, such as the delayed sleep phase syndrome, are frequent in psychiatric disorders and their evaluation and management in early stages should be a priority. The aim of this paper was to express recommendations on the use of exogenous melatonin, which exhibits both chronobiotic and sleep-promoting actions, for the treatment of these sleep disturbances in psychiatric disorders. Methods: To this aim, we conducted a systematic review according to PRISMA on the use of melatonin for the treatment of insomnia and circadian sleep disorders in neuropsychiatry. We expressed recommendations for the use of melatonin in psychiatric clinical practice for each disorder using the RAND/UCLA appropriateness method. Results: We selected 41 studies, which included mood disorders, schizophrenia, substance use disorders, attention deficit hyperactivity disorders, autism spectrum disorders, neurocognitive disorders, and delirium; no studies were found for both anxiety and eating disorders. Conclusion: The administration of prolonged release melatonin at 2–10 mg, 1–2 h before bedtime, might be used in the treatment of insomnia symptoms or comorbid insomnia in mood disorders, schizophrenia, in adults with autism spectrum disorders, neurocognitive disorders and during sedative-hypnotics discontinuation. Immediate release melatonin at <1 mg might be useful in the treatment of circadian sleep disturbances of neuropsychiatric disorders.
AB - Introduction: Insomnia and circadian rhythm disorders, such as the delayed sleep phase syndrome, are frequent in psychiatric disorders and their evaluation and management in early stages should be a priority. The aim of this paper was to express recommendations on the use of exogenous melatonin, which exhibits both chronobiotic and sleep-promoting actions, for the treatment of these sleep disturbances in psychiatric disorders. Methods: To this aim, we conducted a systematic review according to PRISMA on the use of melatonin for the treatment of insomnia and circadian sleep disorders in neuropsychiatry. We expressed recommendations for the use of melatonin in psychiatric clinical practice for each disorder using the RAND/UCLA appropriateness method. Results: We selected 41 studies, which included mood disorders, schizophrenia, substance use disorders, attention deficit hyperactivity disorders, autism spectrum disorders, neurocognitive disorders, and delirium; no studies were found for both anxiety and eating disorders. Conclusion: The administration of prolonged release melatonin at 2–10 mg, 1–2 h before bedtime, might be used in the treatment of insomnia symptoms or comorbid insomnia in mood disorders, schizophrenia, in adults with autism spectrum disorders, neurocognitive disorders and during sedative-hypnotics discontinuation. Immediate release melatonin at <1 mg might be useful in the treatment of circadian sleep disturbances of neuropsychiatric disorders.
KW - circadian sleep disorders
KW - delirium
KW - dementia
KW - expert opinion
KW - insomnia
KW - melatonin
KW - psychiatric disorders
UR - http://www.scopus.com/inward/record.url?scp=85108867553&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85108867553&partnerID=8YFLogxK
U2 - 10.3389/fpsyt.2021.688890
DO - 10.3389/fpsyt.2021.688890
M3 - Review article
AN - SCOPUS:85108867553
VL - 12
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
SN - 1664-0640
M1 - 688890
ER -