Melatonin

Reviewed by the HeyPsych Medical Review Board

Board-certified psychiatrists and mental health professionals

Published September 16, 2026•Updated September 16, 2026

Mechanism

Melatonin binds to MT1 and MT2 receptors in the suprachiasmatic nucleus of the hypothalamus, regulating circadian rhythms and promoting sleep initiation. It also exerts antioxidant and anti-inflammatory effects.

Indications

Primary Indications

Insomnia (particularly delayed sleep onset)Jet lagShift work sleep disorderDelayed sleep phase syndromeAdjunctive use in anxiety or depression (off-label)

Dosing

Adult Dosing

typical: 1–5 mg taken 30–60 minutes before bedtime

range: 0.5–10 mg depending on indication and individual sensitivity

Dosage Forms

Tablets
Capsules
Sublingual tablets
Gummies
Liquid drops
Extended-release tablets

Onset Duration

Onset: 30–60 minutes. Duration: 4–8 hours depending on formulation (immediate vs extended release).

Adverse Effects

Common Side Effects

• Drowsiness

• Headache

• Dizziness

• Vivid dreams

⚠️ Serious Side Effects

Exacerbation of autoimmune conditions (theoretical)

Warnings

Critical Safety Information

→May cause daytime sedation if taken late at night or in high doses.
→Caution with long-term use in children—safety not well established.

Interactions

With: CNS depressants

Risk: Additive sedation

Action: Monitor for drowsiness

With: Anticoagulants/antiplatelet drugs

Risk: Potential increased bleeding risk

Action: Monitor closely

With: Immunosuppressants

Risk: May counteract effects

Action: Use caution

Monitoring

Sleep quality and latency
Daytime sedation
Potential drug interactions

Special Populations

👶Pregnancy

Not recommended—safety data insufficient

🤱Breastfeeding

Not recommended

👧Children & Adolescents (Under 18)

May be used short-term under medical supervision for sleep/circadian disorders

👴Older Adults (65+)

Effective and safe; often used for insomnia and circadian rhythm disorders

Tapering

Generally no tapering required; melatonin is not habit-forming. Gradual reduction may be helpful for those on long-term high-dose use.

Clinical Notes

Extended-release formulations are useful for sleep maintenance insomnia.
Lower doses (0.5–1 mg) may be as effective as higher doses for circadian shifting.
Non-pharmacological sleep hygiene measures should be combined with supplementation.

This treatment information is for educational purposes only. Treatment decisions should be made in consultation with qualified healthcare professionals based on individual circumstances, symptoms, and medical history. Do not attempt treatment without professional guidance.

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