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Posted Nov 17 2010 10:48am

I’ve been taking prescribed melatonin (Circadin) for a week now. It is a prolonged release 2 mg tablet and became available in Australia only in April or May this year. Its prescription is only for 3 weeks. It is not not recommend for longer than 3 weeks use as they do not have sufficient information on long-term effectiveness. I read this from somewhere that the safety of more than 3 months use is unknown.

It is not under PBS listing. It would cost you about $30, which is not too bad for one-off use.

Melatonin is a hormone produced from the amino acid, tryptophan, via serotonin in the pineal gland. Its production is unique in that it is synthesised and secreted predominantly at night between about 9 p.m. and 8 a.m. The control of the production occurs via interactions between the brain’s biological timing centre (the suprachiasmatic nucleus of the hypothalamus) and retinally perceived light. While melatonin secretion is high during night-time darkness, it is not produced during casual darkness during the day. Similarly, while it is secreted while we sleep, sleep is not a prerequisite for its production and it is not produced during daytime sleep.

The very first day, I felt the effect from the tablet as strange sleepy spell, although it didn’t work. It is just starting to do what it’s supposed to do; regulate circadian rhythm of waking and sleeping. Acknowledging that my sleep problem is disastrous, I could say it would take time until I form more noticeable circadian cycle…

What I noticed is that I get sleepy spell (although it is not strong) after midnight. It still takes for a while for me to fall asleep, however I’ve fell asleep before I see the day light. Waking up is much more obvious as I wake up in the morning regardless of how little hours I slept. (Getting out from the bed is another issue, though.)

The first couple of days, I had shocking nightmare that woke me up with horror. I still have lots of vivid dreams every night. I may be having a very short but deep sleep as I wake up rather refreshed despite of short sleep.

After a few days, I started sensing the sleepy spell before I take the tablet at night. Accordingly, I’m hopeful for a little more improvement in the next fortnight.

When Dr TL suggested to try melatonin, I was a little hesitant. He worried about the cost. And I worried wasting the money on something that doesn’t work. He gave me the script and let me think about it.

Dr TL may be a little disappointed that I wasn’t so keen to try it at first. He has been thinking and checking for anything to help with my stubborn sleep problem which was only getting worse.

I decided to give it a try the following week. I wouldn’t know if it works or not unless I try. Dr TL was very happy when I told him about some positive improvement. He worried that it is only for 3 weeks. I still have 2 weeks melatonin left. And I will think about “what’s next” when I see the improvement or non-improvement at the end of three weeks.

If it’s effect doesn’t last long enough, maybe I could try it once or twice a year to help adjust circadian cycle depending on how my sleep goes.

I was very confused by melatonin use in Australia. I hear stories about how people get it without doctor’s prescription. Some said they got in trouble with Australian Customs from importing it (for personal use) from overseas shops without doctor’s prescription. I also hear mixed feedback, including many disappointing ones. I noticed Australian online stores who sell melatonin claims its benefit for not only the sleep but also other problems.

I read from somewhere (sorry I cannot remember where) that melatonin can help weight loss, anti-aging and improve immune system. However, improved immune system could exacerbate auto-immune conditions. It could also adversely affect POTS symptoms. This means it may not be ideal treatment for some people with ME/CFS. I guess the benefit and negative effect need to be weighted.

It seems we can buy OTC melatonin for homoeopathic purpose without doctor’s prescription in Australia. The following comment on online forum helped me understand the difference between OTC and prescription is the amount of melatonin in the tablet. OTC melatonin contains only negligible amount of melatonin. It is possible the positive effect from OTC melatonin is more like placebo effect… It also explains why some people/stores state that its safety of long time use has been proven while some doctors/pharmaceutical company state otherwise.

As I understand, a homeopathic strength described as 3mg 6X, where the 6X signifies 10-fold dilutions six times over – i.e. 3 nanograms of melatonin, not 3 milligrams. The usual dose for sleep disturbance or jet lag is of the order of 3mg (a real 3mg), so the effect of the homeopathic product may be disappointing, to say the least. Unless, of course, the placebo response proves satisfactory.

I will report how my sleep goes with melatonin treatment. Hopefully, my circadian cycle would improve a little more.

Also, I’m aware that melatonin is not a magic pill. It only gives the help I desperately needed. The rest depends on my discipline to keep up with the new day/night sleep routines I want to see.

~ * ~

Articles I read about melatonin in Australia.

Australian Prescriber: Melatonin – what’s all the fuss about?

Medical Observer: TGA approves melatoning for adult insomnia

Natural Health: Melatonin

NPS: Melatonin prolonged-release tablets (Circadin) for primary insomnia in older people

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