Child and Adolescent Mental Health Services, East London NHS Foundation Trust, Bedford, UK.
School of Pharmacy, University College London, London, UK.
Expert Opin Drug Saf. 2022 Dec;21(12):1469-1481. doi: 10.1080/14740338.2022.2160444. Epub 2022 Dec 26.
Exogenous melatonin is regulated as a drug in the UK and EU but is available as an over-the-counter dietary supplement in the US and Canada. In the last 15 years, melatonin use has increased rapidly in many countries, in particular, in children and adolescents who frequently have many years of continuous exposure. Despite this, the potential risks associated with extended use continue to be unclear, and there remains a lack of systematically assessed safety data from long-term prospective trials.
This review focuses on adverse event data reported in long-term (≥6 months) prospective trials of melatonin.
The Embase and Medline electronic databases were searched from inception to 12 September 2022 for long-term studies of melatonin, in which adverse events were systematically monitored and reported.
Although the reported frequency of possible adverse events associated with long-term melatonin use is low and few clinically significant adverse events have been reported, the scarcity of data from double-blind randomized placebo-controlled trials should caution against complacency. Ideally, analysis of data from large well-established research databases should be conducted to provide good quality evidence on which to base a more rigorous evaluation of the safety profile.
外源性褪黑素在英国和欧盟被作为药物监管,但在美国和加拿大则作为非处方膳食补充剂供应。在过去的 15 年中,褪黑素在许多国家的使用迅速增加,特别是在经常持续暴露多年的儿童和青少年中。尽管如此,与长期使用相关的潜在风险仍不清楚,而且长期前瞻性试验中仍缺乏系统评估的安全性数据。
本综述重点关注褪黑素长期(≥6 个月)前瞻性试验中报告的不良事件数据。
从创建到 2022 年 9 月 12 日,在 Embase 和 Medline 电子数据库中搜索了系统监测和报告不良事件的褪黑素长期研究。
尽管报告的与长期褪黑素使用相关的可能不良事件的频率较低,且报告的临床显著不良事件很少,但缺乏双盲随机安慰剂对照试验的数据应引起警惕。理想情况下,应从大型成熟研究数据库中分析数据,以提供高质量证据,从而更严格地评估安全性概况。