From the Guidelines
Melatonin is not directly associated with causing palpitations, according to the most recent and highest quality study available 1. When considering the potential effects of melatonin on heart rate and blood pressure, it's essential to note that the study focuses on the use of melatonin in the treatment of isolated REM sleep behavior disorder (RBD) [ 1 ]. The study recommends a starting dose of immediate-release melatonin of 3 mg taken at bedtime, which can be titrated up to 15 mg to address dream enactment [ 1 ]. While the study does not specifically mention palpitations as a side effect of melatonin, it highlights the importance of customizing therapy for patients based on each agent's unique mechanism of action and therapeutic profile, as well as the patient's comorbidities [ 1 ]. Key points to consider when using melatonin include:
- Starting with the lowest effective dose and monitoring the body's response
- Informing your doctor about any supplements you're taking, including melatonin
- Being aware of potential interactions with certain medications and medical conditions
- Discontinuing use and seeking medical attention if you experience persistent or concerning symptoms.
From the Research
Melatonin and Palpitations
- Melatonin is a hormone that influences the cardiovascular system, and its effects on heart rate and blood pressure have been studied 2.
- A case report found that a healthy 22-year-old male experienced palpitations and dizziness after taking 20 mg of melatonin, which led to marked bradycardia 3.
- A systematic review of adverse events associated with melatonin for the treatment of sleep disorders found that palpitations were a rare but reported side effect 4.
- Another study discussed the potential toxicology of melatonin, including its effects on the cardiovascular system, but did not specifically mention palpitations as a common side effect 5.
- A review of sleep disorders and melatonin found that melatonin is generally well-tolerated and has no obvious short- or long-term adverse effects, but did not discuss palpitations in detail 6.
Mechanisms and Effects
- Melatonin may affect heart rate and blood pressure through various mechanisms, including direct effects on the hypothalamus, antioxidant effects, and relaxation of smooth muscle in the aorta wall 2.
- The study on melatonin-induced symptomatic bradycardia suggested that melatonin may induce cardiac vagal tone and affect heart rate and mean arterial pressure 3.
- The systematic review found that most adverse events associated with melatonin, including palpitations, were mild to moderate and resolved spontaneously or with withdrawal of treatment 4.