Maximum Recommended Dosage of Melatonin
The maximum recommended dosage of melatonin varies by population, but generally ranges from 1-15 mg for adults, with 5 mg being sufficient for most sleep disorders and up to 15 mg being used for specific conditions like REM Sleep Behavior Disorder. 1
Dosage Guidelines by Population
Adults
- General sleep difficulties: 1-5 mg taken 1-2 hours before bedtime 1
- Delayed Sleep-Wake Phase Disorder (DSWPD): 5 mg taken between 7:00-9:00 PM 1
- REM Sleep Behavior Disorder: Starting with 3 mg at bedtime, may be titrated up to 15 mg if needed 2, 1
- Jet lag prevention: 0.5-5 mg taken at target bedtime (10 PM to midnight) at destination 3
Children and Adolescents
- With DSWPD, no comorbidities: 0.15 mg/kg taken 1.5-2 hours before habitual bedtime 2, 1
- With DSWPD and psychiatric comorbidities: 3-5 mg (weight-based) taken at 18:00 or 19:00 2, 1
Elderly
- Starting dose: 1-2 mg, with careful titration as needed 1, 4
- Recommended range: 1-6 mg appears effective for improving sleep in older adults 5
Formulation Considerations
- Immediate-release melatonin: Preferred for sleep onset difficulties 1
- Sustained/prolonged-release melatonin: Better for sleep maintenance issues 1
- Higher doses (≥5 mg): May help people fall asleep faster and sleep better compared to lower doses (0.5 mg) 3
- Doses above 5 mg: Generally do not appear more effective for most sleep disorders, except in specific conditions like REM Sleep Behavior Disorder 3
Safety Profile
- Melatonin appears to have a good safety profile even at higher doses (≥10 mg), though adverse events like drowsiness, headache, and dizziness may increase 6
- The American Academy of Sleep Medicine found minimal dosage tolerance and no instances of medication abuse with melatonin 2
- For most adults, low to moderate dosages (approximately 5-6 mg daily or less) appear safe for long-term use 7
Important Considerations
- Timing is crucial: taking melatonin at the wrong time (early in the day) can cause sleepiness and delay adaptation to local time 1, 3
- For older adults, the lowest possible dose of immediate-release formulation is advised to mimic normal physiological circadian rhythm 4
- Look for products with USP (United States Pharmacopeia) verification to ensure stated dose accuracy 1
- Special caution is needed for patients with epilepsy or those taking warfarin due to potential interactions 3
Conclusion
While melatonin is generally safe even at higher doses, the evidence suggests that for most conditions, doses above 5 mg provide little additional benefit. The maximum recommended dose should be tailored to the specific condition being treated, with REM Sleep Behavior Disorder potentially requiring higher doses (up to 15 mg) than general sleep difficulties or circadian rhythm disorders.