From the Guidelines
The maximum dose of melatonin that can be taken is 15 mg, as doses above this have not been studied and may not provide additional benefits while increasing the risk of side effects. When considering the use of melatonin, it's essential to weigh the potential benefits against the risks, particularly in terms of morbidity, mortality, and quality of life 1. The American Academy of Sleep Medicine clinical practice guideline recommends starting with a dose of 3 mg taken at bedtime and titrating up in 3-mg increments as needed to address dream enactment in patients with isolated REM sleep behavior disorder 1. Key points to consider when using melatonin include:
- Starting with a low dose and gradually increasing as needed
- Being aware of potential side effects, such as headaches, dizziness, and nausea
- Considering the potential for interactions with other medications, including blood thinners, seizure medications, and immunosuppressants
- Recognizing that long-term safety data is limited, and it's best to use the lowest effective dose for the shortest duration needed 1. In clinical practice, combination therapy using clonazepam and melatonin may be considered if response to monotherapy is inadequate, although there is a paucity of data examining combination therapies 1. Ultimately, the decision to use melatonin and the dose at which it is used should be individualized and made in consultation with a healthcare provider, taking into account the patient's specific needs and medical history 1.
From the Research
Maximum Dose of Melatonin
The maximum dose of melatonin that can be taken is not explicitly stated in the provided studies. However, the following information can be gathered:
- A study published in 2022 2 investigated the safety of higher doses of melatonin (≥10 mg) in adults and found that melatonin appears to have a good safety profile, but better safety reporting in future long-term trials is needed.
- A study published in 2022 3 used a high dose of 5.0 mg of melatonin in older adults and found that it significantly increased sleep efficiency during both biological day and night.
- Another study published in 2001 4 used melatonin doses ranging from 0.5 mg to 6 mg in elderly insomniacs and found that low doses of melatonin improved initial sleep quality in selected elderly insomniacs.
Key Findings
- The safety of higher doses of melatonin (≥10 mg) in adults has been investigated, but more research is needed to confirm its safety profile 2.
- High doses of melatonin (5.0 mg) have been used in older adults to increase sleep duration during nighttime and daytime sleep episodes 3.
- Low doses of melatonin (0.5-6 mg) have been used in elderly insomniacs to improve initial sleep quality 4.
Dosage Considerations
- The dosage of melatonin used in studies varies widely, ranging from 0.3 mg to 10 mg or more 4, 2, 3.
- The timing of melatonin administration is also important, with some studies administering it 30-120 minutes before bedtime 4 or 30 minutes before lights out 3.
- The use of prolonged-release melatonin formulations, such as Circadin®, has been shown to improve sleep quality and latency in older adults 5.