What medication is recommended for managing jet lag?

Medication for Jet Lag

Melatonin is the most effective medication for managing jet lag, particularly when taken close to the target bedtime (10pm to midnight) at the destination for flights crossing five or more time zones. 1, 2

Melatonin Recommendations

• Melatonin is remarkably effective with a Number Needed to Treat (NNT) of 2, making it the first-line pharmacological intervention for jet lag 2
• Dosage: 0.5-5mg is effective, with 3mg being a common starting dose; higher doses (5mg) may help patients fall asleep faster and sleep better than lower doses (0.5mg) 1, 2
• Timing is crucial: melatonin should be taken close to the target bedtime at the destination (10pm-midnight); taking it at the wrong time (early in day) can cause sleepiness and delay adaptation 2
• Immediate-release formulations appear more effective than slow-release forms 2
• The benefit is greater when crossing more time zones and for eastward flights compared to westward flights 1

Administration Protocol

• For flights crossing 5 or more time zones:
  • For short trips (1-2 days): Not recommended to attempt circadian adaptation 3
  • For longer trips (3+ days): Take melatonin at bedtime at the destination for up to 4 days after arrival 2
  • For very long distances (7-8+ time zones): Consider starting melatonin 2-3 days before departure 4

Safety Considerations

• Melatonin is generally considered safe for short-term use 2
• Melatonin is available as an over-the-counter dietary supplement in the US (not FDA-regulated for quality) 5
• Important precautions:
  • People with epilepsy should avoid melatonin due to case reports of adverse effects 2
  • Potential interaction with warfarin has been reported 2
  • All pharmacological sleep interventions should be overseen by a medical doctor 6

Complementary Approaches

• Light exposure management is the most powerful external regulator of circadian rhythms and should be combined with melatonin for optimal results 6
• Slow-release caffeine or a combination of caffeine and melatonin may help reduce jet lag symptoms 6
• Sleep hygiene practices should always be considered first before pharmacological interventions 6
• Avoid alcohol during flights as it can alter cognitive function, trigger anxiety, and disrupt sleep 6
• Maintain appropriate hydration while avoiding excessive caffeine or tea consumption during flights 6

Special Considerations

• For travelers with cognitive impairment, adapting medication timing to the local time at arrival is recommended 6
• The severity of jet lag is proportional to the number of time zones crossed and cumulative sleep loss 6
• Performance decrements may persist for up to 72 hours following travel across multiple time zones 6