Can You Take Melatonin and Restavit Together?
I do not recommend combining melatonin with Restavit (doxylamine) for insomnia treatment, as neither agent is supported by current clinical practice guidelines for chronic insomnia, and combining sedating medications increases risks without established benefit.
Key Evidence Against This Combination
Melatonin Is Not Recommended for Insomnia Treatment
- The American Academy of Sleep Medicine (2017) explicitly recommends against using melatonin for treatment of sleep onset or sleep maintenance insomnia in adults 1
- This recommendation is based on insufficient evidence of efficacy at the 2 mg doses studied 1
- An older 2008 guideline similarly noted that over-the-counter substances including melatonin "are not recommended in the treatment of chronic insomnia due to the relative lack of efficacy and safety data" 1
Restavit (Doxylamine) Is Not Guideline-Supported
- Doxylamine is an antihistamine similar to diphenhydramine, which the American Academy of Sleep Medicine recommends against using for insomnia treatment 1
- The 2008 guideline states that "OTC sleep medications contain antihistamines as the primary agent; efficacy for treatment of insomnia is not well established, especially its long-term use" 1
Safety Concerns with Combination Therapy
- Research shows melatonin is associated with increased fracture risk (adjusted hazard ratio 1.44,95% CI 1.01-2.04), particularly with three or more prescriptions 2
- Combining two sedating agents without evidence of synergistic benefit increases the risk of:
- Excessive daytime sedation
- Falls and fractures (especially in older adults)
- Cognitive impairment
- Additive CNS depression 1
What You Should Use Instead
First-Line Pharmacological Options
The American Academy of Sleep Medicine (2017) suggests the following evidence-based treatments for insomnia 1:
For Sleep Onset Insomnia:
- Zaleplon 10 mg
- Triazolam 0.25 mg
- Ramelteon 8 mg (melatonin receptor agonist, not melatonin itself)
For Sleep Onset AND Maintenance Insomnia:
- Temazepam 15 mg (note: this is different from Restavit)
- Eszopiclone 2-3 mg
- Zolpidem 10 mg
For Sleep Maintenance Insomnia:
- Suvorexant 10-20 mg
- Doxepin 3-6 mg
Important Clinical Considerations
- All pharmacotherapy should ideally be supplemented with cognitive behavioral therapy for insomnia (CBT-I) when possible 1
- The choice of specific agent should be guided by symptom pattern, treatment goals, comorbid conditions, and side effect profile 1
- Patients should be followed regularly (every few weeks initially) to assess effectiveness and side effects 1
- Efforts should be made to use the lowest effective dose and taper when conditions allow 1
Common Pitfall to Avoid
Do not confuse temazepam (a benzodiazepine recommended for insomnia) with Restavit (doxylamine, an antihistamine not recommended for insomnia). The question may reflect this confusion, as temazepam is guideline-supported while doxylamine is not 1.