What is Melatonin and How Can it Help a Child with Epilepsy?

Hi Tim,

I don't have any personal experience using melatonin but I came across an interesting article written by Dr. Josiane LaJoie, MD from NYU medical center. The article is called "The Use of Melatonin in Epilepsy".

Here is a link to the full article:

http://www.med.nyu.edu/cec/assets/melatoninarticle.pdf

The third paragraph reads:

"In previous studies, it has been shown that not only is melatonin helpful in regulating sleep, but also has anti-seizure properties. Seizures are though to be the result of an imbalance of neurochemicals and the seizures themselves lead to the production of substances called free radicals which can be damaging to brain cells. Melatonin appears to enhance the major neurochemical GABA, whose function is to stop or inhibit seizures. In addition, melatonin blocks the neurochemical glutamate which promotes seizures. Lastly, Melatonin is an anti-oxidant which means that it blocks the bad effects of free radicals such as brain damage."

I think it may be worth a discussion with your doctor to find out what affect it may have. The reason I printed this paragraph is because I used to buy a suppliment for Adam called "GABA" and it is likely the same neurochemical they talk about. It might be worth buying some GABA as I did. I found that it made Adam more restful at night.

Does anyone else have experience with Melatonin or GABA?

Arlene Martell
Publisher, EpilepsyMoms.com

We have used Melatonin to help our daughter get off to sleep for the last year, but have just stopped giving it to her (she is now able to get herself off to sleep without it). Not sure that it helped control her seizures although we also read that it did have anti convulsant properties. It did, however, give us back some sort of quality of life, as before Melatonin, getting her to bed took hours.

She is now on the ketogenic diet and doing well. Unfortunately still on Keppra, burt we're hoping to reduce it asap.

I've recently had to start giving my daughter melatonin at bedtime, but not everynight. It has helped her fall asleep because evenings she has oncontrolable energy that keeps rising. So for us it has helped. I do feel bad having t give it to her, but the good side is that she is getting the sleep she needs. I have not seen a differnence in her seizures, she still has many! good luck

My son is on keppra and has had problems getting to sleep. The melatonin really works for sleep but It has done nothing to control his siezures that I can speak to. Sleep deprivation is sometimes a trigger for siezures so for our son the better the sleep the better the siezure control seems to be ( to a certain extent)

Maria

Like my children, my nephew has autism and he has so many challenges and difficulties when it comes to sleep. He's exhausted, she's exhausted; it makes me tired even listening to her. I did some research, if you'd like the sources let me know, and there is some data supporting the use of melatonin specific to children with autism; the only reason I'm excited about data is because, until we have more of this, the mainstream community that treats my children will simply not understand some of these treatments; supplements or otherwise. I passed the info along to my sister and I'm going to pass along your comments as well, so thank you for them. Amber Kane

I could have sworn that I read somewhere recently that melatonin causes growing children (specifically males) to stop producing testosterone during the night while they slept, however I can't find the research now. I have given my son melatonin on and off for about a year now.

He has always had trouble sleeping. He wakes up at 6 in the morning, and the doesn't want to go to sleep until midnight, unless I put him in his room with the lights off. Melatonin is effective for getting him to sleep, however I notice that he wakes up earlier when he takes melatonin. It's almost as if as soon as the drug wears off, he is wide awake. Also, I notice he is much calmer the next day after he has had melatonin. Does anyone else notice this?

The good news is that everything I have read says melatonin is safe to give your child and it also doesn't increase the risk of seizures in children who already have epilepsy as well as autism (http://www.ncbi.nlm.nih.gov/pubmed/18182647).

I happened to come across this article on the uses of melatonin.

................... Melatonin was first reported to improve significantly clinical electroencephalogram (EEG) patterns in untreatable epileptic patients with different aetiologies by Anton Tay et al in 1974. There are several explanations for the effect of melatonin on epilepsy. It is known to have a neuroprotective role, due to its ability to inhibit glutamate receptors and potentiate GABA-benzodiazepine receptors. Melatonin is also known as an antioxidant, scavenging highly toxic free radicals that are generated during seizures. Finally, it is known that epilepsy is exacerbated by lack of sleep, therefore improved sleep patterns would lead to fewer seizures. Many investigations have been carried out examining the effect of melatonin on children with epilepsy.

These studies have shown very contrasting results, whereby some have found significant improvement, while others reported remarkable deterioration. Several studies have found contrasting results within the same investigation, reporting random cases of worsening and improvement. One study described worrying results that seizure frequency increased with melatonin administration, in spite of improved sleep patterns. Discontinuation of treatment led to the return of seizure activity to baseline, and re-challenge with melatonin caused a recurrence of seizures. It must be noted that this study only included six children, which is not a representative sample, and there have been no other studies that reported similar results.

Alternatively, several studies have reported significant decreases in seizure frequency confirming the anticonvulsant action of melatonin, particularly for myoclonus seizures and nocturnal seizures. Melatonin has also been investigated as adjunctive treatment to valproate and phenobarbital. Such studies showed favourable effects of melatonin, leading to lower anticonvulsant doses, thereby reducing the side effects. The above results suggest the need for further investigation regarding the effect of melatonin on epilepsy. =================================================================

Several studies on children with epilepsy were conducted using varying doses of melatonin. One recommendation was that fast release melatonin is administered one hour before bedtime using the following doses: 6 mg for children younger than 9 years or weighing < 30 kg 9 mg for children older than 9 years or weighing > 30 kg In another study, children were started on 5 mg and if there was no improvement after 3–5 days the dose was slowly increased to a maximum of 10 mg.

One particular study attempted to initiate melatonin in an untreatable child with severe myoclonic epilepsy as an adjunctive to anticonvulsant therapy. In this particular study, the child was given an initial dose of 500 mg which triggered a convulsive seizure lasting three hours. After one week, another attempt was made to start melatonin with a dose of 50 mg, resulting in a notable decrease in the number of seizures.

After much experimentation, the optimal dosing regimen for this child was 120 mg/day (20 mg at 9 am and 100 mg at 9 pm). When the melatonin dose was reduced, seizures were more likely to occur, and the melatonin concentrations were to be maintained high throughout the entire day. ================================================================== Source -

http://ep.bmjjournals.com/cgi/content/full/90/3/ep74