Anxiety and depression: Melatonin may lower risk of self harm in youth

• Researchers analyzed the effects of melatonin use on self-harm in teenagers and children.
• They found that melatonin use decreased self-harm in young people, especially in adolescent girls with depression and anxiety.
• Further studies are needed to confirm these results and the possible benefits of melatonin for mental health and well-being.

Sleep disorders such as insomnia are common among young people, especially those with psychiatric conditions.

According to some estimates, around 17% of youth engage in self-harming behavior. There are currently few empirically-supported treatments for the condition in youth.

A recent meta-analysis suggests that treating the causes of self-harm may reduce its incidence. Some have thus suggested that treating sleep problems may reduce the incidence of self-harm.

In Sweden, melatonin is the most commonly prescribed drug for sleep disturbances in children and teenagers. Melatonin is a naturally-occurring hormone that helps maintain the normal sleep-wake cycle and other biological processes.

Understanding more about how melatonin affects self-harm in children and adolescents could inform treatment options for the behavior.

Recently, researchers examined the risk of self-harm and unintentional injuries before and after melatonin treatment in youth with and without psychiatric conditions.

They found that melatonin treatment was linked to lower levels of self-harm—especially in adolescent girls with depression and anxiety.

The study was published in the Journal of Child Psychology and Psychiatry.

Decreased risk of self-harm with melatonin

For the study, the researchers analyzed public healthcare data from 25,575 youths in Sweden who began melatonin treatment between ages 6 and 18.

The children and adolescents were followed for a year prior to melatonin prescription and a year following. They began treatment at an average of age 13 years old, and most commonly initiated treatment in November. Treatment lasted for an average of 6.4 months.

The researchers found that 87.2% of melatonin users received at least one psychiatric diagnosis by age 18. Over 50% received an ADHD diagnosis. Self-harm was around five times more common in girls than boys.

In the end, the researchers found that melatonin use decreased the risk of self-harm by 42% and poisoning risk by 41%. Effects were especially prevalent among girls and adolescents with depression and or anxiety.

They noted, however, that melatonin use did not decrease rates of bodily injuries, falls, or transport accident rates.

How melatonin may help mental health

When asked how melatonin might reduce self-harm in young people, Dr. Kelly Johnson-Arbor,medical toxicologist, co-medical director, and interim executive director at the National Capital Poison Center, who was not involved in the study, told Medical News Today:

“Melatonin, a natural hormone produced by the brain, helps regulate sleep-wake cycles and circadian rhythm. Sleep disturbances are common in young people who have psychiatric disorders, and sleep problems are also associated with emotional and behavioral impairments in childhood.”

“Given that sleep problems can affect emotion and behavior, it’s possible that improvements in sleep quality may result in improved emotional stability and behavioral control.”
— Dr. Kelly Johnson-Arbor

“Because of this, the authors of this study aimed to investigate whether regulation of the sleep cycle, through the use of melatonin, could potentially help prevent self-harm, body injuries, and falls in young people between the ages of 6 and 18 years of age,” she said.

Is melatonin safe to use during puberty? 

MNT also spoke with Dr. Johnston-Arbor about whether taking melatonin regularly at a young age may speed the onset of puberty.

“In animal studies, melatonin administration was found to both speed up and delay the start of puberty, depending on the animal species. Melatonin administration may alter the brain’s production of hormones, including the gonadotropin-releasing hormone, which regulates puberty in humans,” she said.

“Melatonin may also alter the process of female reproductive organ development. However, multiple human studies involving children who were administered melatonin over prolonged periods of time have not shown adverse effects on puberty,” she added.

When asked the same question, Dr. Michael J. McGrath, board-certified psychiatrist, medical director of The Ohana Luxury Alcohol Rehab, who was also not involved in the study, told MNT:

“There is no solid research that establishes a link between melatonin and changes in the timing of puberty but there are some conflicting reports, and so it should be used with caution in prepubescent children.”

Limitations 

Dr. Lokesh Shahani, associate professor of psychiatry at McGovern Medical School at UTHealth Houston, who was not involved in the study, said:

“The study used a national register to extract patient diagnosis, prescription, and death records, leading to some missed cases. Further, the effect of other sleep aids and their impact on suicidal behavior was not investigated in this city.”

Dr. McGrath added that as many patients in the study were also taking antidepressants, it’s possible that the results may have been affected by their use.

Dr. Johnson-Arbor additionally noted that the results might not translate to other countries where melatonin is available as a dietary supplement—as opposed to a prescription—and is thus not highly regulated and may be contaminated with other substances.

Optimal dose of melatonin still not clear

When asked about the study’s implications, Dr. Johnson-Arbor said the findings “indicate that children with sleep disorders may experience additional benefits, other than sleep regulation, after the use of melatonin.”

“Additional studies are needed to determine whether the results of this study can be applied to other populations and to confirm the optimal dose and duration of use of melatonin needed to achieve the results found in this investigation,” she said.

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