Frontiers in Psychiatry (Jun 2021)
International Expert Opinions and Recommendations on the Use of Melatonin in the Treatment of Insomnia and Circadian Sleep Disturbances in Adult Neuropsychiatric Disorders
- Laura Palagini,
- Raffaele Manni,
- Eugenio Aguglia,
- Mario Amore,
- Mario Amore,
- Roberto Brugnoli,
- Stéphanie Bioulac,
- Patrice Bourgin,
- Patrice Bourgin,
- Jean-Arthur Micoulaud Franchi,
- Paolo Girardi,
- Luigi Grassi,
- Régis Lopez,
- Régis Lopez,
- Claudio Mencacci,
- Giuseppe Plazzi,
- Giuseppe Plazzi,
- Julia Maruani,
- Antonino Minervino,
- Pierre Philip,
- Sylvie Royant Parola,
- Isabelle Poirot,
- Lino Nobili,
- Lino Nobili,
- Giovanni Biggio,
- Carmen M. Schroder,
- Carmen M. Schroder,
- Pierre A. Geoffroy,
- Pierre A. Geoffroy,
- Pierre A. Geoffroy,
- Pierre A. Geoffroy
Affiliations
- Laura Palagini
- Psychiatry Division, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, Istituto di Ricovero e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy
- Eugenio Aguglia
- Department of Experimental and Clinical Medicine, Psychiatric Clinic University Hospital “Gaspare Rodolico”, University of Catania, Catania, Italy
- Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Mario Amore
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy
- Roberto Brugnoli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
- Stéphanie Bioulac
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, and USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
- Patrice Bourgin
- Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France
- Patrice Bourgin
- Centre des troubles du sommeil - CIRCSom, Strasbourg University Hospitals, Strasbourg, France
- Jean-Arthur Micoulaud Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, and USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
- Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
- Luigi Grassi
- 0Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Régis Lopez
- 1Service de Neurologie, Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier, Montpellier, France
- Régis Lopez
- 2PSNREC, Univ Montpellier, INSERM, Montpellier, France
- Claudio Mencacci
- 3Department of Neuroscience, Aziende Socio Sanitarie Territoriali Fatebenefratelli Sacco, Milan, Italy
- Giuseppe Plazzi
- 4Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Giuseppe Plazzi
- 5Istituto di Ricovero e Cura a Carattere Scientifico, Institute of Neurological Sciences of Bologna, Bologna, Italy
- Julia Maruani
- 6Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
- Antonino Minervino
- 7Department of Psychiatry, Italian Society of Psychosomatic Medicine (SIMP), Parma, Italy
- Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, and USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
- Sylvie Royant Parola
- 8Reseau Morphee Paris, Paris, France
- Isabelle Poirot
- 9Service de psychiatrie adulte, Hôpital Fontan, CHU de Lille, Lille, France
- Lino Nobili
- 0Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Lino Nobili
- 1Istituto di Ricovero e Cura a Carattere Scientifico, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genoa, Italy
- Giovanni Biggio
- 2Department of Life and Environmental Sciences, Institute of Neuroscience, CNR, University of Cagliari, Cagliari, Italy
- Carmen M. Schroder
- Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France
- Carmen M. Schroder
- 3Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France
- Pierre A. Geoffroy
- 6Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
- Pierre A. Geoffroy
- 4GHU Paris - Psychiatry & Neurosciences, Paris, France
- Pierre A. Geoffroy
- 5CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
- Pierre A. Geoffroy
- 6Université de Paris, NeuroDiderot, Inserm, Paris, France
- DOI
- https://doi.org/10.3389/fpsyt.2021.688890
- Journal volume & issue
-
Vol. 12
Abstract
Introduction: Insomnia and circadian rhythm disorders, such as the delayed sleep phase syndrome, are frequent in psychiatric disorders and their evaluation and management in early stages should be a priority. The aim of this paper was to express recommendations on the use of exogenous melatonin, which exhibits both chronobiotic and sleep-promoting actions, for the treatment of these sleep disturbances in psychiatric disorders.Methods: To this aim, we conducted a systematic review according to PRISMA on the use of melatonin for the treatment of insomnia and circadian sleep disorders in neuropsychiatry. We expressed recommendations for the use of melatonin in psychiatric clinical practice for each disorder using the RAND/UCLA appropriateness method.Results: We selected 41 studies, which included mood disorders, schizophrenia, substance use disorders, attention deficit hyperactivity disorders, autism spectrum disorders, neurocognitive disorders, and delirium; no studies were found for both anxiety and eating disorders.Conclusion: The administration of prolonged release melatonin at 2–10 mg, 1–2 h before bedtime, might be used in the treatment of insomnia symptoms or comorbid insomnia in mood disorders, schizophrenia, in adults with autism spectrum disorders, neurocognitive disorders and during sedative-hypnotics discontinuation. Immediate release melatonin at <1 mg might be useful in the treatment of circadian sleep disturbances of neuropsychiatric disorders.
Keywords
