The therapeutics of melatonin: a paediatric perspective

The production of melatonin by the pineal gland and its functions are consi dered, and then its possible uses in the treatment of children. Institution alized children, and those with severe learning disorders, often have irreg ular sleep-wake patterns, and there is evidence that melatonin can result i n improvement to the benefit of both the child and the carers. The affected children can become less irritable, calmer, happier, and content. Also the y may socialize better and become more attentive, with an improvement in th eir cognitive abilities. Another group of children who are likely to suffer from disturbed sleep are those who are visually handicapped. Melatonin giv en in the evening can improve their sleep patterns, and often their perform ance. No important side-effects have been reported. It is generally accepte d that if a child is liable to epileptic seizures sleep deprivation may wel l exacerbate them. There is some evidence from clinical trials that in that event melatonin can be helpful. There are many other problems in which it is claimed that treatment with melontin is justifiable. These are mentioned , but further confirmatory studies are needed in most of them. There is no doubt that melatonin can effect the circadian system, and shift the sleep-w ake cycle; and that there are situations in which this can be desirable. (C ) 2000 Published by Elsevier Science B.V. All rights reserved.