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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Tomatheus on October 11, 2006, at 11:14:48
In reply to Mental Health deteriorating. What is to blame?, posted by adamCanada on October 10, 2006, at 22:11:08
> Also I been taking melatonin before bed. I just started those 1 and a half weeks ago. They help me sleep and fall asleep faster. Could those be doing something negative that I am not aware of?
Yes, absolutely (especially if your response to melatonin is anything like mine)!
Taking melatonin at night almost always makes me feel severely depressed and/or panicky the next day. I'll never forget the day when I experienced the worst panic attacks of my life: I was taking lithium and took melatonin the night before to help me fall asleep quickly and hopefully wake up relatively early so I could make it to my pdoc appointment the next day. Well, the melatonin did help me fall asleep (as it usually does), but it actually made me sleep longer, which is bad enough of a problem for me as it is. I made it to my appointment with my pdoc, but I ended up having such a terrible breakdown in front of him that I'm surprised that he didn't try to have me hospitalized. Lithium made me feel terrible enough as it was, and combining it with melatonin made me feel like I was in hell (not that I know what that feels like, but I felt worse than I've ever felt before or since).
In your case, I think there's a good chance that melatonin could be contributing to your depressive symptoms, and combining it with Paxil could be making matters worse. Paxil in itself may be enhancing the production of melatonin by making more serotonin available in the synapses between your neurons (melatonin is synthesized from serotonin). Then again, this may not be the case because I'm not sure if melatonin is synthesized from synaptic serotonin or pre-synaptic serotonin. If it's synthesized from pre-synaptic serotonin, then the opposite could be true: Paxil could be interfering with the production of melatonin.
At any rate, it seems to be the case that melatonin can make depressive symptoms worse in some individuals. Melatonin itself does not carry any warning labels about its tendency to worsen depressive symptoms in some individuals, but Rozerem (a drug that stimulates the melatonin MT1 and MT2 receptors) does. Specifically, some depressed patients who took Rozerem in clinical trials reported a worsening in their symptoms. Considering that melatonin stimulates the MT1 and MT2 receptors, it seems likely that its tendency to be associated with a worsening of depressive symptoms may be similar to that of Rozerem.
Interestingly enough, I've had the symptoms of delayed sleep phase syndrome for as long as I can remember (it seems that my circadian rhythm may be longer than 24 hours), which would seem to suggest that I'd be a melatonin responder. But even though melatonin does help me fall asleep faster, it always seems to worsen both my hypersomnia and my subjective feelings of depression the next day, which seem to go hand-in-hand. To me, that's not an acceptable trade-off.
I definitely think that you should consider either reducing the amount of melatonin that you take at night or stop taking it entirely to see if you might experience any reduction in your depressive symptoms. The amount of melatonin in most supplements is actually a lot higher than the amount that the body typically produces each night (even in so-called "normal" individuals), so it's possible that lowering your dose might allow you to continue experiencing the benefits of melatonin without its adverse effects. In my case, taking 750 micrograms at night still tended to make my depressive symptoms worse the next day, but you might be different.
Tomatheus
Posted by adamCanada on October 12, 2006, at 1:46:38
In reply to Melatonin » adamCanada, posted by Tomatheus on October 11, 2006, at 11:14:48
They should give some kind of warnings. No wonder I been having such strange dreams.
I will stop the melatonin and see how I feel over next few days.
Posted by Tomatheus on October 20, 2006, at 22:29:21
In reply to wow, posted by adamCanada on October 12, 2006, at 1:46:38
Adam,
I apologize for taking so long to reply to your post. I have been feeling quite unwell as of late and have not had the energy to post a coherent message here.
Based on my experiences with melatonin, reports from other Psycho-Babble members who have described a worsening of depressive symptoms associated with melatonin, and the fact that Rozerem (the M1/M2 agonist prescription sleep aid) has been shown to worsen depressive symptoms, I agree that there is definitely good reason to warn consumers about melatonin's potential to worsen depressive symptoms. Although it is not common for supplements to carry warning labels, there are some (such as kava kava) that do. And in the U.S., the Food and Drug Administration has the authority to place restrictions on supplements and/or to warn consumers about potentially adverse effects associated with the use of a particular supplement. I don't know for sure whether or not Health Canada has the same type of authority when it comes to dietary supplements sold in Canada, but my guess is that it does.
I'm not sure if any cases of melatonin-associated worsening of depressive symptoms have been described in any published research reports, but I intend to search through a few academic databases some time next week or so to see if any such cases have been documented (assuming that I'm feeling well enough to do this). I'm considering writing a letter to the FDA to 1) report the adverse effects that I experienced while taking melatonin, 2) summarize any documented evidence in the peer-reviewed literature describing melatonin's potential to worsen depressive symptoms, and 3) recommend placing a warning label on melatonin supplements. Considering that some people do seem to benefit from melatonin, I certainly would not advocate taking it off the market. However, the public certainly has a right to know about any adverse effects that may arise from the use of melatonin (and all other supplements), especially considering that it's often touted as being "safe and natural."
So, I'm curious...are you feeling any better now that you've stopped taking the melatonin?
Tomatheus
> They should give some kind of warnings. No wonder I been having such strange dreams.
>
> I will stop the melatonin and see how I feel over next few days.
This is the end of the thread.
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