![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by SLS on January 11, 2001, at 19:16:58
I have been having a lot of trouble sleeping since last Spring. It has gotten worse recently. I am able to fall asleep right away, but my sleep is very choppy, and I get very little sleep after 4:00am. I am trying to avoid taking any hypnotic medication so as not to complicate my treatment for bipolar depression.
I bought some melatonin tonight, but I'm not sure how much to take and when to take it. Is there any advantage to sublingual administration?
Thanks for any input.
- Scott
Posted by mars on January 12, 2001, at 21:28:21
In reply to Melatonin - How much ?, posted by SLS on January 11, 2001, at 19:16:58
Hi Scott -
My pdoc had me try melatonin. She suggested I started out at .5 mg and then build up. You can go up to quite large doses, although she didn't mention a maximum to me.
You do know about the problems with melatonin and depression, don't you?
best,
mary
> I have been having a lot of trouble sleeping since last Spring. It has gotten worse recently. I am able to fall asleep right away, but my sleep is very choppy, and I get very little sleep after 4:00am. I am trying to avoid taking any hypnotic medication so as not to complicate my treatment for bipolar depression.
>
> I bought some melatonin tonight, but I'm not sure how much to take and when to take it. Is there any advantage to sublingual administration?
>
> Thanks for any input.
>
>
> - Scott
Posted by SLS on January 12, 2001, at 22:27:47
In reply to Re: Melatonin - How much ?, posted by mars on January 12, 2001, at 21:28:21
> Hi Scott -
>
> My pdoc had me try melatonin. She suggested I started out at .5 mg and then build up. You can go up to quite large doses, although she didn't mention a maximum to me.
>
> You do know about the problems with melatonin and depression, don't you?
Dear Mary,
Now you tell me.No, I didn't know.
What are the details?
I decided to try the melatonin last night. I took one 3mg tablet right before bed at 10:30pm. I was told that I could take two, but I figured I'd take the one, then if I awoke in the middle of the night, I'd take the second. Well, 3:00am came around and I awoke. So, just as planned, I took the second dose. Within fifteen or twenty minutes, I did not like the way I was feeling. I definitely suffered today. I felt groggy. It was sort of like a hangover. Sort of more depressed. The only thing I could figure is that I phase-delayed my cycle, an action that is well-known to cause or make worse depression. Your post helps me put things into perspective.
Thanks for the input. It really helps.
Sincerely,
Scott
Posted by mars on January 13, 2001, at 0:50:45
In reply to Re: Melatonin - How much ?, posted by SLS on January 12, 2001, at 22:27:47
Hello Sincere Scott -
I'm very sorry I didn't reply sooner to your question. You are such a knowledgeable guy I presumed you'd already know. Most packages of melatonin have a warning about taking it if you have a problem with depression. From what I understand certain depressions benefit from it, while it will make others worse. I know that it affects levels of serotonin, but what's going on there I really don't know. (Sorry, I am having some major problems with cognition and memory right now, which makes me feel pretty useless.)
Here's a link for starters:
http://www.dr-bob.org/tips/split/Melatonin-in-depressed-pat.html
I did read somewhere that they did a study that showed fluvoxamine increased the bioavailability of melatonin. Don't know if that's a clue.
Best wishes,
mary
p.s. When I took it I went up to a six tablets a night. It didn't help me. I was so depressed at the time I don't think I would have noticed if I felt worse - it was right before I decided to have ECT.
Posted by dove on January 15, 2001, at 14:08:05
In reply to Re: Melatonin - How much ?, posted by SLS on January 12, 2001, at 22:27:47
Melatonin is a life-preserver in my oceanic world of bipolar insomnia hell. I take sublingual (1-2 mg) because its effects are almost immediate. My struggle is with mental shut-down, I only use it in order to immobilize my brain so I can fall asleep.
Whereas, your situation calls for something to keep you sleeping, and/or help you fall back asleep once awoken, and without morning after-effects. This is a toughie, especially if we're talking about OTC meds.
When you took the second dose, was it sublingual or regular 'down-the-hatch' type?
Why did you start at such a high dosage?
I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am. If that doesn't do the job, go up another 0.5 mg and see what happens. If you find yourself with neck-pain or head-aches in the morning then I would recommend lowering the dosage, or only use every other night. My husband (who has struggled with insomnia) started waking up with head-aches after awhile, he was convinced that it was "building up" in his system and he seemed to completely lose his libido and became quite despondent, so he discontinued regular usage and the symptoms went away. He still takes a 2mg sublingual maybe once a month, when he's too wired to fall asleep, but the symptoms have not reappeared.
With the sublingual (melt under the tongue kind), one should be able to take them and feel the effects immediately (or within 20 minutes) and shouldn't find themselves dropping to the floor in a dead sleep, they should almost feel calmed. I do take sublingual Melatonin about five (5) per month, and whatever depressive effects they reportedly cause, are overshadowed by the positive effects of actually sleeping. But that's just me.
One of the doc's I discussed Melatonin with mentioned something to the tune of "Melatonin will fix delayed precursor REM sleep in manic-depressives, and maybe atypical depressives w/ insomnia." Although, he said he had not personally seen the effects of Melatonin on typical or atypical depressives, and he has witnessed the beneficial effects with manic-depressives when *not* taken on a daily basis. He said it does a good job diffusing the beginnings of a Manic episode.
But, this is all hear-say and wild guess-work. I hope the sandman makes it your way soon, very soon :-) You are in my thoughts (and I will get back to you on the crazy med-cocktail and dxes thingy!) and I send my best wishes and sleeping vibes :-)
~dove
Posted by Ron Hill on January 18, 2001, at 12:24:40
In reply to Re: Melatonin - How much ? » SLS, posted by dove on January 15, 2001, at 14:08:05
Dove,
In your post you state:
"I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am."
Is your 3:00am recommendation applicable to sublingual melatonin as well as *regular* melatonin? Before answering, please go to a prior post of mine (link provided below). My prior post puts my current question into context. Thank you soooo much for your time!
-- Ron
http://www.dr-bob.org/babble/20010111/msgs/51755.html
------------------------------------------> Melatonin is a life-preserver in my oceanic world of bipolar insomnia hell. I take sublingual (1-2 mg) because its effects are almost immediate. My struggle is with mental shut-down, I only use it in order to immobilize my brain so I can fall asleep.
>
> Whereas, your situation calls for something to keep you sleeping, and/or help you fall back asleep once awoken, and without morning after-effects. This is a toughie, especially if we're talking about OTC meds.
>
> When you took the second dose, was it sublingual or regular 'down-the-hatch' type?
>
> Why did you start at such a high dosage?
>
> I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am. If that doesn't do the job, go up another 0.5 mg and see what happens. If you find yourself with neck-pain or head-aches in the morning then I would recommend lowering the dosage, or only use every other night. My husband (who has struggled with insomnia) started waking up with head-aches after awhile, he was convinced that it was "building up" in his system and he seemed to completely lose his libido and became quite despondent, so he discontinued regular usage and the symptoms went away. He still takes a 2mg sublingual maybe once a month, when he's too wired to fall asleep, but the symptoms have not reappeared.
>
> With the sublingual (melt under the tongue kind), one should be able to take them and feel the effects immediately (or within 20 minutes) and shouldn't find themselves dropping to the floor in a dead sleep, they should almost feel calmed. I do take sublingual Melatonin about five (5) per month, and whatever depressive effects they reportedly cause, are overshadowed by the positive effects of actually sleeping. But that's just me.
>
> One of the doc's I discussed Melatonin with mentioned something to the tune of "Melatonin will fix delayed precursor REM sleep in manic-depressives, and maybe atypical depressives w/ insomnia." Although, he said he had not personally seen the effects of Melatonin on typical or atypical depressives, and he has witnessed the beneficial effects with manic-depressives when *not* taken on a daily basis. He said it does a good job diffusing the beginnings of a Manic episode.
>
> But, this is all hear-say and wild guess-work. I hope the sandman makes it your way soon, very soon :-) You are in my thoughts (and I will get back to you on the crazy med-cocktail and dxes thingy!) and I send my best wishes and sleeping vibes :-)
>
> ~dove
Posted by michael on January 18, 2001, at 14:16:56
In reply to Re: Melatonin - How much ? » dove, posted by Ron Hill on January 18, 2001, at 12:24:40
Clinical Pharmacology 2000 (it's a free web site):
http://cp.gsm.com/apps/default.asp?entry=&quickjump=11&rNum=590
I know I've posted this address a number of times, but I think it's the best source for 'clinical' med info that I've found (as opposed to the real-life-experience type of info here).
Actually, I was just looking at the melatonin info last night, and I think it'll answer a lot of the questions posed in this thread.
[Dr. Bob - if you happen to read this - I haven't checked recently, but I think this would be a great addition to your links page, if it's not already been added]
Hope everyone finds it as helpful as I have. michael
> Dove,
>
> In your post you state:
>
> "I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am."
>
> Is your 3:00am recommendation applicable to sublingual melatonin as well as *regular* melatonin? Before answering, please go to a prior post of mine (link provided below). My prior post puts my current question into context. Thank you soooo much for your time!
>
> -- Ron
>
> http://www.dr-bob.org/babble/20010111/msgs/51755.html
> ------------------------------------------
>
> > Melatonin is a life-preserver in my oceanic world of bipolar insomnia hell. I take sublingual (1-2 mg) because its effects are almost immediate. My struggle is with mental shut-down, I only use it in order to immobilize my brain so I can fall asleep.
> >
> > Whereas, your situation calls for something to keep you sleeping, and/or help you fall back asleep once awoken, and without morning after-effects. This is a toughie, especially if we're talking about OTC meds.
> >
> > When you took the second dose, was it sublingual or regular 'down-the-hatch' type?
> >
> > Why did you start at such a high dosage?
> >
> > I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am. If that doesn't do the job, go up another 0.5 mg and see what happens. If you find yourself with neck-pain or head-aches in the morning then I would recommend lowering the dosage, or only use every other night. My husband (who has struggled with insomnia) started waking up with head-aches after awhile, he was convinced that it was "building up" in his system and he seemed to completely lose his libido and became quite despondent, so he discontinued regular usage and the symptoms went away. He still takes a 2mg sublingual maybe once a month, when he's too wired to fall asleep, but the symptoms have not reappeared.
> >
> > With the sublingual (melt under the tongue kind), one should be able to take them and feel the effects immediately (or within 20 minutes) and shouldn't find themselves dropping to the floor in a dead sleep, they should almost feel calmed. I do take sublingual Melatonin about five (5) per month, and whatever depressive effects they reportedly cause, are overshadowed by the positive effects of actually sleeping. But that's just me.
> >
> > One of the doc's I discussed Melatonin with mentioned something to the tune of "Melatonin will fix delayed precursor REM sleep in manic-depressives, and maybe atypical depressives w/ insomnia." Although, he said he had not personally seen the effects of Melatonin on typical or atypical depressives, and he has witnessed the beneficial effects with manic-depressives when *not* taken on a daily basis. He said it does a good job diffusing the beginnings of a Manic episode.
> >
> > But, this is all hear-say and wild guess-work. I hope the sandman makes it your way soon, very soon :-) You are in my thoughts (and I will get back to you on the crazy med-cocktail and dxes thingy!) and I send my best wishes and sleeping vibes :-)
> >
> > ~dove
Posted by SLS on January 18, 2001, at 18:53:17
In reply to Re: Melatonin - How much ? » dove, posted by Ron Hill on January 18, 2001, at 12:24:40
> Dove,
>
> In your post you state:
>
> "I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am."
>
> Is your 3:00am recommendation applicable to sublingual melatonin as well as *regular* melatonin? Before answering, please go to a prior post of mine (link provided below). My prior post puts my current question into context. Thank you soooo much for your time!
I don't know if the following represents the reason for the 3:00am limit. Melatonin is secreted by a small structure within the brain called the pineal gland. Melatonin is manufactured from serotonin. Like so many other endocrine functions, melatonin secretion follows a daily or "circadian" rhythm. Melatonin levels begin to rise during the evening and continue to rise after going to sleep. During the night, melatonin reaches its peak levels at around 2:00am. Thereafter, secretion drops off quickly and reaches a minimum by morning. To add melatonin to the system after the circadian scheduled 2:00am peak would disturb the system of. When the peak melatonin concentration is artificially moved to a time that is later than scheduled, the circadian clock may become "delayed".A circadian rhythm delay is sometimes known as "jet lag". It is also capable of eliciting or making worse a depressive state. By contrast, a rhythm advance can have antidepressant effects. This is how sleep deprivation works in some people to produce a transient antidepressant response. It has been discovered that it is not necessary to undergo a total night's deprivation to accomplish this. The effect can be produced by going to bed the normal time and waking up between 2:00am and 3:00am and remaining awake until the following evening.
For oral preparations of melatonin, I can't see taking it after 1:00am so as to not produce a phase delay. I don't know the exact amount of time it takes for oral administration to produce a peak concentration in the target tissues. If necessary, however, I should think that sublingual administration would be alright to take up until 2:00am. I have no idea when is the optimal time to take melatonin. I have seen recommendations to take it 20 minutes before going to bed.
Dove was kind enough to tell me that melatonin can produce depression. I didn't know that.
- Scott
Posted by mars on January 18, 2001, at 19:26:30
In reply to Re: Melatonin - How much ?, posted by SLS on January 18, 2001, at 18:53:17
Hi Scott -
I was the person who pointed out that melatonin can produce depression. I know I am new here and I'm sure I didn't include enough scientific information for my message to register. Minor point, but one I wanted to make. I am doing the best with my fuzzy brain.
Your posts have been very helpful to me. I hope that I have not offended you in any way.
best regards,
mary
> Dove was kind enough to tell me that melatonin can produce depression. I didn't know that.
>
>
> - Scott
Posted by Ron Hill on January 18, 2001, at 20:12:19
In reply to Re: Melatonin - How much ?, posted by SLS on January 18, 2001, at 18:53:17
Scott,
Very good information. Thank you!-- Ron
---------------------------------> > Dove,
> >
> > In your post you state:
> >
> > "I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am."
> >
> > Is your 3:00am recommendation applicable to sublingual melatonin as well as *regular* melatonin? Before answering, please go to a prior post of mine (link provided below). My prior post puts my current question into context. Thank you soooo much for your time!
>
>
> I don't know if the following represents the reason for the 3:00am limit. Melatonin is secreted by a small structure within the brain called the pineal gland. Melatonin is manufactured from serotonin. Like so many other endocrine functions, melatonin secretion follows a daily or "circadian" rhythm. Melatonin levels begin to rise during the evening and continue to rise after going to sleep. During the night, melatonin reaches its peak levels at around 2:00am. Thereafter, secretion drops off quickly and reaches a minimum by morning. To add melatonin to the system after the circadian scheduled 2:00am peak would disturb the system of. When the peak melatonin concentration is artificially moved to a time that is later than scheduled, the circadian clock may become "delayed".
>
> A circadian rhythm delay is sometimes known as "jet lag". It is also capable of eliciting or making worse a depressive state. By contrast, a rhythm advance can have antidepressant effects. This is how sleep deprivation works in some people to produce a transient antidepressant response. It has been discovered that it is not necessary to undergo a total night's deprivation to accomplish this. The effect can be produced by going to bed the normal time and waking up between 2:00am and 3:00am and remaining awake until the following evening.
>
> For oral preparations of melatonin, I can't see taking it after 1:00am so as to not produce a phase delay. I don't know the exact amount of time it takes for oral administration to produce a peak concentration in the target tissues. If necessary, however, I should think that sublingual administration would be alright to take up until 2:00am. I have no idea when is the optimal time to take melatonin. I have seen recommendations to take it 20 minutes before going to bed.
>
> Dove was kind enough to tell me that melatonin can produce depression. I didn't know that.
>
>
> - Scott
Posted by Ron Hill on January 18, 2001, at 20:27:11
In reply to Re: Melatonin - How much ?, posted by michael on January 18, 2001, at 14:16:56
Michael,
Thanks for the link. Its a great site.-- Ron
------------------------> Clinical Pharmacology 2000 (it's a free web site):
>
> http://cp.gsm.com/apps/default.asp?entry=&quickjump=11&rNum=590
>
> I know I've posted this address a number of times, but I think it's the best source for 'clinical' med info that I've found (as opposed to the real-life-experience type of info here).
>
> Actually, I was just looking at the melatonin info last night, and I think it'll answer a lot of the questions posed in this thread.
>
> [Dr. Bob - if you happen to read this - I haven't checked recently, but I think this would be a great addition to your links page, if it's not already been added]
>
> Hope everyone finds it as helpful as I have. michael
>
>
>
>
>
>
>
>
>
> > Dove,
> >
> > In your post you state:
> >
> > "I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am."
> >
> > Is your 3:00am recommendation applicable to sublingual melatonin as well as *regular* melatonin? Before answering, please go to a prior post of mine (link provided below). My prior post puts my current question into context. Thank you soooo much for your time!
> >
> > -- Ron
> >
> > http://www.dr-bob.org/babble/20010111/msgs/51755.html
> > ------------------------------------------
> >
> > > Melatonin is a life-preserver in my oceanic world of bipolar insomnia hell. I take sublingual (1-2 mg) because its effects are almost immediate. My struggle is with mental shut-down, I only use it in order to immobilize my brain so I can fall asleep.
> > >
> > > Whereas, your situation calls for something to keep you sleeping, and/or help you fall back asleep once awoken, and without morning after-effects. This is a toughie, especially if we're talking about OTC meds.
> > >
> > > When you took the second dose, was it sublingual or regular 'down-the-hatch' type?
> > >
> > > Why did you start at such a high dosage?
> > >
> > > I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am. If that doesn't do the job, go up another 0.5 mg and see what happens. If you find yourself with neck-pain or head-aches in the morning then I would recommend lowering the dosage, or only use every other night. My husband (who has struggled with insomnia) started waking up with head-aches after awhile, he was convinced that it was "building up" in his system and he seemed to completely lose his libido and became quite despondent, so he discontinued regular usage and the symptoms went away. He still takes a 2mg sublingual maybe once a month, when he's too wired to fall asleep, but the symptoms have not reappeared.
> > >
> > > With the sublingual (melt under the tongue kind), one should be able to take them and feel the effects immediately (or within 20 minutes) and shouldn't find themselves dropping to the floor in a dead sleep, they should almost feel calmed. I do take sublingual Melatonin about five (5) per month, and whatever depressive effects they reportedly cause, are overshadowed by the positive effects of actually sleeping. But that's just me.
> > >
> > > One of the doc's I discussed Melatonin with mentioned something to the tune of "Melatonin will fix delayed precursor REM sleep in manic-depressives, and maybe atypical depressives w/ insomnia." Although, he said he had not personally seen the effects of Melatonin on typical or atypical depressives, and he has witnessed the beneficial effects with manic-depressives when *not* taken on a daily basis. He said it does a good job diffusing the beginnings of a Manic episode.
> > >
> > > But, this is all hear-say and wild guess-work. I hope the sandman makes it your way soon, very soon :-) You are in my thoughts (and I will get back to you on the crazy med-cocktail and dxes thingy!) and I send my best wishes and sleeping vibes :-)
> > >
> > > ~dove
Posted by michael on January 18, 2001, at 22:53:25
In reply to Re: Melatonin - How much ?, posted by SLS on January 18, 2001, at 18:53:17
Scott -
The site I mentioned in my previous post to this thread - I think it suggested taking it an hour or two before going to bed, but that may have been oral vs. sub-lingual... take a look to be certain. michael
> > Dove,
> >
> > In your post you state:
> >
> > "I always recommend either regular Melatonin in 1.5 mg increments, and never taking additional *regular* Melatonin after 3:00am."
> >
> > Is your 3:00am recommendation applicable to sublingual melatonin as well as *regular* melatonin? Before answering, please go to a prior post of mine (link provided below). My prior post puts my current question into context. Thank you soooo much for your time!
>
>
> I don't know if the following represents the reason for the 3:00am limit. Melatonin is secreted by a small structure within the brain called the pineal gland. Melatonin is manufactured from serotonin. Like so many other endocrine functions, melatonin secretion follows a daily or "circadian" rhythm. Melatonin levels begin to rise during the evening and continue to rise after going to sleep. During the night, melatonin reaches its peak levels at around 2:00am. Thereafter, secretion drops off quickly and reaches a minimum by morning. To add melatonin to the system after the circadian scheduled 2:00am peak would disturb the system of. When the peak melatonin concentration is artificially moved to a time that is later than scheduled, the circadian clock may become "delayed".
>
> A circadian rhythm delay is sometimes known as "jet lag". It is also capable of eliciting or making worse a depressive state. By contrast, a rhythm advance can have antidepressant effects. This is how sleep deprivation works in some people to produce a transient antidepressant response. It has been discovered that it is not necessary to undergo a total night's deprivation to accomplish this. The effect can be produced by going to bed the normal time and waking up between 2:00am and 3:00am and remaining awake until the following evening.
>
> For oral preparations of melatonin, I can't see taking it after 1:00am so as to not produce a phase delay. I don't know the exact amount of time it takes for oral administration to produce a peak concentration in the target tissues. If necessary, however, I should think that sublingual administration would be alright to take up until 2:00am. I have no idea when is the optimal time to take melatonin. I have seen recommendations to take it 20 minutes before going to bed.
>
> Dove was kind enough to tell me that melatonin can produce depression. I didn't know that.
>
>
> - Scott
Posted by SLS on January 19, 2001, at 8:28:48
In reply to Re: Melatonin - How much ? please read » SLS, posted by mars on January 18, 2001, at 19:26:30
> Hi Scott -
>
> I was the person who pointed out that melatonin can produce depression.I am really, really sorry that *my* fuzzy brain made such a mistake. I am sure you realize that it was nothing personal. I am indebted to you for having posted the information about melatonin and depression. Had I not realized that there were a link, I think I would have stubbornly continued taking it. You surely saved me from a few days of misery. Thanks
> I know I am new here and I'm sure I didn't include enough scientific information for my message to register.
I know this site is very intimidating when one first reads some of the posts that are full of technical stuff. I was. You are not expected to keep up with all of the geniuses here. I can't. Most of important information comes from people with little or no technical background who simply convey thier experiences with various treatments and the information they come across as you have.
> Minor point, but one I wanted to make.
It was a huge point for me. Please don't stop making them.
> I am doing the best with my fuzzy brain.
I know. Me too.
> Your posts have been very helpful to me. I hope that I have not offended you in any way.
Mary, it would take me weeks and weeks to figure out just what you think you may have done that anyone could possibly be offended by.
Just don't do it again! :-) Ha, Ha.
> best regards,
>
> maryDitto.
- Scott
Posted by mars on January 19, 2001, at 10:35:00
In reply to Re: Melatonin - How much ? please read » mars, posted by SLS on January 19, 2001, at 8:28:48
Hi Scott -
Thanks so much for your note.
> I know this site is very intimidating when one first reads some of the posts that are full of technical stuff. I was. You are not expected to keep up with all of the geniuses here. I can't. Most of important information comes from people with little or no technical background who simply convey thier experiences with various treatments and the information they come across as you have.
Uh, Scott, you *are* one of the geniuses here, something I think you should acknowledge to yourself. I love the technical information (as I posted in another reply to you, my dad has a Ph.D. in pharmacology, and his idea of "support" has been to throw textbooks and articles at me); what's frustrating is that I used to know so much of this stuff, and I have lost it, and am in no shape to relearn it right now - which makes me feel like my 23 years of experience with this stuff is worth a little less. =:-(
Your fuzzy-brained admirer,
mary
Posted by Ron Hill on January 19, 2001, at 13:28:30
In reply to Re: Melatonin - How much ?, posted by SLS on January 12, 2001, at 22:27:47
Scott,
Just an FYI. Last night I tried multiple dosing of sublingual melatonin. Today I am experiencing side effects that are almost verbatim as you wrote in your 1/12/01 post. However, I think my next day symptoms are less severe than what you experienced.
I took 2.5 mg just prior to bedtime (9 pm), another 2.5 mg upon waking at 11:45 am, and another 2.5 mg upon waking at 3:00 am. The last dose was taken in violation of your advice, but I always have to try things for myself before I fully believe. :)
The good news is that the melatonin put me to sleep (and back to sleep) and that I got a good nights rest, waking up at 6:30 am. The bad news is that I woke with a noticable (but not severe) headache, feel somewhat groggy, and a little grumpy (depression?).
Please keep us in babble-land informed regarding what you end-up using to successfully treat your insomnia. I'm going to titrate my melatonin dose downward to see if there exists a dose that provides the positive benefits without the next day side effects.
-- Ron
--------------------------------------> Dear Mary,
>
>
> Now you tell me.
>
> No, I didn't know.
>
> What are the details?
>
> I decided to try the melatonin last night. I took one 3mg tablet right before bed at 10:30pm. I was told that I could take two, but I figured I'd take the one, then if I awoke in the middle of the night, I'd take the second. Well, 3:00am came around and I awoke. So, just as planned, I took the second dose. Within fifteen or twenty minutes, I did not like the way I was feeling. I definitely suffered today. I felt groggy. It was sort of like a hangover. Sort of more depressed. The only thing I could figure is that I phase-delayed my cycle, an action that is well-known to cause or make worse depression. Your post helps me put things into perspective.
>
> Thanks for the input. It really helps.
>
>
> Sincerely,
> Scott
Posted by Ron Hill on January 20, 2001, at 11:08:13
In reply to Re: Melatonin - How much ?, posted by SLS on January 18, 2001, at 18:53:17
Scott,
I found the following study interesting and I thought you might find it worth reading (if you have not already seen it):
•For the adjunctive treatment of insomnia† related to major depression:
Oral dosage (extended-release formulations):
Adults: 5—10 mg PO taken 1—2 hours prior to habitual bedtime. In one 4-week placebo-controlled study of 19 patients with major depressive disorder treated with fluoxetine, the sub-group of 10 patients who received concomitant slow-release melatonin at 9 pm for sleep reported significantly improved sleep quality scores versus the patients receiving fluoxetine alone. Melatonin treatment avoided the need for additional sleep medications. No differences in the rates of improvement of depressive symptoms or side effects were reported between the two groups.[2100]Reference [2100]:
Dolberg OT, Hirschmann S, Grunhaus L. Melatonin for the treatment of sleep disturbances in major depressive disorder. Am J Psychiatry 1998;155:1119—21.I find it interesting that this study reports positive results using *extended release* melatonin. As a layman, I would have expected the patients in this study to have experienced simillar "next day problems" as you and I both experienced using a multiple dosing trial. However, I don't know the length of time the extended release continues to provide exogenous melatonin to the subject's brain. If the extended release continues its action well into the night (i.e.; past 2:00 or 3:00 am), I don't understand how the circadian rhythm delay issues were avoided. Know what I mean? What do you think?
-- Ron
----------------------------------------------
> I don't know if the following represents the reason for the 3:00am limit. Melatonin is secreted by a small structure within the brain called the pineal gland. Melatonin is manufactured from serotonin. Like so many other endocrine functions, melatonin secretion follows a daily or "circadian" rhythm. Melatonin levels begin to rise during the evening and continue to rise after going to sleep. During the night, melatonin reaches its peak levels at around 2:00am. Thereafter, secretion drops off quickly and reaches a minimum by morning. To add melatonin to the system after the circadian scheduled 2:00am peak would disturb the system of. When the peak melatonin concentration is artificially moved to a time that is later than scheduled, the circadian clock may become "delayed".
>
> A circadian rhythm delay is sometimes known as "jet lag". It is also capable of eliciting or making worse a depressive state. By contrast, a rhythm advance can have antidepressant effects. This is how sleep deprivation works in some people to produce a transient antidepressant response. It has been discovered that it is not necessary to undergo a total night's deprivation to accomplish this. The effect can be produced by going to bed the normal time and waking up between 2:00am and 3:00am and remaining awake until the following evening.
>
> For oral preparations of melatonin, I can't see taking it after 1:00am so as to not produce a phase delay. I don't know the exact amount of time it takes for oral administration to produce a peak concentration in the target tissues. If necessary, however, I should think that sublingual administration would be alright to take up until 2:00am. I have no idea when is the optimal time to take melatonin. I have seen recommendations to take it 20 minutes before going to bed.
>
> Dove was kind enough to tell me that melatonin can produce depression. I didn't know that.
>
>
> - Scott
Posted by Ron Hill on January 20, 2001, at 11:48:30
In reply to Re: Melatonin - How much ? » SLS, posted by Ron Hill on January 20, 2001, at 11:08:13
Scott,
Here is a link to the article and abstract:
-- Ron
--------------------------------------------> Scott,
>
> I found the following study interesting and I thought you might find it worth reading (if you have not already seen it):
>
> •For the adjunctive treatment of insomnia† related to major depression:
> Oral dosage (extended-release formulations):
> Adults: 5—10 mg PO taken 1—2 hours prior to habitual bedtime. In one 4-week placebo-controlled study of 19 patients with major depressive disorder treated with fluoxetine, the sub-group of 10 patients who received concomitant slow-release melatonin at 9 pm for sleep reported significantly improved sleep quality scores versus the patients receiving fluoxetine alone. Melatonin treatment avoided the need for additional sleep medications. No differences in the rates of improvement of depressive symptoms or side effects were reported between the two groups.[2100]
>
> Reference [2100]:
> Dolberg OT, Hirschmann S, Grunhaus L. Melatonin for the treatment of sleep disturbances in major depressive disorder. Am J Psychiatry 1998;155:1119—21.
>
> I find it interesting that this study reports positive results using *extended release* melatonin. As a layman, I would have expected the patients in this study to have experienced simillar "next day problems" as you and I both experienced using a multiple dosing trial. However, I don't know the length of time the extended release continues to provide exogenous melatonin to the subject's brain. If the extended release continues its action well into the night (i.e.; past 2:00 or 3:00 am), I don't understand how the circadian rhythm delay issues were avoided. Know what I mean? What do you think?
>
> -- Ron
> ----------------------------------------------
>
>
> > I don't know if the following represents the reason for the 3:00am limit. Melatonin is secreted by a small structure within the brain called the pineal gland. Melatonin is manufactured from serotonin. Like so many other endocrine functions, melatonin secretion follows a daily or "circadian" rhythm. Melatonin levels begin to rise during the evening and continue to rise after going to sleep. During the night, melatonin reaches its peak levels at around 2:00am. Thereafter, secretion drops off quickly and reaches a minimum by morning. To add melatonin to the system after the circadian scheduled 2:00am peak would disturb the system of. When the peak melatonin concentration is artificially moved to a time that is later than scheduled, the circadian clock may become "delayed".
> >
> > A circadian rhythm delay is sometimes known as "jet lag". It is also capable of eliciting or making worse a depressive state. By contrast, a rhythm advance can have antidepressant effects. This is how sleep deprivation works in some people to produce a transient antidepressant response. It has been discovered that it is not necessary to undergo a total night's deprivation to accomplish this. The effect can be produced by going to bed the normal time and waking up between 2:00am and 3:00am and remaining awake until the following evening.
> >
> > For oral preparations of melatonin, I can't see taking it after 1:00am so as to not produce a phase delay. I don't know the exact amount of time it takes for oral administration to produce a peak concentration in the target tissues. If necessary, however, I should think that sublingual administration would be alright to take up until 2:00am. I have no idea when is the optimal time to take melatonin. I have seen recommendations to take it 20 minutes before going to bed.
> >
> > Dove was kind enough to tell me that melatonin can produce depression. I didn't know that.
> >
> >
> > - Scott
Posted by SLS on January 22, 2001, at 9:41:54
In reply to Re: Melatonin - SLS, posted by Ron Hill on January 20, 2001, at 11:48:30
Dear Ron,
Thanks for the URL. I have not had the chance to look at it yet, but from your description, it sounds very logical.
To use a slower delivery system of melatonin might serve to enhance the normal rhythmic increase of endogenous melatonin by mimicking the curve of pineal secretion. To take slow-release melatonin at the early hour suggested would allow for this. Hopefully, the peak levels of melatonin will coincide with that point in the circadian clock that is scheduled for this peak.
Maybe there is a place for a rapid-delivery sublingual preparation of melatonin. Perhaps it can be used to help reinforce or reset a normal synchrony of the X and Y clocks (X=brain hypothalamic suprachiasmatic nucleus - pacemaker; Y=endocrine and organal). It might also be used to strategically phase-shift one's aberrant circadian rhythm, or be used to help quickly accommodate to jet-lag.
Scott---------------------------------------------------------
> Scott,
>
> Here is a link to the article and abstract:
>
> http://ajp.psychiatryonline.org/cgi/search?fulltext=Dolberg&sendit=Enter&volume=155&issue=8&journalcode=ajp
>
> -- Ron
> --------------------------------------------
>
> > Scott,
> >
> > I found the following study interesting and I thought you might find it worth reading (if you have not already seen it):
> >
> > •For the adjunctive treatment of insomnia† related to major depression:
> > Oral dosage (extended-release formulations):
> > Adults: 5—10 mg PO taken 1—2 hours prior to habitual bedtime. In one 4-week placebo-controlled study of 19 patients with major depressive disorder treated with fluoxetine, the sub-group of 10 patients who received concomitant slow-release melatonin at 9 pm for sleep reported significantly improved sleep quality scores versus the patients receiving fluoxetine alone. Melatonin treatment avoided the need for additional sleep medications. No differences in the rates of improvement of depressive symptoms or side effects were reported between the two groups.[2100]
> >
> > Reference [2100]:
> > Dolberg OT, Hirschmann S, Grunhaus L. Melatonin for the treatment of sleep disturbances in major depressive disorder. Am J Psychiatry 1998;155:1119—21.
> >
> > I find it interesting that this study reports positive results using *extended release* melatonin. As a layman, I would have expected the patients in this study to have experienced simillar "next day problems" as you and I both experienced using a multiple dosing trial. However, I don't know the length of time the extended release continues to provide exogenous melatonin to the subject's brain. If the extended release continues its action well into the night (i.e.; past 2:00 or 3:00 am), I don't understand how the circadian rhythm delay issues were avoided. Know what I mean? What do you think?
> >
> > -- Ron
> > >
> > > For oral preparations of melatonin, I can't see taking it after 1:00am so as to not produce a phase delay. I don't know the exact amount of time it takes for oral administration to produce a peak concentration in the target tissues. If necessary, however, I should think that sublingual administration would be alright to take up until 2:00am. I have no idea when is the optimal time to take melatonin. I have seen recommendations to take it 20 minutes before going to bed.
This is the end of the thread.
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