Melatonin (Circadin) available as a NHS prescription

Discussion in 'Fibromyalgia Main Forum' started by tansy, Jun 7, 2008.

  1. tansy

    tansy New Member

    Melatonin (as Circadin) becomes available on an NHS prescription

    Although the role of melatonin in the management of sleep disturbance in
    ME/CFS remains uncertain, some people do use this product and claim that
    it is of benefit. But with the Department of Health expressing concerns
    over safety, most doctors have been unwilling to prescribe melatonin and
    instead leave patients to search out their own source of supply.

    One of the worrying aspects to do-it-yourself treatment with melatonin
    is that supplies are often obtained over the internet, sometimes from
    overseas - where there may be no guarantees about quality or safety.

    The pharmaceutical company Lundbeck has just sent out a mailing to UK
    doctors informing them about the availability of a prolonged-release
    preparation of synthetic melatonin (known as Circadin) as a prescription
    only medicine.

    Circadin has been licensed for use in the short-term treatment of
    primary insomnia (ie poor quality sleep) in patients who are 55 or over.
    It is not recommended for use in children and adolescents under the age
    of 18.

    The suggested treatment regime is a 2mg tablet taken once daily
    following food, one to two hours before going to bed. Treatment should
    continue for three weeks.

    Product information for Circadin contains detailed advice about medical
    cautions and contra-indications to its use (including liver damage,
    hereditary galactose intolerance and LAPP lactase deficiency); drug
    interactions (eg fluvoxamine, cimetidine, carbamazepine, oestrogens in
    contraceptive or hormone replacement therapy) and possible adverse
    effects (eg drowsiness, headaches, memory problems, mood alteration,
    vertigo, white blood cell and platelet disturbances)

    It should, however, be noted that Circadin is only being recommended for
    primary insomnia in people aged 55 and over.

    Doctors will therefore take a very cautious view about prescribing this
    product to people with ME/CFS, especially as the manufacturer also
    states that it is not recommended for use in people with autoimmune
    diseases (there is some evidence for an autoimmune immunological
    component to ME/CFS). However, doctors may be willing to consider doing
    so in certain circumstances.

    Medical references to melatonin and ME/CFS:

    Van Heukelom et al. Influence of melatonin on fatigue in severely
    affected in patients with chronic fatigue syndrome and late melatonin
    secretion. European Journal of Neurology, 2006, 13, 55 - 60.

    Williams G et al. Therapy of circadian rhythm disorders in chronic
    fatigue syndrome: no symptomatic improvement with melatonin or
    phototherapy. European Journal of Clinical Investigation, 2002, 32, 831
    - 837.

    Section 7:4 of 'ME/CFS/PVFS - An Exploration of the Key Clinical Issues'
    contains more information on melatonin and other drugs that may be
    useful in helping to correct sleep disturbance in ME/CFS.

    The MEA would be interested to hear from anyone who has received
    Circadin on prescription.

    Dr Charles Shepherd
    Hon Medical Adviser, ME Association


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