Is Melatonin Addictive? Does it Cause Withdrawal Symptoms when you Stop Taking It?

Melatonin is a dietary supplement used primarily for improving the onset, duration and quality of sleep. Melatonin tablets are widely used in the United States with an estimated 3 million users in 2012. [1]

Unlike pharmaceutical sleeping pills, melatonin is available over the counter without a prescription. It is considered to have a lower risk of side effects and user reviews say that it does not cause grogginess or a “hangover” effect the morning after it is used.

But some are concerned about developing a tolerance or dependence on melatonin supplements for falling asleep. What are the health risks of taking melatonin sleeping pills and can you become addicted if you use them for a long period of time?

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Melatonin’s Function and Sleep Cycles

Melatonin is a hormone that is secreted by the pineal gland and helps regulate the sleep/wake cycle.

Exposure to light in a normal day/night cycle stimulates specialized cells on the hypothalamus to increase pineal gland production of melatonin in the evening and to decrease production in the morning.

It is the only hormone in the United States sold over-the-counter as a dietary supplement and is not subject to FDA regulation. Melatonin pills can be purchased without a prescription from your doctor.

Melatonin’s role in the promotion of a normal sleep cycle is mediated by two specific receptors (MT1 and MT2) in the brain.

It is not mediated by the gamma-aminobutyric acid (GABA) receptors through which many sleeping pills work. GABA agonists are known to cause withdrawal problems and tolerance build-up, which could result in addiction.

As a result, melatonin differs from many sleeping pills in that it promotes a more natural slumber by not suppressing rapid eye movement (REM) sleep or normal sleep cycles. [2]

Is Melatonin Addictive?

Key clinical standards on the treatment of sleep disorders note that while the use of melatonin has been associated with a variety of side effects, there have been no reports of melatonin addiction, withdrawal symptoms, or long term negative consequences.

These same clinical standards generally suggest the use of melatonin be limited to less than two or three months due to the lack of long term studies. [3]

Most users take this supplement as needed and experience no adverse effects when they stop taking it. Some report that their sleep difficulties return after they quit using melatonin, but this is not a case of withdrawal symptoms, unlike with GABAergic sleep aids.

If you feel that you are becoming dependent on melatonin for achieving a good night’s sleep, it is recommended to speak to a doctor to determine whether you have an underlying sleep disorder.

The scientific community has reported no significant side effects in children taking melatonin. [4] While it is not considered addictive or habit-forming for kids, it is not recommended to use this supplement for long periods of time due to effects on sexual development.

Children under eighteen should not take melatonin without first consulting a physician. A doctor can determine appropriate dosages for a child and provide information on the risk of side effects.

Negative Side Effects from Melatonin

The National Institutes of Health notes that “side effects of melatonin are uncommon” and those that have been reported include drowsiness, headache, dizziness, and nausea. [5]

Some less frequent side effects include mild abdominal pain and anxiety, confusion and irritability, and brief bouts of depression. [6]

The risk of side effects increases as higher dosages are used. However, in cases where excess melatonin dosages have been taken, there have not been any instances of serious adverse effects.

High doses of melatonin have a very low risk of toxicity and no cases of fatal overdose have been reported. This distinguishes melatonin from many other prescription sleeping drugs, which have a higher risk of abuse and overdose.

Melatonin Interactions and Warnings

Melatonin can interact with a variety of medications, including immunosuppressants, diabetes and blood thinning medications, and birth control pills. Those taking these medications should talk with their physician before taking melatonin.

Pregnant women should not take melatonin without first consulting a physician.

Melatonin supplements do not have to be approved by the FDA. To help assure product safety, look for melatonin that’s made in facilities that have elected to be GMP certified.

GMPs (Good Manufacturing Practices), are regulations established by the FDA to help assure the safety and quality of pharmaceutical products. [7]

How to Use Melatonin Safely

If you are having trouble falling asleep at night or are experiencing low quality sleep, melatonin supplements may help. This natural hormone has been found to improve sleep latency, which is the amount of time it takes to fall asleep at night.

Melatonin supplements may be more effective for some users than others. Melatonin levels decline with age, and studies on subjects over the age of 50 report improvements in sleep with small doses (0.3 mg) of melatonin. [8]

The many studies of this hormone have one finding in common – fairly low doses of melatonin (from .3 mg to 5 mg) are effective for a range of sleep disorders.[9, 10]

The use of melatonin for primary insomnia has similar findings – suggested doses of 1 mg [11, 12] and 2 mg [13] before sleep are the norm.

If low doses work, and melatonin is safe, why shouldn’t the higher doses offered by 5 mg and 10 mg tablets be better? The answer is that that these higher push plasma melatonin levels to many times above normal levels. [14]
Animal studies have reported that high doses of melatonin can desensitize the receptors that regulate the effect of this endogenous hormone. [15] This might reduce the effect of melatonin taken by tablet or naturally secreted by the pineal gland. [16]

In other words, the science says low doses of melatonin work, and suggests that higher doses might make getting to sleep harder by desensitizing the part of the brain that responds to melatonin.

This is known as down-regulation because the receptors in the brain become less sensitive to melatonin. If using high dosages for a long period of time, this could result in a tolerance forming.

However, research suggests that the effect is not large enough to result in a true addiction to melatonin pills. But this mechanism could theoretically increase one’s reliance on sleep aids.

Conclusion

The answer to the question “Is melatonin addictive?” is very clear: there is no scientific evidence to suggest melatonin is in any way addictive.

At the same time, those who report trouble sleeping without melatonin should note that the current science indicates that lower dosages may be more effective than higher dosages.

It is always recommended to use the lowest effective dosage of melatonin to improve sleep quality. Following safe dosing guidelines can reduce the likelihood of receptor down-regulation and prevent a tolerance from forming.

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