[Melatonin. Neurobiological background and neuropsychiatric application in children].
BACKGROUND
The therapeutic use of melatonin in children is based on research into the properties of the product and on experience gained from its use in specific populations. Our knowledge about melatonin is increasing steadily.


OBJECTIVE
To summarise the state of our knowledge regarding melatonin and to assess the clinical relevance of this knowledge.


METHODS
The PsycINFO and Pub Med databases were used to locate and study the relevant literature, using as key words 'melatonin', 'child*' and 'adolescen*'.


RESULTS
Melatonin is a fat-soluble neuro-hormone which is produced in the pineal gland and is characterised by a circadian secretion that operates via a feedback circuit. Research has identified various neurobiological mechanisms which have chronobiotic, hypnotic, anticonvulsive, anxiolytic and antioxidant effects. With regard to the use of melatonin for chronobiotic and hypnotic purposes, the literature seems to be unanimous concerning the efficacy and safety of melatonin, at least in the short-term, in cases where the secretion of melatonin is disrupted. In clinical applications the efficacy is assessed by compiling a 24-hour profile within which the moment of the nocturnal increase in secretion is compared to the time at which the patient is expected to fall asleep. So far not enough is known about the effects of long-term use and about the interaction of melatonin with pubertal development. No consensus has yet been reached concerning the role of melatonin in the treatment of affective disorders. Recently there has been increasing interest in the effects of melatonin on seizures and the mechanism involved.


CONCLUSIONS
Melatonin is a product with considerable potential provided it is administered in a controlled manner and the results are assessed accurately. At the moment it seems advisable to use melatonin only in clinical trials.
Debruyne
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UPC Sint Kamillus te Bierbeek. Caroline.Debruyne@opzgeel.be
D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002657:Child Development / Q000187:drug effects; D021081:Chronobiology Disorders / Q000188:drug therapy / Q000503:physiopathology*; D002940:Circadian Rhythm / Q000502:physiology*; D006801:Humans; D008550:Melatonin / Q000009:adverse effects / Q000378:metabolism* / Q000627:therapeutic use; D010870:Pineal Gland / Q000378:metabolism / Q000502:physiology*; D011627:Puberty / Q000187:drug effects; D012890:Sleep / Q000502:physiology
D000927:Anticonvulsants; D008550:Melatonin