title: [A nationwide survey on the uses of melatonin and ramelteon in Japanese children].
abstract: OBJECTIVE
  We carried out a questionnaire survey to investigate the uses of melatonin and ramelteon in Japanese children.
  
  
  METHODS
  We sent a questionnaire to councilors of the Japanese Society of Child Neurology by e-mail, and sent the same questionnaire to members of the Japanese Society of Pediatric Psychiatry and Neurology by postal mail.
  
  
  RESULTS
  During the first phase of the survey, 220 responses were obtained, and 45% of the respondents prescribed melatonin. Imported supplements and chemical reagents were used by 64% and 29% of melatonin prescribers, respectively. Some prescribed melatonin without patient consent or institutional approval. In patients with pervasive developmental disorder, cerebral palsy, attention-deficit hyperactivity disorder, Rett syndrome, and visual disturbance, melatonin was prescribed by 37%, 29%, 10%, 6%, and 6% of the respondents, respectively. In terms of sleep disorders, melatonin was prescribed by 49% and 42% of respondents in patients with circadian rhythm disorders and insomnia, respectively. Ramelteon was prescribed by 52% of respondents. Regarding types of target diseases and sleep disorders, the use of ramelteon differed little from that of melatonin. In the second phase of the survey on the use of melatonin, 23 doctors prescribed the drug for 254 patients. The daily effective dose ranged from 0.2 mg to 8 mg in patients aged 2 months to 37 years. In more than 60% of the patients who took melatonin, PDD was diagnosed. In the patients with melatonin for insomnia, 90% and 25% had difficulty falling asleep and disorders in circadian rhythm, respectively.
  
  
  CONCLUSIONS
  Both melatonin and ramelteon were widely prescribedin Japanese children. Melatonin tended to be used without sufficient ethical consideration in Japan, indicating the necessity of melatonin as medicine. Then, careful determination of an applicable dose are required in future studies.
authors: Michio
authors: M
authors: Fukumizu
authors: Masaharu
authors: M
authors: Hayashi
authors: Tasuku
authors: T
authors: Miyajima
authors: Asayo
authors: A
authors: Ishizaki
authors: Hajime
authors: H
authors: Tanaka
authors: Jun
authors: J
authors: Kohyama
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002940:Circadian Rhythm / Q000187:drug effects*; D003625:Data Collection; D005260:Female; D006801:Humans; D007192:Indenes / Q000627:therapeutic use*; D007223:Infant; D007564:Japan; D008297:Male; D008550:Melatonin / Q000627:therapeutic use*; D012890:Sleep / Q000187:drug effects* / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D007192:Indenes; C495910:ramelteon; D008550:Melatonin