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Tangentially I'm interested to know whether taking melatonin for long periods of time (years) reduces its effectiveness. I've been taking it for nearly a year b
by canttestthis 8y ago
Tangentially I'm interested to know whether taking melatonin for long periods of time (years) reduces its effectiveness. I've been taking it for nearly a year but I've heard stories about how you need to keep increasing the dose to get the same effect.
- gnulinux 8y agoI have chronic insomnia, I had it all my life. I used to use melatonin but yes over time it lost its effect and melatonin is not one of those drugs you can just take more to sleep. It has a very precise dosage and if you take more it doesn't make you more sleepy. If you have chronic insomnia, you need to solve the root cause. In my case it is anxiety, and currently I'm trying to solve my anxiety and my sleep quality improves as a corrolary.
- waterhouse 8y agoWhat dosage were you taking? (Same goes to zdragnar.)
- ProfessorLayton 8y agoMelatonin works mildly well for me for a few days, but quickly stops working again, which is unfortunate. I will admit I also have some anxiety issues I need to work on. For better or worse, a low dose of diphenhydramine hcl (12mg) has continued working for me for over a decade without needing to up the dose. My personal experience as far as habit forming goes: I only take it on work nights, and sleep just fine on weekends, or if I'm on vacation. My main issue with sleeping is the specific times I need to do it. If I'm able to sleep when I'm sleepy, and wake up when I'm not, then I don't need any medication. Unfortunately, that doesn't fit in with a typical work schedule.
- davidgay 8y agoThe problem with is diphenhydramine is the increased Alzheimer's risk: https://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-201501287667 https://www.health.harvard.edu/blog/common-anticholinergic-d...
- 80mph 8y agoFascinating, thanks for that link. I had never heard of the "anticholinergic cognitive burden scale". http://www.miltonkeynesccg.nhs.uk/resources/uploads/ACB_scale_-_legal_size.pdf http://www.miltonkeynesccg.nhs.uk/resources/uploads/ACB_scal...
- ProfessorLayton 8y agoWell that's concerning. I brought up long-term use to my GP, and didn't seem too concerned, but asked me to switch to melatonin, which I tried for a while. These studies are extremely difficult to make an informed decision on, thanks to nearly everything being "linked" to some disease. See: Red meat [1] I need to wean off it though. Thankfully dementia doesn't run in my family. https://www.iarc.fr/wp-content/uploads/2018/07/pr240_E.pdf https://www.iarc.fr/wp-content/uploads/2018/07/pr240_E.pdf
- raducu 8y agoHave you tried trazadone or mirtapine? I've had good results with trazadone, bu would wake up after 5-6 hours with adolescent-like erections and read that it can actually cause priapism; mirtazapine works wonderfully(also a very strong antihistamine at lower dosages) but it leaves me groggy for 24 hours.
- howard941 8y agoOn the subject of mirtazapine, I was like a zombie for the first week @15mg and ready to ditch it but the doc persuaded me to stick it out and sure enough the chronic drowsiness went away by the following week, leaving only the potent sleep induction that encouraged an increase to 30mg. But this thread terrifies me now, finding it's also a dementia-inducer. Is there any literature I can review to either allay or justify the fear? Additional horrifying fact from same physician: Chronic benzo use also linked to dementia?
- howard941 8y agoGauche to follow up on my own post but the mirtazapine-dementia link is strong in this study https://www.health.harvard.edu/mind-and-mood/two-types-of-drugs-you-may-want-to-avoid-for-the-sake-of-your-brain https://www.health.harvard.edu/mind-and-mood/two-types-of-dr... but rather weak, and correlative rather than causative if my reading of this study https://www.ehealthme.com/ds/mirtazapine/dementia/ https://www.ehealthme.com/ds/mirtazapine/dementia/ is correct (in that roughly half of the demented patients were co-dosed with an antipsychotic, presumably to help manage the agitation that can accompany dementia) . So now I feel I really need someone much better versed in medicine to advise. (copyedited)
- omeze 8y agoI have this exact same pattern, where the effectiveness lasts for 1-3 days then stops. This is regardless of whether the dosage is 10 mg or 1 mg (Ive never tried 0.3 mg because I never bothered to crush the pills and weigh). The reset period seems to be on the order of 4-8 weeks before its effective again.
- jm__87 8y agoI too suffered from insomnia regularly for most of my life (for at least 25+ years that I can remember) and just have managed to figure it out this past year. The major things for me have been light therapy in the morning, carefully watching my diet (certain foods cause mild digestive problems but this seems to really mess with my sleep), meditation and trying to control inflammation (again, partly through being very careful with my diet, partly by taking supplements and taking ibuprofin on rare occasion). The difference has been absolutely phenomenal. Your entire life changes for the better once you can sleep properly on a consistent basis. Glad to hear you have found something that is working for you.
- themodelplumber 8y agoI take doxylamine succinate 5-10 mg about an hour before bed and find that it helps with sleep much more than melatonin, which only seemed to help with a very time-limited form of tiredness (it wore off and I'd wake up). Still, even the antihistamine (sold as a sleep aid) can't do all the work when something big is going down the next day. Like a meeting with a big client requiring a lot of travel. A big stressor must be addressed. In that case though, I find that writing 1000 to 2000 words about everything that could possibly go wrong gets me to the point where I can sleep like a baby. Precisely because I'm attaking the source of the anxiety. Most nights though it's easier just to do some basic organization and scheduling and take 1/3 of a little pill. In the morning I do often take 50-100mg Jet Alert to blunt the fade-in. It's way easier to feel comfortable taking caffeine when fully rested. An experiment in progress always, but at 9h average sleep (excluding waking times as recorded on FitBit) I managed to go 10 months between illness, as someone with an autoimmune condition (sjogrens). My previous record was 4 months. On top of that, no more depression. My subjective day ratings have gone through the roof. I have to laugh when I'm working with 10 hours of sleep and literally cannot find a single thing to be sour about in my entire life condition (the journaling template I use takes me through this). Plenty of problems, just more resources to work with. Sleep is worth the chase. Edit: While I'm talking about anxiety, I have been testing L-theanine recently and so far it seems to lower the anxiety floor a little bit. There's nothing like getting your stressors sorted directly, but sometimes things are more complex than that, and if supplements can help, great.
- pmiller2 8y agoDoxylamine succinate is a potent anticholinergic drug, as are (IIRC) all other OTC antihistamines that cause drowsiness. Long term use of such drugs have been linked to dementia later in life. I would at least read some of the literature and re-evaluate whether using drugs like this to sleep on a regular basis is worthwhile.
- themodelplumber 8y agoAlready done. No dementia in family history, and the actual literature leaves much to be desired in terms of qualitative result. By the way I discourage the use of the term "linked" in light conversation as it has recently and unfortunately become a socio-culturally appropriated term indicating proof of causality. That a linkage exists often means far less than most people think, and this could immediately impact their health-related decision-making for the worse.
- timClicks 8y agoI don't have specific knowledge to counter this, but am surprised. It implies that humans would need more melatonin over the course of their lives, yet they produce less and less as they age...
- andy_ppp 8y agoTo be honest I think lots of systems in the body are working less well over time?
- gnulinux 8y agoSorry I didn't mean it lost its effect over the years. As other answers say it makes me sleep for a few days and then it stops being effective and I try to increase the dose a little which doesn't help. Other drugs I used were Xanax and Ambien, but I dropped all of them for different reasons. Currently, I'm using Prozac.
- egypturnash 8y agoWell, old people do tend to start sleeping poorly... (citation needed, just got up, not looking for one.)
- bamboozled 8y agoI used to suffer from something similar, nothing and I mean nothing has helped me like a regular sleep schedule. Curious if you've tried that?
- geggam 8y agowhat i have found is when i take 3mg of melatonin i sleep well. When i take more than 6mg of melatonin i get into deeper sleep and sleep less hours feeling refreshed as if i slept longer
- zdragnar 8y agoIt lost effectiveness after a few months for me. On top of that, it gives me very restless legs, to the point that it can actually be harder to fall asleep :/
- ip26 8y agoI used to have that and read recently it can be related to an iron deficiency.
- beagle3 8y agoRestless legs is not yet a solved problem, but supplementation with either iron, niacin or both seems to help most suffers. AFAIK, no clinical deficiency of either is observed (with iron it will be in your blood chemistry, with Niacin it would manifest as Pelagra if observed). Do your own reading about them. Both iron and niacin can be overdosed. From my experience, use only pure niacin (nicotinic acid), rather than nictoinamide or inositol forms (the latter apparently completely useless but still marketed). Also, avoid the time release forms. But ... this is the internet, I might as well be a dog. Do your own research. Woof.
- all2 8y agoRestless legs can be a sign of micro nutrient deficiencies. - https://www.ncbi.nlm.nih.gov/pubmed/25827521 https://www.ncbi.nlm.nih.gov/pubmed/25827521 - https://clinicaltrials.gov/ct2/show/NCT02011191 https://clinicaltrials.gov/ct2/show/NCT02011191 (if you follow this to its completed paper it claims there are neurological effects of biotin supplementation in their study group).
- qwerty456127 8y agoIndeed melatonin supplementation causes tolerance development. The correct dose to avoid it is 0.3 mg [1]. Nevertheless I'm glad pharmacies sell pills with much higher dosage - you can just buy the 2-10mg pills, crush them and take the dose you need. I bet they would sell 0.3 mg pills for the same high price if they knew. [1] https://slatestarcodex.com/2018/07/10/melatonin-much-more-than-you-wanted-to-know/ https://slatestarcodex.com/2018/07/10/melatonin-much-more-th...
- kgwxd 8y agoI had no choice but to downvote for the greater good.
- qwerty456127 8y agoWould be nice if you could explain how am I wrong. For whatever greater good you mean as downvoting doesn't really change anything except multiplying hatred perhaps (I didn't downvote you back but I can hardly save you from being downvoted by others). If I said something stupid that can harm others and you want to save us you should probably be a little bit more informative.
- m0zg 8y agoDon't give away such valuable secret. One 3mg tablet lasts me a week!
- chrischen 8y agoBrilliant idea! And here I was buying the only 0.5mg I could find and breaking that in half.
- kristofferR 8y agoWhat a waste. You can buy premade 300mcg melatonin pills for $0.03/pill (Sundown Naturals on iHerb), so the time you spend measuring melatonin yourself is just wasted time.
- vegardx 8y agoThis is melatonin, so it's not really dangerous, but you should be careful with breaking up pills that aren't supposed to be broken in two or more. The amount of active ingredient is not evenly distributed in the pills, so you're not really halving the dosage. For some reason melatonin is sold i boxes of 30x2mg for $25, and you need a prescription. It's completely ludicrous. You're only allowed to bring a months worth across the border. It's illegal to order by mail. /rant
- heimatau 8y agoThis isn't true. Even if your experience is contrary to what I'm about to say. Melatonin isn't more effective by increasing the dose. Especially past 3mg. The body doesn't register anything past 3mg. But you also need to keep in mind that the placebo effect is strong.
- hn19128ks8 8y agoAnecdotally, I am taking it for years and haven't noticed any reduced effectiveness. Effectiveness increased when I reduced the dose to 0.3 mg. and started taking it several hours before sleep. https://slatestarcodex.com/2018/07/10/melatonin-much-more-than-you-wanted-to-know/ https://slatestarcodex.com/2018/07/10/melatonin-much-more-th... is pretty much a required reading on melatonin, as well as https://www.gwern.net/Melatonin https://www.gwern.net/Melatonin. Neither discuss tolerance at length unfortunately.
- takeda 8y agoI'm wondering if people who need to increase doses of melatonin also drink caffeine, especially in afternoon or later.
- Lewton 8y agoAnectdotal: daily use of 3 mg every night for three years Still works wonders
- tluyben2 8y agoSame here.
- rollulus 8y agoA while ago an article [1] was posted here [2] with focus on its effects on sleep. Might be useful as well. [1]: https://www.lesswrong.com/posts/E4cKD9iTWHaE7f3AJ/melatonin-much-more-than-you-wanted-to-know https://www.lesswrong.com/posts/E4cKD9iTWHaE7f3AJ/melatonin-... [2]: https://news.ycombinator.com/item?id=17632668 https://news.ycombinator.com/item?id=17632668