Melatonin is a naturally produced hormone in the body that helps to regulate the body’s sleep cycle. [1] Because of this, melatonin has become a widely available and popular supplement that people take to improve sleep. However, it’s possible to have a melatonin overdose by taking too much of these supplements.
Melatonin overdose is rare. However, there has been a huge increase in the number of pediatric melatonin overdoses, with a 550% rise between 2012 and 2021, 15% of which required hospitalization. [4] This is of particular concern as overdose in children can be more dangerous than in adults.
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Can you overdose on melatonin?
Melatonin is one of the least toxic medications you can take; however, overdose is still possible. [2] For adults, it’s recommended to start at a low dose (0.5-1mg) and gradually increase it as needed. There is no standardized or safe melatonin dose that applies to everyone, with some people taking 10mg or even more per night.
In a melatonin overdose, there is too much melatonin in the body for it to handle, leading to adverse effects. The amount of melatonin that would trigger this reaction varies from person to person. However, melatonin overdose is not typically life-threatening.
How does a melatonin overdose happen?
The two main ways melatonin overdose can happen are accidentally or intentionally. In accidental overdoses, people might unintentionally take stronger doses of melatonin than they intended, or forget they have already taken some, so they take more. Intentional overdoses happen when people purposely take a high quantity of melatonin to do themselves harm. [2][3]
People often take melatonin as ‘gummies’, which are available in high strengths and can make an overdose more likely, particularly for individuals who aren’t used to taking melatonin or this format of supplements in general. Accidental overdose is the most common cause in children, often due to the child mistaking melatonin gummies for candy. Dosing errors can also occur, with accidental double-dosing or unintentionally giving an adult dose of melatonin to a child.
Symptoms and severity of melatonin overdose
There is a wide range of symptoms that can be caused by melatonin overdose. These include: [2]
- Excessive drowsiness
- Dizziness
- Fatigue
- Headache
- Confusion
- Low blood pressure
- Low body temperature
- High heart rate
Low-level overdoses are likely to cause only mild symptoms. However, larger overdoses have been found to cause some severe symptoms, including reduced levels of consciousness, which require hospital treatment. [2][3] Despite this, melatonin overdose is rarely life-threatening. There has been a case report of an individual who took 900mg of melatonin and made a full recovery after hospital treatment. [3] However, melatonin can affect people differently, so it’s important not to exceed your recommended dose.
Risk factors that increase harm
Several factors can increase the risk of harm from a melatonin overdose. Children are more susceptible to the adverse effects of higher melatonin doses than adults. Individuals who are used to taking higher doses of melatonin are less likely to experience harm from overdose compared to someone who is not used to higher doses, or who doesn’t take melatonin at all. Additionally, the higher the dose of melatonin taken, the greater the likelihood of harm and adverse effects.
What to do if you suspect a melatonin overdose
If you think that you, or someone you know, might have had a melatonin overdose, it’s important to get professional advice. If the amount of melatonin is relatively small and no serious adverse effects are being experienced, you can call Poison Control at 1-800-222-1222 to receive free, expert, and confidential advice.
If you or someone else has taken a large amount or is showing serious symptoms — such as confusion, difficulty staying awake, or reduced consciousness — call 911 immediately. If the person is unconscious but breathing, place them in the recovery position (on their side) and stay with them until help arrives. If you think they have stopped breathing, call 911 right away and begin CPR if you are trained to do so.
Treatment and management of melatonin overdose
There is no specific treatment for melatonin overdose. Several generic treatments can be used to help prevent the absorption of melatonin, such as gastric lavage and activated charcoal. [2] Monitoring of vital signs and IV fluids can play a role, especially for individuals with reduced consciousness who might be unable to eat and drink. Flumazenil, a treatment for benzodiazepine overdose, can also sometimes be used to help treat melatonin overdose. [3]
Preventing melatonin overdose: Safety tips for families and individuals
Prevention of melatonin overdose is preferable to treatment, and the following safety tips can help with this:
- Safe storage. Store melatonin in child-resistant containers, away from children's reach. Never leave gummies or supplements on display where they could be mistaken for candy.
- Family education. Teach all household members that melatonin requires the same caution as prescription medications, so it shouldn’t be taken without proper guidance. Ensure children understand the difference between supplements and candy.
- Proper dosing. Start with the lowest effective dose (0.5-1mg for adults) and track doses to prevent double-dosing. Pill organizers or phone reminders can be used if needed, and never exceed recommended doses without medical guidance.
Regulation, label variability, and public health issues
As melatonin is viewed as a dietary supplement rather than a prescription drug, it isn't subject to rigorous testing requirements or regulations. There have been significant issues with mislabelling and quality control, with research finding some melatonin products contain up to 478% more melatonin than labeled, while others contain less. [5] This makes accurate dosing difficult and increases overdose risk.
Additionally, melatonin gummies can be viewed as candy, despite containing high doses of melatonin, which can make overconsumption more likely. Stricter regulations for accurate dose testing and labelling, clearer safety warnings, and trading gummies for pills could help reduce overdose risk.
Balancing the benefits and risks of melatonin use
While overdose risks exist, melatonin remains relatively safe when used appropriately. Many people find it helps to improve their sleep, and it can be particularly useful for those who are jet-lagged or do shift work. Starting with the lowest effective dose, using melatonin intermittently rather than nightly when possible, and following the safety tips can help reduce the risks while still getting the key benefits.
It’s recommended to have guidance from a medical professional about melatonin dosing, particularly for children. Choosing reputable manufacturers can help ensure accurate labeling and quality. By staying informed about proper use and potential risks, people can safely benefit from melatonin's sleep-promoting effects while protecting themselves and their families from overdose.
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