Clinical efficacy and safety of melatonin supplementation in multiple sclerosis: a systematic review

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#humans #melatonin #multiple-sclerosis #multiple-sclerosis-relapsing-remitting #treatment-outcome

Clinical efficacy and safety of melatonin supplementation in multiple sclerosis: a systematic review

Morsali et al., 2023 | Inflammopharmacology | Systematic Review

Citation

Morsali Soroush, Sabahi Zahra, ... Naseri Amirreza. Clinical efficacy and safety of melatonin supplementation in multiple sclerosis: a systematic review. Inflammopharmacology. 2023-Oct;31(5):2213-2220. doi:10.1007/s10787-023-01271-4

Abstract

BACKGROUND: Melatonin is a neurohormone secreted predominantly by the pineal gland that is demonstrated to be associated with the pathogenesis of multiple sclerosis (MS). This research desires to evaluate the tolerability and beneficial effects of exogenous melatonin supplementations in patients with MS. METHODS: This study was executed following the PRISMA 2020 statement. Both observational and interventional studies which reported the clinical effectiveness and/or safety of melatonin supplementation in patients with MS were included in this systematic review. Ovid, PubMed, Scopus, Embase, and Web of Science databases were searched and the risk of bias in included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools based on study design. RESULTS: Out of 1304 results of database searches, finally, 14 articles, including 7 randomized controlled trials (RCTs), 6 case-control studies, and one quasi-experimental study, were included based on the full-text review. Included phenotypes of MS were mostly relapsing-remitting MS (RRMS) (in 11 studies); it was secondary progressive MS (SPMS) in only one study, and two other studies had a mixture of the different phenotypes. The course of treatment with melatonin supplementation was between 2 weeks and 12 months. There were no substantial safety issues. Although melatonin was associated with enhanced oxidative stress and inflammation status, concerning the clinical benefits, limited studies suggested improvements in sleep conditions, cognitive outcomes, and fatigue in MS. DISCUSSION: There are insufficient data to support the regular melatonin prescription in MS. Limitations such as the small number of included studies, the diversity of the dosage, route, and duration of melatonin administration, and the diversity of assessment tests lead to unconvincing findings in this study. There is a need for future studies to achieve a comprehensive judgment on this subject.

Key Findings

Out of 1304 results of database searches, finally, 14 articles, including 7 randomized controlled trials (RCTs), 6 case-control studies, and one quasi-experimental study, were included based on the full-text review. Included phenotypes of MS were mostly relapsing-remitting MS (RRMS) (in 11 studies); it was secondary progressive MS (SPMS) in only one study, and two other studies had a mixture of the different phenotypes. The course of treatment with melatonin supplementation was between 2 weeks a

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population ms
Sample Size 11
Age Range See abstract
Condition sleep

MeSH Terms

  • Humans
  • Melatonin
  • Multiple Sclerosis
  • Multiple Sclerosis, Relapsing-Remitting
  • Treatment Outcome
  • Dietary Supplements

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article
  • Vertical: melatonin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09