Melatonin as an add-on treatment for epilepsy: A systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#melatonin #humans #epilepsy #anticonvulsants #drug-therapy-combination

Melatonin as an add-on treatment for epilepsy: A systematic review and meta-analysis

Liu et al., 2024 | Seizure | Meta Analysis

Citation

Liu Zhifan, Zhu Jie, ... Jiang Guohui. Melatonin as an add-on treatment for epilepsy: A systematic review and meta-analysis. Seizure. 2024-Apr;117:133-141. doi:10.1016/j.seizure.2024.02.016

Abstract

PURPOSE: Epilepsy, one severe prevalent brain disorder, primarily relies on drug treatment. However, approximately one-third of patients with epilepsy do not achieve effective control with current medications, underscoring the need for more innovative treatment approaches. Notably, melatonin has gained attention for its anti-seizure properties and favourable safety profile. This systematic review aimed to evaluate the efficacy and safety of melatonin as an add-on treatment for epilepsy. METHODS: We searched for articles published before June 2023 in Web of Science, Cochrane Library, and PubMed. We used RevMan 5.4 software to compute relative risks (RRs) and 95 % confidence intervals (CIs). Key outcomes included total sleep time, wakefulness after sleep onset, sleep latency, seizure frequency, seizure severity, and safety. The quality of randomised controlled studies (RCTs) was assessed using the Cochrane Risk of Bias tool. RESULTS: Of the 264 publications retrieved, 10 RCTs were included in the meta-analysis. Add-on melatonin treatment improved sleep latency (RR: 0.56; 95 %CI: 0.10-1.02; P = 0.02) and seizure severity (RR: 0.33; 95 %CI: 0.04-0.62; P = 0.03) compared with placebo treatment. Adverse events (increased headache severity in children with a history of migraines, bronchitis, ear infections, agitation, and urinary frequency) were reported in only one trial. CONCLUSION: This systematic review found that add-on melatonin therapy improved sleep latency and seizure severity in patients with epilepsy. However, several of the included studies did not systematically assess sleep quality, seizures, and safety and lacked long-term follow-up data. Further RCTs with extended follow-up periods are required to definitively determine the efficacy and safety of melatonin.

Key Findings

Of the 264 publications retrieved, 10 RCTs were included in the meta-analysis. Add-on melatonin treatment improved sleep latency (RR: 0.56; 95 %CI: 0.10-1.02; P = 0.02) and seizure severity (RR: 0.33; 95 %CI: 0.04-0.62; P = 0.03) compared with placebo treatment. Adverse events (increased headache severity in children with a history of migraines, bronchitis, ear infections, agitation, and urinary frequency) were reported in only one trial.

Outcomes Measured

  • sleep quality

Population

Field Value
Population epilepsy do not achieve
Sample Size 10
Age Range See abstract
Condition sleep

MeSH Terms

  • Melatonin
  • Humans
  • Epilepsy
  • Anticonvulsants
  • Drug Therapy, Combination

Evidence Classification

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

Provenance

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