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Efficacy and safety of exogenous melatonin in the adjuvant therapy of tumor: a meta-analysis

Bibliographic details: Xu WP, Wang WD, Xu TJ, Wei W, Sun ZG, Hu SL, Yan G.  Efficacy and safety of exogenous melatonin in the adjuvant therapy of tumor: a meta-analysis. Chinese Journal of Evidence-Based Medicine 2011; 11(6): 681-686 Available from: http://www.cjebm.org.cn/en/oa/DArticle.aspx?type=view&id=201106015

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Melatonin for treatment of sleep disorders

The aim of this review was to review the effectiveness of melatonin for the treatment of sleep disorders. The authors concluded that the short-term use of melatonin is generally not effective in treating primary or secondary sleep disorders, or the sleep disturbance aspect of jet lag and shift-work disorder. These conclusions were derived from a well-conducted review of relevant randomised studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Melatonin for the treatment of tardive dyskinesia

This review assessed melatonin for the treatment of tardive dyskinesia (TD). The authors concluded that there was insufficient evidence to support the use of melatonin for TD. Since the methods used to conduct the review were not reported, the reliability of the authors' conclusions could not be verified.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2003

Systematic review of melatonin treatment in children with neurodevelopmental disabilities and sleep impairment

This well-conducted review found improvements in time to sleep onset in children with neurodevelopmental disabilities and sleep impairment who were taking melatonin compared with placebo. However, the evidence was based on three trials of just 35 children. The authors highlighted the need for further, adequately powered trials to more clearly determine potential benefits and risks.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

A systematic review of the effectiveness of oral melatonin for adults (18 to 65 years) with delayed sleep phase syndrome and adults (18 to 65 years) with primary insomnia

This review assessed melatonin for adults with delayed sleep phase syndrome (DSPS) or primary insomnia (PI). The authors concluded that there is limited support for its use in people with DSPS, and little evidence to support its use for PI. These conclusions reflect the included evidence, which was poorly reported, but it is not clear whether they are reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

A systematic review of peri-operative melatonin

We systematically reviewed randomised controlled trials of peri-operative melatonin. We included 24 studies of 1794 participants that reported eight peri-operative outcomes: anxiety; analgesia; sleep quality; oxidative stress; emergence behaviour; anaesthetic requirements; steal induction; and safety. Compared with placebo, melatonin reduced the standardised mean difference (95% CI) pre-operative anxiety score by 0.88 (0.44-1.33) and postoperative pain score by 1.06 (0.23-1.88). The magnitude of effect was unreliable due to substantial statistical heterogeneity, with I(2) 87% and 94%, respectively. Qualitative reviews suggested the melatonin improved sleep quality and emergence behaviour, and might be capable of reducing oxidative stress and anaesthetic requirements.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Efficacy and safety of melatonin as an anxiolytic and analgesic in the perioperative period: a qualitative systematic review of randomized trials

Melatonin possesses sedative, hypnotic, analgesic, antiinflammatory, antioxidative, and chronobiotic properties that distinguish it as an attractive alternative premedicant. A qualitative systematic review of the literature concerning the perioperative use of melatonin as an anxiolytic or analgesic in adult patients was carried out using the recommended guidelines provided by the Cochrane Handbook for Systematic Reviews of Interventions. Nine of the 10 studies showed statistically significant reduction of preoperative anxiety with melatonin premedication compared with placebo. An opioid-sparing effect or reduced pain scores were evident in five studies whereas three studies were contradictory. Thus, melatonin premedication is effective in ameliorating preoperative anxiety in adults, but its analgesic effects remain controversial in the perioperative period. Additional well designed randomized controlled trials are necessary to compare melatonin premedication with other pharmacological interventions, investigate its effect on more varied surgical populations, and to delineate its optimal dosing regimen.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Melatonin in the treatment of cancer: a systematic review of randomized controlled trials and meta-analysis

Most observational studies show an association between melatonin and cancer in humans. We conducted a systematic review of randomized controlled trials (RCTs) of melatonin in solid tumor cancer patients and its effect on survival at 1 yr. With the aid of an information specialist, we searched 10 electronic databases from inception to October 2004. We included trials using melatonin as either sole treatment or as adjunct treatment. Prespecified criteria guided our assessment of trial quality. We conducted a meta-analysis using a random effects model. We included 10 RCTs published between 1992 and 2003 and included 643 patients. All trials included solid tumor cancers. All trials were conducted at the same hospital network, and were unblinded. Melatonin reduced the risk of death at 1 yr (relative risk: 0.66, 95% confidence interval: 0.59-0.73, I2=0%, heterogeneity P<or=0.56). Effects were consistent across melatonin dose, and type of cancer. No severe adverse events were reported. The substantial reduction in risk of death, low adverse events reported and low costs related to this intervention suggest great potential for melatonin in treating cancer. Confirming the efficacy and safety of melatonin in cancer treatment will require completion of blinded, independently conducted RCTs.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Exogenous melatonin for sleep problems in individuals with intellectual disability: a meta-analysis

The authors concluded that melatonin decreased sleep latency and the number of wakes per night and increased total sleep time in people with intellectual disabilities. These conclusions appeared supported by the evidence, but the limited search and incomplete reporting of review methods made it difficult to assess their reliability.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

The use of exogenous melatonin in delayed sleep phase disorder: a meta-analysis

STUDY OBJECTIVES: To perform a meta-analysis of the efficacy and safety of exogenous melatonin in advancing sleep-wake rhythm in patients with delayed sleep phase disorder.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Effectiveness of melatonin treatment on circadian rhythm disturbances in dementia: are there implications for delirium? A systematic review

The review concluded that sundowning (exacerbation of delirium during the evening or night)/agitated behaviour improved with melatonin treatment in patients with dementia. The authors? conclusions appear overly strong given the limitations of the evidence presented.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Optimal dosages for melatonin supplementation therapy in older adults: a systematic review of current literature

BACKGROUND: Melatonin is a hormone that regulates circadian rhythm, and its levels decline with age. As melatonin levels decrease, older adults are prone to develop disorders related to an altered circadian rhythm. The effective dose of melatonin supplementation in these disorders remains unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Association between the melatonin receptor 1B gene polymorphism on the risk of type 2 diabetes, impaired glucose regulation: a meta-analysis

BACKGROUND: Melatonin receptor 1B (MTNR1B) belongs to the seven-transmembrane G protein-coupled receptor superfamily involved in insulin secretion, which has attracted considerable attention as a candidate gene for type 2 diabetes (T2D) since it was first identified as a loci associated with fasting plasma glucose level through genome wide association approach. The relationship between MTNR1B and T2D has been reported in various ethnic groups. The aim of this study was to consolidate and summarize published data on the potential of MTNR1B polymorphisms in T2D risk prediction.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Melatonin as adjuvant cancer care with and without chemotherapy: a systematic review and meta-analysis of randomized trials

BACKGROUND: Melatonin (MLT) is known to possess potent antioxidant, antiproliferative, immune-modulating, and hormone-modulating properties. Clinical evidence suggests that MLT may have a possible role in the treatment of cancer. The authors systematically reviewed the effects of MLT in conjunction with chemotherapy, radiotherapy, supportive care, and palliative care on 1-year survival, complete response, partial response, stable disease, and chemotherapy-associated toxicities.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Melatonin supplementation during controlled ovarian stimulation for women undergoing assisted reproductive technology: systematic review and meta-analysis of randomized controlled trials

OBJECTIVE: To examine the best evidence available regarding the effect of melatonin supplementation during controlled ovarian stimulation (COS) on the main assisted reproductive technology (ART) outcomes.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Meta-analysis: melatonin for the treatment of primary sleep disorders

The review concluded that melatonin decreased sleep onset latency, increased total sleep time, and improved overall sleep quality compared with placebo in patients with primary sleep disorders. Given the limited search, inability to judge the quality of included trials, and results dominated by one large trial, the reliability of the authors' conclusion is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Effect of melatonin on nocturnal blood pressure: meta-analysis of randomized controlled trials

This review found that controlled-release melatonin treatment may have improved blood pressure control in patients with nocturnal hypertension. Some methodological flaws mean that the reliability of the authors' conclusions is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

The efficacy and safety of melatonin in concurrent chemotherapy or radiotherapy for solid tumors: a meta-analysis of randomized controlled trials

The authors concluded that melatonin as an adjuvant therapy for solid tumour cancer led to substantial improvements in tumour remission, one-year survival, and alleviation of radiochemotherapy-related side effects. Although the results were based mainly on small single-centre studies, the authors' conclusion reflects the moderate-quality evidence presented and seems likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

The use of melatonin as an adjunctive treatment for epilepsy

Epilepsy is one of the most common chronic neurologic disorders, and despite several antiepileptic drugs being available, 30% of patients continue having seizures. Reports have suggested an antiepileptic role of melatonin with a good safety profile. Four trials representing 102 participants were included in the present review. Two different comparisons were available: 1. melatonin versus placebo and 2. melatonin 5 mg versus melatonin 10 mg. Included trials were of poor methodologic quality, and did not systematically evaluate seizure frequency, seizure freedom and adverse events. Only one study systematically reported seizure frequency occurring during the trial compared to the baseline, and only one trial evaluated the direct influence of melatonin on quality of life. It is not possible to draw any definitive conclusions about the role of melatonin in reducing seizure frequency or improving the quality of life in people with epilepsy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Melatonin treatment may be effective for the treatment of dementia‐related behavior disturbances

There are a number of studies that suggest a relationship between decline of melatonin function and the symptoms of dementia. Meta‐analysis was conducted on data from three randomised, placebo controlled trials that were designed to evaluate melatonin for managing dementia‐related cognitive changes; data also were pooled from two of these trials that evaluated melatonin for managing mood and behavioral disturbances. Significantly improved outcomes were found from the meta‐analysis of psychopathologic behavior and mood scale scores. Melatonin treatment may be effective for the treatment of dementia‐related psychopathologic behavior disturbances. No evidence was found to support the effectiveness of melatonin for the treatment of cognitive impairment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Systematic Reviews in PubMed

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