Effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment

Gabriele Masi,1 Pamela Fantozzi,1 Arianna Villafranca,1 Annalisa Tacchi,1 Federica Ricci,1 Laura Ruglioni,1 Emanuela Inguaggiato,1 Chiara Pfanner,1 Samuele Cortese2 1IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy; 2Clinical and Experimental Scien...

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Autores principales:	Masi G, Fantozzi P, Villafranca A, Tacchi A, Ricci F, Ruglioni L, Inguaggiato E, Pfanner C, Cortese S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Attention Deficit Hyperactivity Disorder Sleep disorders Children Melatonin Methylphenidate Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/33e1087922814972bcc0ac0b63dcd611
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spelling	oai:doaj.org-article:33e1087922814972bcc0ac0b63dcd6112021-12-02T09:04:59ZEffects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment1178-2021https://doaj.org/article/33e1087922814972bcc0ac0b63dcd6112019-03-01T00:00:00Zhttps://www.dovepress.com/effects-of-melatonin-in-children-with-attention-deficithyperactivity-d-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Gabriele Masi,1 Pamela Fantozzi,1 Arianna Villafranca,1 Annalisa Tacchi,1 Federica Ricci,1 Laura Ruglioni,1 Emanuela Inguaggiato,1 Chiara Pfanner,1 Samuele Cortese2 1IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy; 2Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK Purpose: Methylphenidate (MPH), the first-line medication in children with attention-deficit/hyperactivity disorder (ADHD), is associated with increased risk of sleep disorders. Melatonin has both hypnotic and chronobiotic properties that influence circadian rhythm sleep disorders. This study explores the effectiveness of melatonin in children with ADHD who developed sleep problems after starting MPH. Patients and methods: This study, based on a clinical database, included 74 children (69 males, mean age 11.6±2.2 years) naturalistically treated with MPH (mean dosage 33.5±13.5 mg/d). The severity of sleep disorder (sleep onset delay) was recorded at baseline and after a follow-up of at least 4 weeks using a seven-point Likert scale according to the Clinical Global Impression Severity score. Effectiveness of melatonin on sleep (mean dosage 1.85±0.84 mg/d) after 4 weeks was assessed using a seven-point Likert scale according to the Clinical Global Impression Improvement (CGI-I) score, and patients who scored 1 (very much improved) or 2 (much improved) were considered responders. Results: Clinical severity of sleep disorders was 3.41±0.70 at the baseline and 2.13±1.05 after the follow-up (P<0.001). According to the CGI-I score, 45 patients (60.8%) responded to the treatment with melatonin. Gender and age (children younger and older than 12 years) did not affect the response to melatonin on sleep. Patients with or without comorbidities did not differ according to sleep response. Specific comorbidities with disruptive behavior disorders (oppositional defiant disorder or conduct disorder), affective (mood and anxiety) disorders and learning disabilities did not affect the efficacy of melatonin on sleep. Treatment was well tolerated, and no side effects related to melatonin were reported. Conclusion: In children with ADHD with sleep problems after receiving MPH treatment, melatonin may be an effective and safe treatment, irrespective of gender, age and comorbidities. Keywords: attention–deficit/hyperactivity disorder, sleep disorders, children, melatonin, methylphenidateMasi GFantozzi PVillafranca ATacchi ARicci FRuglioni LInguaggiato EPfanner CCortese SDove Medical PressarticleAttention Deficit Hyperactivity DisorderSleep disordersChildrenMelatoninMethylphenidateNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 663-667 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Attention Deficit Hyperactivity Disorder Sleep disorders Children Melatonin Methylphenidate Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	Attention Deficit Hyperactivity Disorder Sleep disorders Children Melatonin Methylphenidate Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Masi G Fantozzi P Villafranca A Tacchi A Ricci F Ruglioni L Inguaggiato E Pfanner C Cortese S Effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment
description	Gabriele Masi,1 Pamela Fantozzi,1 Arianna Villafranca,1 Annalisa Tacchi,1 Federica Ricci,1 Laura Ruglioni,1 Emanuela Inguaggiato,1 Chiara Pfanner,1 Samuele Cortese2 1IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy; 2Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK Purpose: Methylphenidate (MPH), the first-line medication in children with attention-deficit/hyperactivity disorder (ADHD), is associated with increased risk of sleep disorders. Melatonin has both hypnotic and chronobiotic properties that influence circadian rhythm sleep disorders. This study explores the effectiveness of melatonin in children with ADHD who developed sleep problems after starting MPH. Patients and methods: This study, based on a clinical database, included 74 children (69 males, mean age 11.6±2.2 years) naturalistically treated with MPH (mean dosage 33.5±13.5 mg/d). The severity of sleep disorder (sleep onset delay) was recorded at baseline and after a follow-up of at least 4 weeks using a seven-point Likert scale according to the Clinical Global Impression Severity score. Effectiveness of melatonin on sleep (mean dosage 1.85±0.84 mg/d) after 4 weeks was assessed using a seven-point Likert scale according to the Clinical Global Impression Improvement (CGI-I) score, and patients who scored 1 (very much improved) or 2 (much improved) were considered responders. Results: Clinical severity of sleep disorders was 3.41±0.70 at the baseline and 2.13±1.05 after the follow-up (P<0.001). According to the CGI-I score, 45 patients (60.8%) responded to the treatment with melatonin. Gender and age (children younger and older than 12 years) did not affect the response to melatonin on sleep. Patients with or without comorbidities did not differ according to sleep response. Specific comorbidities with disruptive behavior disorders (oppositional defiant disorder or conduct disorder), affective (mood and anxiety) disorders and learning disabilities did not affect the efficacy of melatonin on sleep. Treatment was well tolerated, and no side effects related to melatonin were reported. Conclusion: In children with ADHD with sleep problems after receiving MPH treatment, melatonin may be an effective and safe treatment, irrespective of gender, age and comorbidities. Keywords: attention–deficit/hyperactivity disorder, sleep disorders, children, melatonin, methylphenidate
format	article
author	Masi G Fantozzi P Villafranca A Tacchi A Ricci F Ruglioni L Inguaggiato E Pfanner C Cortese S
author_facet	Masi G Fantozzi P Villafranca A Tacchi A Ricci F Ruglioni L Inguaggiato E Pfanner C Cortese S
author_sort	Masi G
title	Effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment
title_short	Effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment
title_full	Effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment
title_fullStr	Effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment
title_full_unstemmed	Effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment
title_sort	effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/33e1087922814972bcc0ac0b63dcd611
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Effects of melatonin in children with attention-deficit/hyperactivity disorder with sleep disorders after methylphenidate treatment

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