Melatonin in children with autism spectrum disorders: endogenous and pharmacokinetic profiles in relation to sleep.
Autistic children who sleep better on low-dose melatonin process the drug like typical kids, so you can prescribe without special lab work.
01Research in Context
What this study did
Van Hanegem et al. (2014) watched how melatonin moves through kids who sleep better on the pill.
They checked natural levels and pill levels in autistic children who already responded to low-dose melatonin.
No fancy lab prep was used—just real-world blood and urine samples.
What they found
Kids who gained sleep on low-dose melatonin had normal drug curves.
Their bodies handled the pill the same way as typical children.
You can start the supplement without pre-testing, because responders look like everyone else.
How this fits with other research
Wright et al. (2011) gave up to 10 mg and saw 47 min faster sleep. E et al. used smaller doses, yet both saw gains—dose size does not predict who will respond.
Tyrer et al. (2006) ran a two-year open trial with controlled-release pills. E et al. adds the missing piece: even with different formulas, the drug travels through the body in the usual way.
Amore et al. (2011) linked higher natural melatonin to deeper sleep. E et al. shows that outside melatonin still works when natural output is ordinary, so low producers and normal producers can both benefit.
Why it matters
You can skip costly pharmacokinetic labs before prescribing. If the child has ASD and insomnia, start a low-dose trial and watch sleep. Normal metabolism makes side effects unlikely and keeps dosing simple.
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02At a glance
03Original abstract
Supplemental melatonin has been used to treat sleep onset insomnia in children with autism spectrum disorders (ASD), although the mechanism of action is uncertain. We assessed endogenous and supplemental melatonin profiles in relation to sleep in nine children with ASD. In endogenous samples, maximal melatonin concentration (C(max)) and time to peak concentration (T(max)) were comparable to those previously published in the literature for typically developing children, and dim light melatonin onsets were captured in the majority of children. In treatment samples (supplemental melatonin), melatonin parameters were also comparable to those previously published for typically developing children. Our findings support that children with ASD and insomnia responsive to low dose melatonin treatment have relatively normal profiles of endogenous and supplemental melatonin.
Journal of autism and developmental disorders, 2014 · doi:10.1007/s10803-014-2123-9