Bipolar Disorder: Melatonin Fails to Treat Mania

Pavankumar Kamat

June 08, 2020

Melatonin failed to effectively treat emerging hypomania or mania in patients with bipolar disorder in a small randomised controlled trial. The findings were published in the journal  Bipolar Disorders .

The Melatonin In Acute Mania Investigation (MIAMI-UK) was a randomised, double-blind, parallel-group, three-week trial that compared modified-release melatonin (n=21) and placebo (n=20) in patients with bipolar disorder aged 18-65 years.

There was no significant difference between melatonin and placebo on the mean Young Mania Rating Scale score at day 21 (mean difference [MD], −1.77; P=.447). A significantly lesser proportion of individuals treated with melatonin scored ≥10 on the Altman Self Rating Mania Scale (OR, 0.164; P=.05). There was no significant difference between the groups on the Quick Inventory of Depression Symptomatology (QIDS) Clinician Version-16 scores (OR, 1.77; P=.430). More patients in the melatonin group scored ≤5 on the QIDS Self-Rated Version-16 at endpoint than those in the placebo group (OR, 8.35; P=.046).

Despite negative findings, the authors call for further research to determine whether melatonin can decrease mood instability over a longer period of time. They add: "Growing evidence of the relevance of circadian rhythms as a construct in a subset of patients with mood disorder and the use of light and chronotherapeutic interventions as treatments argues for additional investigations."

Quested DJ, Gibson JC, Sharpley AL, Cordey JH, Economou A, De Crescenzo F, Voysey M, Lawson J, Rendell JM, Al-Taiar H, Lennox A, Ahmad F, Geddes JR. Melatonin In Acute Mania Investigation (MIAMI-UK). A randomised controlled trial of add-on melatonin in bipolar disorder. Bipolar Disord. 2020 May 31 [Epub ahead of print]. doi: 10.1111/bdi.12944. PMID: 32474993. View abstract.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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