What is the link between epilepsy and melatonin?

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Limited studies have explored melatonin as a complementary treatment for epilepsy.

According to a 2016 review, research estimates that 30% of epilepsy cases are resistant to medications, meaning that three or more treatment options were not sufficient. Some people with epilepsy may require treatment with more than one drug to prevent seizures.

However, treatment with more than one drug, called polytherapy, can sometimes cause disruptive side effects, such as dizziness, daytime sleepiness, and behavioral changes.

Some research has proposed melatonin as an option with low side effects for supporting epilepsy medication.

However, the 2016 review concluded that melatonin did not reduce the number of seizures or even assess changes in quality of life after taking the supplement.

A 2023 observational study involving 20 children with epilepsy suggests a link between sleep and epilepsy. Epilepsy seizures might interfere with sleep, and sleep disturbances could make epilepsy worse.

In the study, supplementation with 4 milligrams (mg) of melatonin improved sleep quality and reduced daytime sleepiness.

However, melatonin did not directly reduce seizures. Larger studies are necessary to confirm this potential link.

Other theories suggest that melatonin may have protective effects on the brain and reduce inflammation, which could lend itself to a role in reducing seizures.

However, no hard evidence based on high quality studies has confirmed this.

The 2016 review mentioned above found that studies into melatonin and epilepsy up to 2016 were of poor quality and had mixed results.

This means it is not possible to reach a firm conclusion about whether melatonin can help people with epilepsy.

The National Center for Complementary and Integrative Health (NCCIH) also warns doctors to supervise melatonin supplementation for people while receiving epilepsy treatment.

However, some small, recent studies found that melatonin may show some promise alongside epilepsy treatments pending larger, higher quality research.

A 2023 study with 60 participants found that people taking valproic acid, which is an epilepsy medication, with a melatonin supplement had less severe epilepsy symptoms and higher quality sleep than people taking valproic acid with a placebo.

According to the NCCIH, short-term side effects of melatonin may include:

• dizziness
• feeling sleepy
• headache
• nausea

No research has explored the long-term side effects of melatonin.

The World Health Organization (WHO) estimates that the cause of seizures is unclear in roughly half of all people with epilepsy.

However, the WHO identifies several medical issues that can trigger epilepsy, including:

• brain trauma for a child during pregnancy or birth, such as not getting enough oxygen during delivery or a low birth weight
• congenital abnormalities that cause brain development issues
• head injury
• a stroke that reduces brain oxygen
• brain infections, including meningitis
• genetic conditions, such as autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE)
• brain tumors

Epilepsy is treatable in most people with the condition.

Self-management

Certain lifestyle strategies can help people manage their epilepsy. These can include:

• getting sufficient sleep
• exercising regularly
• trying to identify and avoid potential triggers

Doctors might also recommend low carb, high fat, moderate protein eating plans for managing epilepsy, which they start and oversee in a hospital. Examples include:

• keto
• low glycemic index
• a modified Atkins diet

Medications

Antiepileptic drugs can stop seizures in around 70% of people with epilepsy, according to the American Association of Neurological Surgeons. These drugs reduce the risk of excessive brain signals that can lead to seizures.

A wide range of antiepileptic drugs is available since there are many types and causes of epilepsy. Finding the right drug may take some trial and error.

Surgery

Epilepsy that is resistant to medications may be treated with surgery.

Brain surgery can help stop or reduce seizures. Epilepsy treatment centers thoroughly assess people with epilepsy to see whether they qualify for surgery.

People are suitable candidates for surgery if they meet several criteria:

• the seizures happen in a single part of the brain and not the whole brain
• the seizures do not respond to medication
• the seizures happen in a part of the brain that will not cause severe issues with daily function if a surgeon removes it

Epilepsy surgery aims to either remove, disconnect, or modify parts of the brain and nervous system to reduce seizures.

It is advisable people speak with a doctor after their first suspected seizure.

A person may not have epilepsy. A seizure can have many underlying causes or may just be an isolated event. A medical professional can help determine why a seizure happened and arrange treatment where necessary.

People who witness someone else having a seizure should call 911 in the following circumstances:

• The person having the seizure has never had one before.
• The seizure lasts longer than 5 minutes.
• The person has several seizures, one after another.
• The person has sustained an injury during a seizure.
• The person is struggling to breathe.

Some research has suggested a link between melatonin and epilepsy. Epilepsy and sleep may interact. Some studies have suggested melatonin as a low risk complementary therapy due to its possible protective effects on the brain and sleep-promoting qualities.

However, the research quality is low, and the results are inconclusive.

Melatonin carries a risk of mild side effects, but it is still a good idea for a person to speak with a doctor before trying melatonin to manage epileptic seizures.

A range of treatments, including medications, dietary and lifestyle interventions, and surgery, are available to treat epilepsy.