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    Melatonin is a naturally occurring “lights off” hormone produced by the pineal gland.

    In addition to resolving sleep-related symptoms through their primary therapeutic effects, many psychiatric medications have secondary effects on sleep that can contribute to their overall therapeutic benefit or sometimes counter them through adverse effects.Various classes of agents have been shown to be associated with risks of abuse, dependency, and toxicity with overdosage, but among classes of agents perceived to be more safe have been the antidepressants, various herbal reparations thought to be effective in promoting and sustaining sleep, and the naturally occurring hormone melatonin.This column reviews the safety and efficacy of these agents, including suggestions and concerns about their use from the 2005 State of the Science Conference on Insomnia sponsored by the National Institutes of Health (NIH).For example, Buscemi and colleagues 14 trials were included for efficacy and 10 for safety.No difference was seen between melatonin and placebo for any efficacy outcome except for sleep-onset latency, which was reduced with melatonin by 11.7 minutes.

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