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Paediatric melatonin poisonings increasing

Posted 12 June 2022

Melatonin, which is regulated by the U.S. Food and Drug Administration as a dietary supplement, is widely used as a sleep aid. According to an analysis of 260,435 reports of ingestion of melatonin by teenagers and preteens made to the American Association of Poison Control Centers’ National Poison Data System from 2012 to 2021:

  • 94.3% of the ingestions were unintentional
  • 83.8% were among children under age six
  • 17.2% involved symptoms, mostly of the gastrointestinal, cardiovascular, or central nervous systems
  • 99.0% occurred in the home
  • 88.3% were managed on-site
  • among 27,795 patients who received care at a health care facility, 19,892 (71.6%) were discharged, 4,097 (14.7%) were hospitalized, and 287 (1.0%) required intensive care
  • most of the hospitalized were teenagers with intentional ingestions
  • 4,555 (1.6%) resulted in more serious outcomes including five children who required mechanical ventilation and two died
  • pediatric ingestion reports increased from 8,337 in 2012 to 52,563 in 2021
  • the number of pediatric ingestions per 100,000 people in the U.S. increased more than six-fold from 2012 to 2021
  • melatonin ingestions represented 2.25% of all pediatric ingestions during the 10-year study period, 0.6% of pediatric ingestions in 2012, and 4.9% of pediatric ingestions in 2021
  • the largest increase in melatonin-related hospitalization occurred among children under six years of age with unintentional ingestions
  • the increase in melatonin-related hospitalizations and serious outcomes may be due to: (a) the huge variability in melatonin content between lots of the same product, particularly chewable formulations that are most likely used by children, and (b) toxicity due to serotonin, a breakdown product of melatonin that has been frequently found in melatonin supplements

The researchers suggested that child-resistant packaging of melatonin products should be considered.

Reference: Lelak K and others. Pediatric Melatonin Ingestions – United States, 2012–2021. MMWR, 71:725–729, 2022

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