Low-dose melatonin may be ineffective therapy for nocturia in adult patients with multiple sclerosis (MS), according to a new study.
Melatonin is known to regulate circadian rhythm and decrease smooth muscle activity such as in the bladder, Marcus J. Drake, MD, of the University of Bristol in Bristol, UK, and colleagues explained in BMC Neurology (2018;18:107). Limited evidence exists supporting the use of melatonin to ease urinary frequency at night in the treatment of nocturia. In MS, sleep quality commonly is decreased as a consequence of a wide range of sleep abnormalities, nocturia among them, according to the researchers.
In a double-blind placebo-controlled trial, Dr Drake’s team randomly assigned 31 patients with nocturia secondary to MS to receive either 2 mg per night of capsulated sustained-release melatonin (taken at bedtime) or 1 placebo capsule for 6 weeks, followed by crossover to the other regimen for an additional 6 weeks after a 1-month washout period.
Twenty-six patients completed the study. The investigators found no significant difference in the signs or symptoms of nocturia when taking 2 mg melatonin vs placebo. The mean number of nocturia episodes recorded in bladder diaries—the primary outcome measure—was 1.8 per night at baseline and 1.4 per night on melatonin and 1.6 per night on placebo. Dr Drake’s team also found no significant difference in lower urinary tract symptoms, quality of life, and sleep quality when taking melatonin.
The authors concluded that “a low dose of melatonin taken at bedtime may be an ineffective therapy for nocturia in MS, studying an adult population with nocturia once per night or more often. A different dose regimen of melatonin or recruitment selection criteria would need to be considered to ascertain whether melatonin could influence nocturia in MS.”
Drake MJ, Canham L, Cotterill N, et al. Results of a randomized, double blind, placebo controlled, crossover trial of melatonin for treatment of nocturia in adults with multiple sclerosis (MeNiMS). BMC Neurol. 2018;18:107.