Melatonin Treatment Options
Immediate release melatonin should be considered the treatment choice for ADHD patients with sleep onset difficulties1
For patients with sleep onset difficulties, such as the majority of children with ADHD insomnia,2 an immediate release formulation should be considered.1 Where sleep maintenance is the prominent insomnia issue, a controlled release formulation is of greater benefit.1
Immediate Release e.g. Adaflex
Benefits
More useful when there is an issue with delayed sleep onset.1
Time to Maximum Concentration
52 minutes.3
Suitable for Crushing
Yes, crushing has no impact on efficacy profile.3
Timing
Insomnia: 30-60 minutes before bedtime and 2 hours before or after food.3
Prolonged / Modified Release – Not Licensed for Use in Children With ADHD Insomnia
Indications
Monotherapy for short-term treatment of primary insomnia characterised by poor quality sleep in patients who are aged 55 or over. Treatment of insomnia in children and adolescents aged 2-18 with Autism Spectrum Disorder (ASD) and/or Smith/Magenis syndrome where sleep hygiene measures have been insufficient.
Benefits
More useful for sleep maintenance.1
Time to Maximum Concentration
2-3 hours after food.5,6
Suitable for Crushing
No – crushing or dividing tablets into quarters changes the pharmacokinetic release profile and is off-label usage.5-7
Timing
Insomnia: 0.5-2 hours before bedtime and must be taken with or after food.5,6
Oral Solutions
Benefits
More useful when patient has swallowing difficulties.
Time to Maximum Concentration
~50 minutes.8
Suitable for Crushing
N/A
Timing
Insomnia: 30-60 minutes before bedtime and 2 hours before or after food.8
UK-AGB-ADA-0021 | Date of preparation: January 2024