See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/341294034

The role of melatonin in COVID-19 infected patients with psychiatric illness

Article  in  The British Journal of Psychiatry · May 2020

CITATIONS

1 author:

N.A. Uvais
IQRAA INTERNATIONAL HOSPITAL AND RESEARCH CENTRE
84 PUBLICATIONS   49 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Autoimmune Psychosis View project

Case Reports View project

All content following this page was uploaded by N.A. Uvais on 11 May 2020.

The user has requested enhancement of the downloaded file.

Home > Journals > The British Journal of Psychiatry > Treatment concerns for psychiat...

English | Français

The British Journal of Psychiatry

FirstView

Treatment concerns for psychiatric symptoms in patients with COVID-

19 with or without psychiatric disorders
Kai Zhang (a1), Xiaoqin Zhou (a1), Huanzhong Liu (a1) and Kenji Hashimoto (a2)

DOI: https://doi.org/10.1192/bjp.2020.84
Published online by Cambridge University Press: 09 April 2020

Submit a response

eLetters

The role of melatonin in COVID-19 infected patients with psychiatric illness

N.A. Uvais, Consultant Psychiatrist, Iqraa International Hospital and Research Centre
11 May 2020

Zhang et al described treatment concerns for psychiatric symptoms in COVID-19-infected patients with or
without psychiatric disorders and listed multiple psychotropic agents with tolerability and minimal drug–drug
interactions with antivirals recommended by the NHCC.1 I would like to add melatonin to that list. Melatonin is
a hormone secreted by the pineal gland at night which has many physiological functions, mainly to
synchronise individuals' biological rhythms.2 Recent evidences recommends the use of exogenous melatonin
in both acute and stabilised phase of many psychiatric illnesses when there are insomnia symptoms or to
prevent relapse in case of associated complaints of insomnia, poor quality sleep or delayed sleep phase
syndrome.2 In patients with COVID-19 infection with anxiety and insomnia, melatonin can be one of the first
line treatment modality as it also has been considered to be a potential adjuvant treatment in COVID-19
infection.2 This possible beneficial effects of melatonin as adjuvant use in COVID-19 is due to its role in anti-
inflammation, anti-oxidation, and immune response regulation.3 Moreover, the safety profile of melatonin in
humans is very high especially among patients admitted to the intensive care units and no adverse effects
were recorded with its use in acute lung injury and acute respiratory distress syndrome animal studies.3 There
are no drug interactions between melatonin and antivirals recommended by the NHCC.

Agomelatine, a melatonergic antidepressant can also be used among COVID-19 infected patients with
depression. A recent met analysis exploring the comparative efficacy and acceptability of 21 antidepressant
drugs for the acute treatment of adults with major depressive disorder found that agomelatine is an effective
and acceptable antidepressant with fewer dropouts than placebo.4 Moreover, it has no drug interactions with
antivirals recommended by the NHCC. However, clinicians should be aware of its rare adverse effect of
hepatotoxicity.

References:

Zhang K, Zhou X, Liu H, Hashimoto K. Treatment concerns for psychiatric symptoms in COVID-19-infected
patients with or without psychiatric disorders [published online ahead of print, 2020 Apr 9]. Br J Psychiatry
2020;1–3.

Geoffroy PA, Micoulaud Franchi JA, Lopez R, Schroder CM; membres du consensus Mélatonine SFRMS. The use
of melatonin in adult psychiatric disorders: Expert recommendations by the French institute of medical
research on sleep (SFRMS). Encephale 2019;45(5):413–423.

Zhang R, Wang X, Ni L, et al. COVID-19: Melatonin as a potential adjuvant treatment [published online ahead of
print, 2020 Mar 23]. Life Sci 2020;250:117583.

Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for
the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis.
Lancet 2018;391(10128):1357–1366.

Conflict of interest: None declared

Write a reply

Back to top

View publication stats