Melatonin use among children, adolescents, and young adults: a Danish nationwide drug utilization study

• Published in: European child & adolescent psychiatry 2023-10, Vol.32 (10), p.2021-2029
• Main Authors: Bliddal, Mette, Kildegaard, Helene, Rasmussen, Lotte, Ernst, Martin, Jennum, Poul Jørgen, Mogensen, Stine Hasling, Pottegård, Anton, Wesselhoeft, Rikke
• Format: Article
• Language: English
• Subjects: Adolescents; Age; Age groups; Child and Adolescent Psychiatry; Cohort analysis; Family physicians; Long term; Medical diagnosis; Medicine; Medicine & Public Health; Melatonin; Original Contribution; Prescription drugs; Private practice; Psychiatry; Psychopathology; Specialists; Young adults
• ISSN: 1018-8827; 1435-165X
• DOI: 10.1007/s00787-022-02035-1

We aimed to provide a detailed description of the use of melatonin in Danish children, adolescents, and young adults during 2012–2019. We identified melatonin users 0–24 years of age ( n  = 43,652; median age 16 years) via the Danish nationwide health registers. Melatonin is a prescription drug in Denmark. The incidence of melatonin use increased from 2.4 to 3.9/1000 person-years during 2012 to 2019. Among 6,557 incident users in 2019, 53% filled only a single prescription within the first 6 months. Long-term use was most common among the younger age groups, with 17% of 5–9-year-olds and 14% of 10–13-year-olds being in continued treatment (no treatment breaks) 12 months after their first melatonin prescription. Disregarding treatment breaks, 3 in 10 were using melatonin 12 months after their first melatonin prescription and this proportion was also highest among 5–9-year-olds (63%) and 10–13-year-olds (51%). Psychopathology was common among melatonin users with 75% registered with either a psychiatric disorder diagnosis (54%), a filled prescription for another psychotropic (58%), or a contact to a private practice psychiatrist (15%) within ± 12 months of treatment initiation. General practitioners authorized melatonin prescriptions to almost half of all new users (48%), while psychiatric specialists authorized 37% of first prescriptions. In conclusion, the incidence of melatonin use increased in Denmark from 2012 to 2019. A substantial proportion of users had concurrent psychopathology most likely explaining their use of melatonin. Long-term melatonin use was more common among the youngest age groups, which should be a focus of interest due to limited safety data.