Something Weird Is Going On With Melatonin

According to a study, something weird is going on with melatonin as the number of annual calls to poison control for pediatric melatonin overdoses has risen by 530 percent over the prior 10 years.

In the dark, early days of the coronavirus pandemic, Michael Toce noticed a surprising trend. As a pediatric-emergency-medicine doctor at Boston Children’s Hospital, he was seeing lots of kids who had taken too much medication. The problem wasn’t that they’d overdosed on opioids or painkillers or marijuana. Instead, they’d swallowed too much melatonin, an over-the-counter supplement used as a sleep aid. The ill effects of this mistake seemed mild at the worst—drowsiness, nausea, vomiting—but the number of kids who were affected was going up, up, up.

Other doctors around the country were observing something similar. In 2022, a group in Michigan invited Toce to collaborate on a study of the phenomenon. Their findings, published last June, were striking. Over the prior 10 years, the number of annual calls to poison control for pediatric melatonin overdoses had risen by 530 percent. By 2020, poison control was receiving more calls about pediatric overdoses on melatonin than on any other substance. Just last month, in a broader study based on emergency-room data over a similar period, researchers at the CDC reported a 420 percent increase in visits for pediatric melatonin ingestions. Meanwhile, the overdose numbers for other substances plummeted during the 2010s: Tylenol, down 53 percent; opioids, down 54 percent; many cough and cold medications, down 72 percent. The question is: What sets melatonin apart?

The most obvious answer is its recent surge in popularity. From 2009 to 2018, American melatonin use increased fivefold, and from 2016 to 2020, U.S. sales of the supplement rose from $285 million to $821 million. A pandemic-era surge in diagnosed sleep disorders may have only accelerated this growing popularity. The year before melatonin usage began to rise, the CDC launched an initiative to reduce pediatric overdoses as a whole. It promoted the widespread adoption of flow restrictors and child-resistant packaging, and ran campaigns to educate parents about medication safety and storage. It’s possible that melatonin overdoses are rarer now than they would have been without the CDC’s safety initiative, but are still increasing on account of the supplement’s overall success in the marketplace.

Those changes in demand are “definitely a factor” in the associated surge in overdoses, says Pieter Cohen, a doctor and supplements expert at Cambridge Health Alliance, in Somerville, Massachusetts. Whether they account for all of the surge or most of it or merely some of it remains a mystery. Several other factors would also seem to be involved, Cohen told me. For starters, many melatonin supplements come in an appetizing gummy form. So do all sorts of vitamins and minerals for kids—vitamin A, vitamin C, calcium, zinc—but melatonin is not a vitamin or a mineral. It’s an active hormone, and the body has not developed great mechanisms for coping with its intake in excess, Cohen said.

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