Patients should not be prescribed melatonin for jet lag on NHS, review finds

Patients should not be prescribed melatonin for jet lag on the NHS, a new expert review has concluded.

In the study published in Drug and Therapeutics Bulletin, researchers said the treatment should be added to the list of treatments which are not routinely funded by the NHS, as it's a condition which clears up on its own within a few days and there is little evidence to suggest that prescription melatonin makes a significant difference to symptom relief.

Jet lag can occur when crossing time zones too quickly for your body clock to adjust, and is more often worse when flying eastwards. It may result in poor sleep, fatigue, brain fog and gut issues, or what some have described as "gut lag".

Melatonin meanwhile is a hormone which the body produces naturally predominantly at nighttime and is believed to play an important role in regulating the circadian rhythm or sleep/wake cycle. According to the NHS, melatonin is typically used to treat sleep problems in over 55s and sometimes in children.

In 2019 the Medicines and Healthcare products Regulatory Agency (MHRA) licensed two melatonin products for short-term jet-lag treatment in the UK and it is currently available on prescription only. It has been licensed for the treatment of jet lag in the EU for the last decade and so the manufacturer was not required to provide new data for UK approval, the authors note.

A meta-analysis of data from four studies suggests melatonin does appear to reduce symptoms, albeit not entirely. People using melatonin ranked their jet lag severity 27 out of 100 while those who took a placebo rated theirs 45 out of 100.

But review co-author Dr David Phizackerley said there is still "lots of unanswered questions about [melatonin for jet lag]," in a linked podcast.

Reported side effects of use include drowsiness and sleepiness, headache, dizziness and disorientation and it may increase seizure frequency in people who have epilepsy and is not recommended for those with autoimmune diseases.

Meanwhile co-author Dr James Cave also raised concerns that people could start to overuse melatonin for general insomnia.

"I have concerns also perhaps that you will get licence creep, and that it will be used for people with sleep problems in general, and it's not really a good way of dealing with those," he said in the podcast.

The authors conclude: "Since jet lag is a self-limiting short term problem and there is limited published evidence of the benefit of melatonin on symptoms, we do not think that it is appropriate for such a product to be made available through the National Health Service.

"We would suggest that melatonin for jet lag is added to the list of drugs that may not be ordered under a General Medical Services Contract."