Melatonin Helped Schizophrenia with Insomnia: Low melatonin levels have also been observed in patients with schizophrenia. In a DB PC study of 40 stable DSM-IV schizophrenic outpatients with initial insomnia of at least 2 weeks' duration, melatonin (3-12 mg/night did better than placebo and significantly improved the quality and depth of nighttime sleep, reduced the number of nighttime awakenings, and increased the duration of sleep without producing a morning hangover (p < .05). Subjectively, melatonin also significantly reduced sleep-onset latency, heightened freshness on awakening, improved mood, and improved daytime functioning (p < .05). The authors conclude, “Melatonin could be considered for patients in whom conventional hypnotic drug therapy or higher sedative antipsychotic drug doses may be problematic.” Melatonin in schizophrenic outpatients with insomnia: a double-blind, placebo-controlled study. Suresh Kumar PN, et al. Kozhikode . J Clin Psychiatry 2007 Feb;68(2):237-41.

Anti-Oxidant Values Low and Inversely Related to Symptom Scores: 76 patients with schizophrenia and 25 healthy volunteers had their Total Antioxidant Response values measured. Plasma TAR levels of each schizophrenia subtype were significantly lower than healthy controls (P < 0.01 each for disorganized, residual, undifferentiated, and paranoid subtypes). TAR levels were significantly and negatively correlated with Positive and Negative Syndrome Scale scores, and duration of illness. Total antioxidant response in patients with schizophrenia. Ustundag B, et al. Firat University, Elazig, Turkey. Psychiatry Clin Neurosci 2006 Aug;60(4):458-64. Ed: Melatonin is a very powerful antioxidant naturally produced by the human body.

Obesity: Melatonin Reduces Olanzapine and Age Induced Fat Stores: The atypical antipsychotic drug olanzapine increases body weight and visceral adiposity in schizophrenia. In rats, aging-associated increased body weight and visceral adiposity are reversed by administration of the pineal hormone melatonin. Four groups (n=11/group) of female rats (240-250 g) were treated for 8 weeks with olanzapine, melatonin, olanzapine+melatonin, or vehicle alone. At week 8, olanzapine treatment reduced nocturnal plasma melatonin by 55% (p<0.001), which was restored to control levels by olanzapine+melatonin. Body weight increased 18% in rats treated with olanzapine alone, 10% with olanzapine+melatonin, 5% with melatonin alone, and 7% with vehicle control. Melatonin may be useful for the management of olanzapine-induced weight gain in humans. Olanzapine-Induced Weight Gain and Increased Visceral Adiposity is Blocked by Melatonin Replacement Therapy in Rats. Raskind MA, et al. University of Washington, Seattle. Neuropsychopharmacology 10 May 2006.

Schizophrenia: Speculation That Melatonin Might Help: Neuronal shape, loss of dendrites and spines, as well as irregular distribution of neuronal elongations occur in specific brain areas of schizophrenic patients. Increase in non-phosphorylated MAP2 and MAP 1B at hippocampus has been suggested as responsible for somatodendritic and cytoarchitectural abnormalities found in schizophrenia. In addition, neurofibrillary tangles are more frequent among schizophrenic patients who received pharmacologic antipsychotic treatment. Melatonin promotes neuritogenesis through cytoskeletal rearrangements. The neuronal cytoskeleton as a potential therapeutical target in neurodegenerative diseases and schizophrenia. Benitez-King G, et al. Mexico, D.F., Mexico. Curr Drug Targets CNS Neurol Disord. 2004 Dec;3(6):515-33

Schizophrenia: Possible Lack of Daily Pattern or Inadequate Production: In a study of 10 male schizophrenics, 7 had low daily melatonin production or lack a normal circadian pattern. Reduction of night/day difference in melatonin blood levels as a possible disease-related index in schizophrenia. Bersani G, Mameli M, et al. University of Rome La Sapienza. Neuro Endocrinol Lett. 2003 Jun-Aug;24(3-4):181-4; Similar: Schizophr Res. 1992 Apr;7(1):77-84.

Schizophrenia: ICU Surgical Psychosis Higher with Melatonin Irregularity: Intensive care unit (ICU) psychosis is frequent complication after esophageal surgery. In 41 patients who underwent esophagectomy for esophageal cancer, 11 (26.8%) developed ICU psychosis. These patients were older (P =.01), but had no significant differences in the duration of surgery, volume of blood loss, term in the ICU, term of intubation, tumor location, disturbances of organ function, and postoperative complications. There was a significant correlation was seen between ICU psychosis and an irregular melatonin circadian rhythm (P =.0001). Authors suggest that supplementation with melatonin may protect patients from development of ICU psychosis. Correlation between serum melatonin circadian rhythm and intensive care unit psychosis after thoracic esophagectomy. Miyazaki T, Kuwano H, et al. Gunma University, Maebashi, Japan. Surgery. 2003 Jun;133(6):662-8.

Schizophrenia: Melatonin Low; Supplement Helps Sleep: In a DB PC crossover study of 19 schizophrenic adults, during 3 weeks of melatonin 2 mg at bedtime, there was improved rest-derived sleep efficiency (83.5% vs. 78.2%, p = .038). Improvement of sleep efficiency was significantly greater (p < .0014) in low-efficiency (80% vs. 67%) than high-efficiency sleepers (88% vs. 90%). There were trends toward shortened sleep latency (by 40 minutes, p < .056) and increased sleep duration (by 45 minutes, p < .078) in low- but not high-efficiency sleepers. All patients were low in melatonin. Melatonin improves sleep quality of patients with chronic schizophrenia. Shamir E, Laudon M, Tel Aviv University, Israel. J Clin Psychiatry. 2000 May;61(5):373-7. 

Schizophrenia: Night Time Melatonin Low: The 24-h profiles of plasma melatonin and cortisol were evaluated in 7 drug-free male paranoid schizophrenics and in 7 healthy controls. Compared with that of the normal controls, the circadian rhythm of plasma melatonin was absent in paranoid schizophrenics (p < 0.0001) whereas the 24-h profile of plasma cortisol was preserved, although at a slightly higher level (p < 0.0002). The melatonin/cortisol ratio was significantly higher in healthy subjects than in the schizophrenic patients. Depressed nocturnal plasma melatonin levels in drug-free paranoid schizophrenics. Monteleone P, et al. University of Naples, Italy. Schizophr Res. 1992 Apr;7(1):77-84; Similar: Neuro Endocrinol Lett. 2003 Jun-Aug;24(3-4):181-4; Neuro Endocrinol Lett. 2001 Apr;22(2):137-41; and J Formos Med Assoc. 1998 Dec;97(12):830-7.

Schizophrenia: Hypothalamus Damage May Cause Low Melatonin: Melatonin secretion is stimulated by the paraventricular nucleus (PVN) of the hypothalamus. Lesions of the PVN mimic the endocrine effects of pinealectomy. Since the PVN lies adjacent to the third ventricle, periventricular damage may account for the third ventricular dilatation seen on computed tomographic (CT), may disrupt PVN-pineal interactions and ultimately enhance the process of pineal calcification (PC) in schizophrenia. A CT study on the relationship of PC size to third ventricular width (TVW) in 12 chronic schizophrenic patients (mean age: 34) found a significant correlation between PC size and TVW (p < .05). Habenular calcification (HAC) on CT in 23 chronic schizophrenic-patients was present in 87% vs. 15% of controls (p < .0001) in chronic schizophrenia as compared to normal controls. Pineal and habenula calcification in schizophrenia. Sandyk R. Albert Einstein. Int J Neurosci. 1992 Nov-Dec;67(1-4):19-30.

Schizophrenia: Pineal Calcification More Common in Pre-menopausal Onset Schizophrenia: In a study of 29 randomly selected chronic institutionalized female schizophrenic patients, premenopausal-onset patients were more likely to have pineal gland calcificationn (PC) on CT: 55.5% vs. 18.1%, p < .05. PC was unrelated to historical, demographic, and treatment variables. The pineal gland may exert a protective effect against its onset. Pineal calcification in relation to menopause in schizophrenia. Sandyk R. Albert Einstein. Int J Neurosci. 1992 Nov-Dec;67(1-4):1-8.