Melatonin sits on pharmacy shelves in many countries as an over-the-counter (OTC) supplement. For people struggling with sleeplessness, it feels like a quick and safe fix. After all, it’s “natural” and doesn’t require a prescription. But easy access also brings risks—especially when melatonin is used casually or without guidance.

Why OTC Melatonin Is So Popular

• Perceived safety: It’s a hormone the body already makes.

• No prescription needed: Easier to access than most sleep medications.

• Marketing appeal: Promoted as “gentle” and “non-addictive.”

• Widespread sleep struggles: From stress to late-night screen time, modern lifestyles fuel demand.

Hidden Dangers of OTC Melatonin

1. Incorrect Dosing

• Natural melatonin levels peak at 0.3–1 mg, but many OTC products start at 3 mg, 5 mg, or even 10 mg.

• Higher doses don’t always mean better sleep. Instead, they can cause grogginess, dizziness, or vivid dreams.

2. Poor Quality Control

• Studies show some OTC melatonin tablets contain much more or less melatonin than labeled—sometimes varying by 80–400%.

• Some even contain serotonin contamination, which can be harmful.

3. Mistimed Use

• Taking melatonin at the wrong time (e.g., after midnight, in the morning) can shift the circadian clock in the wrong direction, worsening sleep.

4. Masking Underlying Problems

• People with chronic insomnia, sleep apnea, restless legs, depression, or anxiety may turn to OTC melatonin instead of seeking proper diagnosis and treatment.

5. Drug Interactions

• OTC buyers may not realize melatonin can interact with blood thinners, antidepressants, blood pressure medication, diabetes drugs, and immunosuppressants.

6. Children and Adolescents

• Parents sometimes give melatonin to kids for sleep issues. While short-term supervised use in conditions like autism may help, long-term OTC use in healthy children is poorly studied and could affect puberty or hormonal rhythms.

7. Overconfidence in “Natural”

• “Natural” doesn’t mean harmless. Melatonin acts on the brain, endocrine system, and circadian rhythm—delicate processes that can be disrupted if misused.

Responsible Use of Melatonin

• Start low (0.3–1 mg). Use the minimum effective dose.

• Mind the clock. Take it 30–90 minutes before bedtime, unless directed otherwise for circadian disorders.

• Short-term tool. Safer for jet lag or temporary insomnia than as a daily habit.

• Check interactions. If you’re on other medications, consult a doctor.

• Children & older adults. Should only use melatonin under medical guidance.

Bottom Line

Melatonin as an OTC supplement is both a blessing and a risk. It can help reset sleep when used thoughtfully, but careless use—especially at high doses, poor timing, or without medical input—can do more harm than good. Respecting melatonin’s role as a timekeeper, not a sleeping pill, is key to making it safe.

About the Author

I’m Dr. Srinivas Rajkumar T, MD (AIIMS, New Delhi), Consultant Psychiatrist based in Chennai. Through my clinical practice and writing, I aim to make psychiatry more understandable and less intimidating.

📍 Mind and Memory Clinic, Apollo Clinic, Velachery, Chennai (Opp. Phoenix Mall)
📞 +91 85951 55808
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