Review

Is there a role for melatonin in fibromyalgia?

  • Received: 30 August 2019 Accepted: 25 November 2019 Published: 26 November 2019
  • Fibromyalgia, characterised by persistent pain, fatigue, sleep disturbance and cognitive dysfunction, is a central sensitivity syndrome that also involves abnormality in peripheral generators and in the hypothalamic pituitary adrenal axis. Heterogeneity of clinical expression of fibromyalgia with a multifactorial aetiology has made the development of effective therapeutic strategies challenging. Physiological properties of the neurohormone melatonin appear related to the symptom profile exhibited by patients with fibromyalgia and thus disturbance of it’s production would be compatible with the pathophysiology. Altered levels of melatonin have been observed in patients with fibromyalgia which are associated with lower secretion during dark hours and higher secretion during daytime. However, inconsistencies of available clinical evidence limit conclusion of a relationship between levels of melatonin and symptom profiles in patients with fibromyalgia. Administration of melatonin to patients with fibromyalgia has demonstrated suppression of many symptoms and an improved quality of life consistent with benefit as a therapy for the management of this condition. Further studies with larger samples, however, are required to explore the potential role of melatonin in the pathophysiology of fibromyalgia and determine the optimal dosing regimen of melatonin for the management of fibromyalgia.

    Citation: Kim Lawson. Is there a role for melatonin in fibromyalgia?[J]. AIMS Molecular Science, 2019, 6(4): 73-86. doi: 10.3934/molsci.2019.4.73

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  • Fibromyalgia, characterised by persistent pain, fatigue, sleep disturbance and cognitive dysfunction, is a central sensitivity syndrome that also involves abnormality in peripheral generators and in the hypothalamic pituitary adrenal axis. Heterogeneity of clinical expression of fibromyalgia with a multifactorial aetiology has made the development of effective therapeutic strategies challenging. Physiological properties of the neurohormone melatonin appear related to the symptom profile exhibited by patients with fibromyalgia and thus disturbance of it’s production would be compatible with the pathophysiology. Altered levels of melatonin have been observed in patients with fibromyalgia which are associated with lower secretion during dark hours and higher secretion during daytime. However, inconsistencies of available clinical evidence limit conclusion of a relationship between levels of melatonin and symptom profiles in patients with fibromyalgia. Administration of melatonin to patients with fibromyalgia has demonstrated suppression of many symptoms and an improved quality of life consistent with benefit as a therapy for the management of this condition. Further studies with larger samples, however, are required to explore the potential role of melatonin in the pathophysiology of fibromyalgia and determine the optimal dosing regimen of melatonin for the management of fibromyalgia.


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    Abbreviation ACR: American College of Rheumatology; BDNF: Brain-derived neurotrophic factor; cAMP: Cyclic adenosine monophosphate; CNS: Central nervous system; CS: Central sensitization; CSF: Cerebrospinal fluid; DNIC: Diffuse noxious inhibitory control; FIQ: Fibromyalgia Impact Questionnaire; GABA: Gamma-aminobutyric acid; HPA: Hypothalamic pituitary adrenal axis; HRQOL: Health-related quality of life; MT: Melatonergic; NO: Nitric oxide; NMDA: N-methyl-D-aspartate; RCT: Randomized controlled trial; 6-SMT: 6-sulfatoxymelatonin;

    Conflict of interest



    The author declares no conflict of interest for the contributions in this manuscript.

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