Analgesic and sedative effects of melatonin in temporomandibular disorders: a double-blind, randomized, parallel-group, placebo-controlled study.

Abstract

CONTEXT:

The association between myofascial temporomandibular disorder (TMD) and nonrestorative sleep supports the investigation of therapies that can modulate the sleep/wake cycle. In this context, melatonin becomes an attractive treatment option for myofascial TMD pain.

OBJECTIVES:

To investigate the effects of melatonin on pain (primary aim) and sleep (secondary aim) as compared with placebo in a double-blind, randomized, parallel-group trial.

METHODS:

Thirty-two females, aged 20-40 years, with myofascial TMD pain were randomized into placebo or melatonin (5mg) treatment groups for a period of four weeks.

RESULTS:

There was a significant interaction (time vs. group) for the main outcomes of pain scores as indexed by the visual analogue scale and pressure pain threshold (analysis of variance; P<0.05 for these analyses). Post hoc analysis showed that the treatment reduced pain scores by -44% (95% CI -57%, -26%) compared with placebo, and it also increased the pressure pain threshold by 39% (95% CI 14%, 54%). The use of analgesic doses significantly decreased with time (P<0.01). The daily analgesic doses decreased by -66% (95% CI -94%, -41%) when comparing the two groups. Additionally, melatonin improved sleep quality, but its effect on pain was independent of the effect on sleep quality.

CONCLUSION:

This study provides additional evidence supporting the analgesic effects of melatonin on pain scores and analgesic consumption in patients with mild-to-moderate chronic myofascial TMD pain. Furthermore, melatonin improves sleep quality but its effect on pain appears to be independent of changes in sleep quality.

• Authors: Liliane Pinto Vidor, Iraci L S Torres, Izabel Cristina Custódio de Souza, Felipe Fregni, Wolnei Caumo
• Journal: Journal of pain and symptom management (J Pain Symptom Manage) Vol. 46 Issue 3 Pg. 422-32 (Sep 2013) ISSN: 1873-6513 [Electronic] United States
• PMID: 23195393 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Chemical References

• Analgesics, Non-Narcotic
• Central Nervous System Depressants
• Hypnotics and Sedatives
• Melatonin

Topics

• Adult
• Analgesics, Non-Narcotic (administration & dosage)
• Central Nervous System Depressants (administration & dosage)
• Double-Blind Method
• Female
• Humans
• Hypnotics and Sedatives (administration & dosage)
• Melatonin (administration & dosage)
• Pain (diagnosis, prevention & control)
• Pain Measurement (drug effects)
• Placebo Effect
• Sleep Initiation and Maintenance Disorders (diagnosis, prevention & control)
• Temporomandibular Joint Dysfunction Syndrome (diagnosis, prevention & control)
• Treatment Outcome