Professor Hospital Israelita Albert Einstein São Paulo, Sao Paulo, Brazil
Melatonin, secreted by the pineal gland, significantly influences headache pathophysiology and treatment. As a powerful circadian regulator and antioxidant, melatonin modulates pain by inhibiting CGRP, scavenging free radicals, enhancing GABA, and reducing inflammation. Clinical evidence supports melatonin as effective prophylaxis for migraines and cluster headaches, often comparable to traditional medications such as amitriptyline. Melatonin receptor agonists and chronobiotics further expand therapeutic possibilities. Recommended guidelines highlight melatonin as a suitable alternative, particularly for patients intolerant to conventional treatments. Practical clinical strategies include using fast-release formulations, adjusting doses according to headache types, and aligning melatonin administration with circadian rhythms. This session addresses the physiological mechanisms, clinical applications, and practical recommendations for incorporating melatonin into migraine management, enhancing therapeutic outcomes
Learning Objectives:
After attending this lecture, participants should be able to:
Describe the physiological roles of melatonin, especially regarding circadian rhythms, antioxidant activity, and neuroendocrine modulation, and explain the mechanisms by which melatonin influences migraine and other headache disorders, including its action on CGRP, GABA, inflammation, and oxidative stress.
Upon completion, participants will be able to
Evaluate current clinical evidence and guideline recommendations supporting melatonin use as prophylaxis for migraines and cluster headaches. Identify appropriate patient populations and practical dosing strategies, formulations, and clinical caveats for melatonin treatment.
Upon completion, participants will be able to Integrate melatonin therapy into clinical practice effectively, emphasizing individual patient tolerability, circadian alignment, and therapeutic optimization.
