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GPs go forth

GPs should not prescribe melatonin on NHS for jet lag, independent review recommends

GPs should not prescribe melatonin for jet lag on the NHS because there is little evidence it makes any real difference, an evidence review has concluded.

Two melatonin products for short-term use in jet lag were approved by the Medicines and Healthcare Products Regulatory Agency last year.

But a new review, published in the Drug and Therapeutics Bulletin, concluded there remain a lot of unanswered questions about the use of melatonin in jet lag.

The review points out that because melatonin had already been licensed for jet lag within the EU for a long period - of 10 years - the manufacturer did not need to supply any new evidence about the preparation of the new products, which could affect its efficacy.

Available studies, most of which were small, show only a moderate effect from the drug on jet lag and report a range of adverse effects, the review said.

It concluded that melatonin – which costs £10.83 for a short course of tablets – should be added to the list of drugs that GPs cannot prescribe on the NHS.

‘Since jet lag is a self-limiting short-term problem and there is limited published evidence of the benefit of melatonin on symptoms, we do not think that it is appropriate for such a product to be made available through the National Health Service,’ the review said.

‘We would suggest that melatonin for jet lag is added to the list of drugs that may not be ordered under a General Medical Services contract.’

The symptoms of jet lag can include disrupted sleep, fatigue, mental fog and gut disturbances, and seem to be worse when travelling eastwards.

Data from openprescribing.net, which analyses NHS data, shows a steady increase in prescriptions in the past few years - although the drug is also used for insomnia.

GPs are currently not required to prescribe medicines for a condition that may arise when a patient is abroad, the review added.

A clinical knowledge summary by NICE on jet lag that was updated in 2019 - but before melatonin was marketed for the treatment of jet lag - did not recommend its use.

In a podcast to discuss the evidence, Dr James Cave, editor in chief of DTB, said: ‘I have concerns also that you will get licence creep, and that it will be used for people with sleep problems in general, and it's not really a good way of dealing with those.’

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Readers' comments (3)

  • David Banner

    Since you can purchase large quantities of high dose melatonin from health stores in the States (and cheaply online in the UK) this advice will be largely redundant.

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  • Seems a bit like worrying about a scratched bumper when your engine and gearbox are wrecked. Hardly going to save the NHS with this advice. It might be better considering bariatric or cosmetic surgery, much of the preventative prescribing or the appropriateness of statins/antihypertensives etc. in the over nineties. Perhaps a bit too controversial.

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  • I wonder how much the state funds these advisers and quangos and how much work and time they have cause doctors. And you wonder why you have no time to see patients dealing with all the bureaucracy.

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