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Melatonin use in hospital settings is common and is increasingly used for off label indications including primary insomnia in those aged &lt;\u200955\u2009years, prevention of delirium and to facilitate benzodiazepine discontinuation. A literature review was conducted to evaluate the efficacy, effectiveness, safety, tolerability, and cost\u2010effectiveness of melatonin for various off\u2010label indications in inpatient hospital settings. The review found limited high quality evidence demonstrating a clinically meaningful benefit from melatonin in improving sleep, delirium, or facilitating benzodiazepine discontinuation in the inpatient setting. Study findings were inconsistent, and those that did show statistical improvement were of uncertain clinical benefit. The review also found a paucity of data on the safety of melatonin when used in hospitalized patients, and no evidence to support cost\u2010effectiveness. Non\u2010pharmacological interventions are recommended as first\u2010line treatment of insomnia and for the prevention of delirium in inpatient settings. The use of interventions without evidence for efficacy or effectiveness is contrary to the quality use of medicines principles in Australia's National Medicines Policy. Context\u2010specific evidence on the efficacy and effectiveness of a medicine should guide clinician decision\u2010making and prescribing, to improve the quality use of medicines.<\/jats:p>","DOI":"10.1002\/prp2.70059","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T08:39:16Z","timestamp":1737535156000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Melatonin: A Review of the Evidence for Use in Hospital Settings"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2575-7910","authenticated-orcid":false,"given":"Josephine A.","family":"Adattini","sequence":"first","affiliation":[{"name":"Medication Safety (Formulary) Clinical Excellence Commission  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Wills","sequence":"additional","affiliation":[{"name":"Medication Safety (Formulary) Clinical Excellence Commission  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8614-0199","authenticated-orcid":false,"given":"Jennifer H.","family":"Martin","sequence":"additional","affiliation":[{"name":"Medication Safety (Formulary) Clinical Excellence Commission  Sydney New South Wales Australia"},{"name":"School of Medicine University of Newcastle  Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787.x12_Sleep-Wake_Disorders"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-6405.2012.00845.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2022.04.133"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s42003-021-02825-4"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1157790"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad089"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S331103"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/33.9.1159"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/20009666.2017.1374108"},{"key":"e_1_2_10_11_1","volume-title":"Getting It Right for Sleep at Night: Guidance for Promoting Sleep and Reducing Harm From Inappropriate Pharmacologic Management of Sleep Disturbance and Insomnia in Hospitalised Patients","author":"NSW Therapeutic Advisory Group","year":"2021"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsab064"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03165-6"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15767"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.02.033"},{"key":"e_1_2_10_16_1","volume-title":"Alcohol, Tobacco & Other Drugs in Australia","author":"Australian Institute of Health Welfare","year":"2023"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00878-9"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyz007"},{"key":"e_1_2_10_19_1","unstructured":"Therapeutic Goods Administration (TGA) \u201cAustralian Product Information\u2014Circadin\u00ae Melatonin Prolonged Release Tablets \u201dAustralian Register of Therapeutic Goods https:\/\/www.ebs.tga.gov.au\/ebs\/picmi\/picmirepository.nsf\/pdf?OpenAgent=&id=CP\u20102011\u2010PI\u201001901\u201032009."},{"key":"e_1_2_10_20_1","unstructured":"Therapeutic Goods Administration (TGA) \u201cAustralian Product Information\u2014Slenyto\u00ae Prolonged Release Tablets (Melatonin) Australian Register of Therapeutic Goods \u201dhttps:\/\/www.ebs.tga.gov.au\/ebs\/picmi\/picmirepository.nsf\/pdf?OpenAgent=&id=CP\u20102020\u2010PI\u201001745\u20101(2020)."},{"key":"e_1_2_10_21_1","unstructured":"Therapeutic Goods Administration (TGA) \u201cAustralian Public Assessment Report for Melatonin \u201dAustralian Government Department of Health and Ageing 2009 https:\/\/www.tga.gov.au\/sites\/default\/files\/auspar\u2010circadin.pdf(2009)."},{"key":"e_1_2_10_22_1","unstructured":"Council of Australian Therapeutic Advisory Groups \u201cRethinking Medicines Decision\u2010Making in Australian Hospitals \u201dGuiding Principles for the Quality Use of Off\u2010Label Medicines. 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