“Melatonin Supplement Attenuates Symptoms of Acute Nicotine Withdrawal in Cigarette Smokers” by Dr. Mohan Raj V


Tobacco use, in any form, elicits physiological and psychological addictive moods among users. Nicotine, the active ingredient in tobacco, is highly addictive, leading to sustained tobacco use. Cigarettes deliver high levels of nicotine to the brain rapidly, making smoking the most reinforcing form of tobacco use. Melatonin, an important regulator of physiological processes, helps maintain body homeostasis. Melatonin levels vary throughout the day, with a nocturnal pattern of secretion. Melatonin supplementation within the physiological range affects symptoms of acute nicotine withdrawal in regular cigarette smokers.


Nicotine Effects and Melatonin Supplementation for Nicotine Withdrawal: 
Nicotine has stimulant activities such as peripheral vasoconstriction, tachycardia, and enhanced mental alertness, along with depressant effects like anxiety reduction. Repetitive nicotine exposure leads to neuroadaptation and tolerance, resulting in withdrawal symptoms upon cessation, including anxiety, irritability, and strong cravings. Nicotine consumption can be influenced by endogenous or exogenous melatonin, which interacts with high-affinity melatonin receptors. Cigarette smoking lowers exogenous serum melatonin levels but does not significantly affect endogenous levels. Cigarette smoking induces the CYP1A2 enzyme, which enhances hepatic metabolism of melatonin.


Currently, four melatonin medicines or derivatives are approved for CNS indications:
Prolonged-release melatonin for relief of primary insomnia in older patients.
Ramelteon, a high-affinity MT2 receptor agonist, for adult insomnia treatment.

Tasimelteon, a nonselective melatonin receptor agonist, for non-24-hour sleep-wake disorder and other sleep-wake disorders.

Agomelatine, a melatonin receptor agonist and serotonin receptor antagonist, for major depressive disorder treatment in adults.

Physiologic doses of melatonin have sleep-promoting effects documented in healthy individuals. The optimal melatonin dosage for reducing nicotine preference does not alter circadian patterns in locomotor activity. Melatonin can counteract the acute effects of smoking cessation on mood. Further research is needed to determine the exact mechanism by which melatonin affects nicotine preference.