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Melatonin and morphine: potential beneficial effects of co-use.

Fundamental & clinical pharmacology
February 1, 2021
Karim Hemati et al. (7 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effects of melatonin when co-administered with morphine, focusing on its potential to enhance morphine's analgesic effects while reducing tolerance and side effects.

Results Summary

Melatonin demonstrated pain-killing properties alone and in combination with morphine, reduced morphine consumption, and attenuated morphine-associated side effects like tolerance and hyperalgesia, likely due to its anti-inflammatory and antioxidant properties.

Population

Patients with various pathological conditions requiring pain management (specific conditions not detailed).

Effective Dosage

Not specified

Duration

Not specified

Interactions

Morphine (enhanced anti-nociceptive effects, reduced tolerance and side effects)

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
melatonin
decrease
pain
-
-
has pain-killing properties
#1
melatonin
increase
anti-nociceptive actions of opioids
-
-
increases the anti-nociceptive actions
#2
melatonin
decrease
opioid tolerance
-
-
reverses their tolerance
#3
melatonin
decrease
morphine consumption
different pathologies
-
decreases morphine consumption
#4
melatonin
decrease
morphine-associated side-effects
-
-
reduction of morphine-associated side-effects
#5
combination of melatonin with morphine
decrease
morphine-induced tolerance and hyperalgesia
-
-
could reduce morphine-induced tolerance and hyperalgesia
#6
Abstract

Morphine is a potent analgesic agent used to control acute or chronic pain. Chronic administration of morphine results in analgesic tolerance, hyperalgesia, and other side effects including dependence, addiction, respiratory depression, and constipation, which limit its clinical usage. Therefore, identifying the new analgesics with fewer side effects which could increase the effect of morphine and reduce its side effects is crucial. Melatonin, a multifunctional molecule produced in the body, is known to play an important role in pain regulation. The strong anti-inflammatory effect of melatonin is suggested to be involved in the attenuation of the pain associated with inflammation. Melatonin also increases the anti-nociceptive actions of opioids, such as morphine, and reverses their tolerance through regulating several cellular signaling pathways. In this review, published articles evaluating the effect of the co-consumption of melatonin and morphine in different conditions were investigated. Our results show that melatonin has pain-killing properties when administered alone or in combination with other anti-nociceptive drugs. Melatonin decreases morphine consumption in different pathologies. Furthermore, attenuation of morphine intake can be accompanied by reduction of morphine-associated side-effects, including physical dependence, morphine tolerance, and morphine-related hyperalgesia. Therefore, it is reasonable to believe that the combination of melatonin with morphine could reduce morphine-induced tolerance and hyperalgesia, which may result from anti-inflammatory and antioxidant properties of melatonin. Overall, we underscore that, to further ameliorate patients' life quality and control their pain in various pathological conditions, melatonin deserves to be used with morphine by anesthesiologists in clinical practice.

Medical Subject Headings (MeSH)
AnalgesicsArachidonate 5-LipoxygenaseCalciumDrug ToleranceHumansHyperalgesiaMelatoninMorphine
Study Links
Quality Scores
Safety85
Efficacy90/10
Quality80/10
Citation Metrics
Total Citations31
Citations/Year7.8
Relative Citation Ratio3.27
NIH Percentile86.7%
Research Impact Scores
APT Score0.75
Weight Score2.68
Normalized Score0.86
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Melatonin and morphine: potential beneficial effects of co-u... | Panacea Index