Seizures are very, very bad for the brain. Status epilepticus is the term for uncontrolled, unstoppable seizures.
Very often, these patients end up in the emergency room pumped full of sedatives just to stop the seizures. The damage to the brain under status epilepticus is even worse than that which occurs with single seizures.
Not to belittle the ongoing damage to is occurring in the brain of epileptics during the interictal (in between seizures) period. Few epileptics are educated on this little tidbit. Most fear the dreaded SUDEP (sudden unexpected death in epilepsy), although the likelihood of any epileptic passing from SUDEP is very small.
The bottom line is that anything that can be done to protect the epileptic brain is a very good thing, whether having seizures or not. This is not to be confused with controlling seizures, since none of the anti-epileptic drugs actually work at protecting and improving brain health.
Which brings us to this particular study. While it is a mouse study, this is not the first time that research has demonstrated that melatonin can help to protect the brain.
In the study, researchers looked to see if melatonin could protect the brain during status epilepticus, arguably the worst-case scenario in an epileptic. Here’s what they found:
• Melatonin use was able to reduce seizure activity
• Melatonin reduced the brain cell damage in certain areas of the brain (CA1 area of the hippocampus and piriform cortex).
• Melatonin decreased the hippocampal serotonin (5-HT) levels.
For something as simple as melatonin, these are some pretty important effects. As a brief primer, the pineal gland deep in the brain releases melatonin once sunlight stops hitting the eyes. Melatonin and serotonin are on the same metabolic pathway derived from the amino acid tryptophan. When sunlight is present, the pathway stops at serotonin. Once darkness arrives (and we are not exposed to blue light) the pathway continues to melatonin.
Interestingly, depression is closely associated with epilepsy. It would not be unreasonable to assume that the tryptophan to serotonin to melatonin pathway is somehow affected, making the supplementation of melatonin a very reasonable recommendation in any epileptic.
In our office, we start with .5 mg, a very small dose. Most patients mistakenly start themselves at much higher dosages.