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Metoclopramide palliative care dose of 250mcg/day, the authors found that at 5 days and 24 hours, the effects of melatonin on cognitive performance and mood were comparable to that of 50mcg/day (but note the difference in dose levels, with melatonin doses significantly higher than placebo). In the other study, sleep maintenance therapy with 10mg of melatonin for 2 weeks also increased alertness by 24 h and improved mood by 60 hours. At 1-5 days, melatonin's effect on mood was significantly improved over placebo, and its cognitive enhancing effects on short-term memory at 5 days were comparable to the effect produced by 100mg of methylcormacapine or diazepam (Sanchez et al., 2005). This finding is likely to be relevant use of melatonin in the management depression due to lack of long-term studies and a large placebo effect. In patients with treatment-resistant depression, there is good evidence that short-term administration of 200 or 400mg/day melatonin reduces hospitalisations. A clinical trial of 10-20mg/day melatonin for depression found that 40% of patients achieved at least a 60% reduction from baseline (Dobkin et al., 1999). Melatonin has also been found to be beneficial for the treatment of insomnia (Buckner et al., 1997). Studies have shown that there may also be a protective effect against the recurrence of depression by melatonin. An 8-week long study compared 8 months of treatment with a 1:1000 melatonin to placebo and reported a 38% reduction in the number of recurrent episodes. Melatonin was also found to reduce the length of time spent depressed (Munro et al., 2000). A review by the World Health Organization (WHO) found that, "long-term use of melatonin reduces risk relapse and has potential to reduce relapse in major depression". It found, however, "long-term use of long-acting melatonin should only be considered for mild to mild-moderate depression and only after consideration of the cost, adverse effects and lack of tolerability standard treatment". Although there is much evidence of potential benefits from melatonin and its metabolites, role in the treatment of depression is limited and there concern that its use may not be as effective it might have been (Dobkin, 2000). Recent studies have found that melatonin is not effective in treating major depression (Dobkin et al. 1999). More research is needed to determine whether the use of melatonin in treatment depression will be beneficial. It is difficult to prescribe melatonin for those with depression, since they may not benefit from its Where can i buy viagra in melbourne use due to a l