Melatonin for Anxiety: Does It Help or Make It Worse?

Melatonin can help anxiety mainly by helping you sleep, and in some people it does the opposite, causing anxiety, irritability or restlessness. It is not a treatment for anxiety disorders such as generalized anxiety disorder or panic disorder. The best human evidence for a direct calming effect comes from a single dose taken before surgery, where it eased pre-operation nerves about as well as a standard sedative. For everyday anxiety, treat melatonin as a short-term sleep aid taken in a low dose before bed, not as a daytime anti-anxiety pill.

Key takeaways

• Melatonin is a timing signal for your body clock. Its main benefit for anxiety is indirect: better sleep can make anxiety easier to manage.
• Its effect on sleep is modest, and sleep-medicine guidelines do not recommend it for chronic insomnia. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment.
• Melatonin can cause anxiety in some people. Mayo Clinic lists mild anxiety, irritability and short-lasting low mood among its less common side effects.
• It is a poor choice for daytime anxiety because it causes drowsiness; Mayo Clinic advises not driving for five hours after a dose.
• Supplement labels are often inaccurate, and some medications, including the antidepressant fluvoxamine, can sharply raise melatonin levels. Check with a clinician if you take other medicines.

Does melatonin help with anxiety?

Melatonin is a hormone your brain releases in response to darkness. It helps set the timing of your 24-hour body clock and your sleep (NCCIH). That role shapes what it can and cannot do for anxiety.

Indirectly, through sleep. Anxiety and poor sleep feed each other: worry keeps you awake, and a short night leaves you more on edge the next day. If melatonin helps you fall asleep, the next day can feel more manageable. But its effect on sleep is smaller than most people expect. A meta-analysis of 19 trials with 1,683 people found that melatonin helped people fall asleep about 7 minutes faster and sleep about 8 minutes longer than a placebo, with a modest improvement in sleep quality (Ferracioli-Oda et al., PLoS One, 2013). The American Academy of Sleep Medicine suggests that clinicians not use melatonin to treat chronic insomnia in adults (Sateia et al., Journal of Clinical Sleep Medicine, 2017).

Directly, in one well-studied situation. A Cochrane review of 27 randomized trials in 2,319 adults found that a dose of melatonin taken before surgery probably reduces pre-operation anxiety compared with a placebo, and works about as well as a benzodiazepine such as midazolam, when measured 50 to 120 minutes after the dose (Madsen et al., Cochrane Database of Systematic Reviews, 2020). Anxiety around surgery is also the anxiety-related use the National Center for Complementary and Integrative Health lists among melatonin's possible benefits: NCCIH says melatonin appears to help with anxiety before surgery, but it's unclear whether it helps after surgery (NCCIH).

Not established for anxiety disorders. Researchers have proposed several ways melatonin might calm the stress response, such as dampening the body's "fight or flight" system and stress hormones, but that work comes largely from animal experiments and specific medical settings (Repova et al., International Journal of Molecular Sciences, 2022). It has not been shown to treat generalized anxiety disorder or panic disorder the way established treatments do.

For many of my patients, insomnia is a symptom of other underlying concerns such as anxiety, stress, ADHD, and mood disorders. This is why an evaluation by your doctor or mental health provider is important to explore the root cause for chronic insomnia as it can lead to better sleep.

Can melatonin cause anxiety?

Yes, in some people, although it is not one of the most common side effects. Mayo Clinic lists headache, dizziness, nausea and drowsiness as melatonin's usual side effects, and short-lasting feelings of depression, mild tremor, mild anxiety, abdominal cramps, irritability, reduced alertness and confusion as less common ones (Mayo Clinic).

When melatonin leaves someone feeling anxious or "weird," these are the usual suspects:

• A bigger dose than you think. Melatonin is sold as a dietary supplement, which the FDA regulates less strictly than medicines (NCCIH). In a test of 31 supplements, actual melatonin content ranged from 83% less to 478% more than the label said, and 8 products also contained serotonin (Erland & Saxena, Journal of Clinical Sleep Medicine, 2017). A 2023 study of U.S. melatonin gummies found 74% to 347% of the labeled amount, and one product had none (Cohen et al., JAMA, 2023).
• A next-day hangover. Grogginess, slowed thinking and reduced alertness the morning after can feel a lot like anxiety, especially if you are already prone to it. Melatonin may also stay active longer in older adults (NCCIH).
• A medication interaction. The antidepressant fluvoxamine (Luvox), often used for OCD, blocks the breakdown of melatonin. In a small study, taking the two together raised melatonin's peak blood level about 12-fold (Härtter et al., Clinical Pharmacology & Therapeutics, 2000), and Mayo Clinic warns it can cause excessive drowsiness. Melatonin can also add to the sedation from other sedating medicines.
• The wrong time of day. Because melatonin is a body-clock signal, taking it at irregular times can work against the sleep schedule you are trying to build.
• Expectations that don't match reality. If you take melatonin hoping it will knock you out and you are still lying awake an hour later, that frustration can become its own source of bedtime anxiety.

If melatonin makes you anxious, stop taking it. If you want to try again, talk with a clinician first about a lower dose and better timing, and mention every medication and supplement you take. Racing heart, chest pain, fainting or severe confusion need prompt medical attention, whatever the cause.

Can you take melatonin during the day for anxiety?

Generally, no. Melatonin causes drowsiness and reduced alertness, and Mayo Clinic advises not driving or using machinery within five hours of taking it (Mayo Clinic). Taking it during the day also sends your body clock a "night" signal at the wrong time.

The surgery studies are not a model for daily use: they gave a single dose in a supervised hospital setting before a procedure. Ongoing daytime anxiety is better treated with options designed for it. The National Institute of Mental Health describes cognitive behavioral therapy (CBT) as the "gold standard" psychotherapy for generalized anxiety disorder and lists antidepressants such as SSRIs and SNRIs among the medications used, with stress management such as exercise and mindfulness as helpful additions (NIMH).

How to take melatonin if anxiety is keeping you up

If you and your clinician decide melatonin is worth a short trial for sleep:

• Use a low dose. "Less is more," says a Johns Hopkins sleep expert, who recommends 1 to 3 milligrams about two hours before bedtime (Johns Hopkins Medicine). More is not better, and it raises the odds of next-day grogginess.
• Take it at a consistent time. Pair it with a consistent wake-up time, even on weekends.
• Keep it short-term. Short-term use appears safe for most people, but there is little information on long-term safety (NCCIH).
• Don't stack sedatives. Avoid combining it with alcohol or other sedating medicines unless your prescriber has said it is safe.
• Fix the basics too. Dim lights and screens in the hour before bed, keep caffeine to the morning, and get out of bed if you have been awake and stewing for a long stretch. Melatonin without better sleep habits usually does little.

Melatonin can be beneficial for sleep, and the secret to it is in the timing. Taking it earlier in the evening helps shift your body’s internal clock so you feel tired and ready to fall asleep at the right time.

Who should check with a doctor before taking melatonin

Talk with a clinician before starting melatonin if you:

• Are pregnant or breastfeeding; there has been little research on safety (NCCIH).
• Have epilepsy or take a blood thinner; NCCIH says both groups need medical supervision.
• Have an autoimmune disease or take immunosuppressants, blood pressure medication, diabetes medication, seizure medication, birth control pills, fluvoxamine or other sedating medicines, all of which Mayo Clinic lists as possible concerns or interactions (Mayo Clinic).
• Are an older adult, since melatonin may stay active longer and cause daytime drowsiness, or care for someone with dementia, since sleep-medicine guidelines recommend against melatonin in people with dementia (NCCIH).
• Are treated for depression, bipolar disorder or another psychiatric condition; any new sleep aid is worth running past the clinician who knows your history.

Is long-term melatonin use bad for your heart?

You may have seen headlines about a new warning. In November 2025, researchers presented an analysis of health records from more than 130,000 adults with insomnia: people who had used melatonin for at least a year were more likely to be diagnosed with heart failure over the next five years (4.6% vs. 2.7%) (American Heart Association). The authors stress that the study cannot prove melatonin caused the difference. It was presented as a conference abstract, which is not peer-reviewed, and, as the researchers note, Americans taking melatonin as an over-the-counter supplement would have been counted in the non-melatonin group.

The reasonable takeaway is not to panic about occasional use. It is one more reason not to take melatonin every night for years without a plan, and to treat ongoing insomnia or anxiety directly.

Better options for anxiety and anxious sleep

Melatonin isn’t the first line treatment for anxiety, but it can support sleep when combined with healthy sleep habits. The most effective treatment for insomnia is cognitive behavioral therapy for insomnia (CBT-I), and for many of my patients, melatonin can sometimes be a helpful tool in their kit.

• For insomnia: CBT-I is the recommended first treatment (NCCIH). When medication is needed, there are prescription options with better evidence. One example is ramelteon, a prescription "melatonin agonist" that acts on the same receptors as melatonin; the American Academy of Sleep Medicine suggests it for trouble falling asleep while suggesting against over-the-counter melatonin (Sateia et al., 2017). Our guide to sleep medications and their risks covers more.
• For anxiety: CBT and medications such as SSRIs and SNRIs are the mainstays, and exercise and mindfulness help alongside them (NIMH). Read more in CBT for anxiety: why it works.

TelepsychHealth's psychiatric clinicians treat anxiety and insomnia by video for adults located in Arizona, California, Connecticut, Florida, Georgia, Illinois, Michigan, Minnesota, New York or Texas at the time of their visits, including reviewing whether melatonin or any other supplement fits with the rest of your care. Therapy, including CBT and CBT-I, is available in Illinois, Texas and Florida. Learn more about our anxiety treatment and insomnia treatment, or request an appointment. You can also contact us at (888) 730-5220.

If anxiety stays severe despite outpatient treatment, a higher level of care, such as an intensive outpatient program (IOP), may help. TelepsychHealth doesn't run an IOP, but our clinicians can help you decide whether you need one and refer you to a program.

If anxiety ever comes with thoughts of harming yourself, call or text 988 (the 988 Suicide & Crisis Lifeline) or call 911 right away.

Frequently asked questions

Can melatonin make your anxiety worse?

It can. Mild anxiety and irritability are listed among melatonin's less common side effects, and next-day grogginess, an unexpectedly strong dose (labels are often inaccurate) or an interaction with medications such as fluvoxamine can all leave you feeling more on edge. If it makes you anxious, stop taking it and talk with a clinician.

Does melatonin help with anxiety at night?

It can help with the trouble falling asleep that anxiety causes, but the effect is modest, about 7 minutes faster on average in clinical trials. It does not quiet worry itself. If anxious thoughts keep you up most nights, treatments aimed at the anxiety and at insomnia, such as CBT and CBT-I, work better.

Can I take melatonin during the day for anxiety?

It is not recommended. Melatonin causes drowsiness, and Mayo Clinic advises not driving or using machinery for five hours after a dose. Daytime doses can also confuse your body clock. Talk with a clinician about treatments designed for daytime anxiety.

How much melatonin should I take for anxiety?

Melatonin isn't dosed for anxiety itself. When it is used for sleep, a Johns Hopkins sleep expert recommends 1 to 3 milligrams about two hours before bedtime. Start low, use it short-term, and check with a clinician first if you take other medications.

Why do I feel weird after taking melatonin?

Common reasons include a dose higher than the label states, a next-day "hangover" of grogginess and slowed thinking, or an interaction with another medication. Less common side effects include dizziness, short-lasting low mood, confusion and mild anxiety.

Can I take melatonin with my anxiety medication?

Sometimes, but ask first. Fluvoxamine can raise melatonin levels many times over, and combining melatonin with benzodiazepines or other sedating medicines adds to drowsiness. Your prescriber or pharmacist can check your specific combination.

Summary

Melatonin can be a reasonable short-term sleep aid for some people whose anxiety keeps them up, and it has real evidence for calming nerves before surgery. It is not a treatment for anxiety disorders, its sleep benefit is modest, and in some people it causes anxiety rather than relieving it. If you're considering melatonin as part of your mental health care, speak to a licensed provider.

“A balanced treatment plan that includes sleep support can often help patients feel more grounded and less anxious,” says Dr. Bruce Bassi, M.D., a psychiatrist with TelepsychHealth.