Shahid Beheshti University of Medical Sciences, Iran
  • Register
  • Login

International Journal of Medical Toxicology and Forensic Medicine

  • Home
  • About
    • About the Journal
    • Aims and Scope
    • Editorial Team
    • Contact
  • Issues
    • Current
    • Archives
  • Indexing & Abstracting
  • Editorial Policies
    • Peer Review Process
    • Ethical Codes: Medical Research
    • Principles of Publishing Ethics
    • Conflicts of Interest
    • Publication Frequency
    • Open Access Policy
    • CrossMark Policy
    • Article Processing Charges
    • Privacy Statement
  • Announcements
  • Register
  • Login
  • Author Guidelines
Advanced Search
  1. Home
  2. Archives
  3. Vol. 14 No. 02 (2024)
  4. Original Article (Clinical Toxicology)

Vol. 14 No. 02 (2024)

April 2024

Evaluation of the Efficacy of Melatonin in Visual Disturbed Methanol-intoxicated Patients: A Randomized Clinical Trial

  • Shiva Samsamshariat
  • Shafeajafar Zoofaghari
  • Rokhsareh Meamar
  • Negar Jalali
  • Asieh Maghmi Mehr

International Journal of Medical Toxicology and Forensic Medicine, Vol. 14 No. 02 (2024), 24 April 2024
https://doi.org/10.32598/ijmtfm.v14i02.43188 Published: 05/29/2024

  • View Article
  • Download
  • Cite
  • References
  • Statastics
  • Share

Abstract

Background: This study evaluates the role of oral melatonin in improving vision in methanol toxicity since vision disorders are one of the side effects related to methanol toxicity and assumes the potential effects of melatonin in protecting neurons and optic nerves. Meanwhile, little attention has been paid by researchers to the effect of melatonin in these patients.
Methods: A double-blind randomized controlled clinical trial study was conducted on 40 patients diagnosed with methanol toxicity who were referred to Khorshid Hospital of Isfahan City, Iran, from May 2022 to May 2023. These patients were randomly divided into two groups. In the first group (the intervention group), in addition to the usual treatment, the patients were prescribed orally 3 mg of melatonin every morning and 6 mg of melatonin every night for 10 days. In the second group (the control group), in addition to the usual treatment, a placebo was administered similar to the intervention group protocol. Then, the clinical and vision parameters of the patients were evaluated before, during, and after the intervention.
Results: The mean pH, PCO2 and HCO3 increased significantly after the intervention compared to the pre-intervention in both groups (P<0.05); however, no significant difference was found between the two groups in any of the two follow-up times (P>0.05). The most common visual complication caused by methadone toxicity was blurred vision with 71.4% and 90% in the melatonin and non-melatonin groups, respectively. Visual complications improved significantly after the intervention compared to the pre-intervention; accordingly, the complete improvement of vision complications in the melatonin group (76.2%) was significantly more than the non-melatonin group (53.3%) (P=0.040).
Conclusion: Melatonin improves blurred or snowfield vision in methanol poisoning. Therefore, the administration of melatonin plus routine treatment can be effective in improving vision disorders (blurred or snowfield vision) caused by methanol poisoning.

Keywords:
  • Methanol
  • Melatonin
  • Vision
  • Alcohol
  • Intoxication
  • Poisoning
  • pdf

How to Cite

Samsamshariat, S., Zoofaghari, S., Meamar, R., Jalali, N., & Maghmi Mehr, A. (2024). Evaluation of the Efficacy of Melatonin in Visual Disturbed Methanol-intoxicated Patients: A Randomized Clinical Trial. International Journal of Medical Toxicology and Forensic Medicine, 14(02). https://doi.org/10.32598/ijmtfm.v14i02.43188
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

References

Çetinkaya A, Sırakaya HA, Aydın K. Methyl alcohol poisoning: An analysis of 18 consecutive cases. Turkish Journal of Nephrology. 2021; 30:57-62. [DOI:10.5152/turkjnephrol.2020.4515]

Robledo C, Saracho R. Methanol poisoning caused by inhalation of solvent. Nefrología. 2018; 38(6):679-80. [DOI:10.1016/j.nefroe.2018.03.013]

Sanaei-Zadeh H, Zamani N, Shadnia S. Outcomes of visual disturbances after methanol poisoning. Clinical Toxicology. 2011; 49(2):102-7. [DOI:10.3109/15563650.2011.556642] [PMID]

Sun Q, Sun M, Zhang Y, Wang S, Bai W, Wei S, et al. Clinical characteristics of methanol-induced optic neuropathy: Correlation between aetiology and clinical findings. Journal of Ophthalmology. 2022; 2022:4671671. [DOI:10.1155/2022/4671671] [PMID] [PMCID]

Ma Z, Jiang H, Wang J. Clinical analysis of severe visual loss caused by inhalational methanol poisoning in a chronic process with acute onset: A retrospective clinical analysis. BMC Ophthalmology. 2019; 19(1):124. [DOI:10.1186/s12886-019-1127-9] [PMID] [PMCID]

Hovda KE, Hunderi OH, Tafjord AB, Dunlop O, Rudberg N, Jacobsen D. Methanol outbreak in Norway 2002-2004: Epidemiology, clinical features and prognostic signs. Journal of Internal Medicine. 2005; 258(2):181-90. [DOI:10.1111/j.1365-2796.2005.01521.x] [PMID]

Yousefinejad V, Moradi B, Mohammadi Baneh A, Sheikhesmaeili F, Babahajian A. Prognostic factors of outcome in methanol poisoning; An 8-year retrospective cross-sectional study. Archives of Academic Emergency Medicine. 2020; 8(1):e69. [PMID] [PMCID]

Paasma R, Hovda KE, Jacobsen D. Methanol poisoning and long term sequelae - a six years follow-up after a large methanol outbreak. BMC Clinical Pharmacology. 2009; 9:5. [DOI:10.1186/1472-6904-9-5] [PMID] [PMCID]

Galvez-Ruiz A, Elkhamary SM, Asghar N, Bosley TM. Visual and neurologic sequelae of methanol poisoning in Saudi Arabia. Saudi Medical Journal. 2015; 36(5):568-74. [DOI:10.15537/smj.2015.5.11142] [PMID] [PMCID]

Nekoukar Z, Zakariaei Z, Taghizadeh F, Musavi F, Banimostafavi ES, Sharifpour A, et al. Methanol poisoning as a new world challenge: A review. Annals of Medicine and Surgery. 2021; 66:102445. [DOI:10.1016/j.amsu.2021.102445] [PMID]

Brent J, McMartin K, Phillips S, Burkhart KK, Donovan JW, Wells M, et al. Fomepizole for the treatment of ethylene glycol poisoning. Methylpyrazole for toxic alcohols study group. The New England Journal of Medicine. 1999; 340(11):832-8. [DOI:10.1056/NEJM199903183401102] [PMID]

Shukla M, Shikoh I, Saleem A. Intravenous methylprednisolone could salvage vision in methyl alcohol poisoning. Indian Journal of Ophthalmology. 2006; 54(1):68-9. [DOI:10.4103/0301-4738.21628] [PMID]

Abrishami M, Khalifeh M, Shoayb M, Abrishami M. Therapeutic effects of high-dose intravenous prednisolone in methanol-induced toxic optic neuropathy. Journal of Ocular Pharmacology and Therapeutics. 2011; 27(3):261-3. [DOI:10.1089/jop.2010.0145] [PMID]

Sharma P, Sharma R. Toxic optic neuropathy. Indian Journal of Ophthalmology. 2011; 59(2):137-41. [DOI:10.4103/0301-4738.77035] [PMID] [PMCID]

Aranda ML, González Fleitas MF, De Laurentiis A, Keller Sarmiento MI, Chianelli M, Sande PH, et al. Neuroprotective effect of melatonin in experimental optic neuritis in rats. Journal of Pineal Research. 2016; 60(3):360-72. [DOI:10.1111/jpi.12318] [PMID]

Mostafalou S, Abdollahi M. Pesticides: An update of human exposure and toxicity. Archives of Toxicology. 2017; 91(2):549-99. [DOI:10.1007/s00204-016-1849-x] [PMID]

Romero A, Ramos E, de Los Ríos C, Egea J, Del Pino J, Reiter RJ. A review of metal-catalyzed molecular damage: Protection by melatonin. Journal of Pineal Research. 2014; 56(4):343-70. [DOI:10.1111/jpi.12132] [PMID]

Asghari MH, Moloudizargari M, Bahadar H, Abdollahi M. A review of the protective effect of melatonin in pesticide-induced toxicity. Expert Opinion on Drug Metabolism & Toxicology. 2017; 13(5):545-54. [DOI:10.1080/17425255.2016.1214712] [PMID]

Andersen LP, Gögenur I, Rosenberg J, Reiter RJ. The Safety of Melatonin in Humans. Clinical Drug Investigation. 2016; 36(3):169-75. [DOI:10.1007/s40261-015-0368-5] [PMID]

Mistraletti G, Umbrello M, Sabbatini G, Miori S, Taverna M, Cerri B, Mantovani ES, et al. Melatonin reduces the need for sedation in ICU patients: A randomized controlled trial. Minerva Anestesiologica. 2015; 81(12):1298-310. [Link]

Mistraletti G, Sabbatini G, Taverna M, Figini MA, Umbrello M, Magni P, et al. Pharmacokinetics of orally administered melatonin in critically ill patients. Journal of Pineal Research. 2010; 48(2):142-7. [DOI:10.1111/j.1600-079X.2009.00737.x] [PMID]

Nordlund JJ, Lerner AB. The effects of oral melatonin on skin color and on the release of pituitary hormones. The Journal of Clinical Endocrinology and Metabolism. 1977; 45(4):768-74. [DOI:10.1210/jcem-45-4-768] [PMID]

Paradies G, Paradies V, Ruggiero FM, Petrosillo G. Protective role of melatonin in mitochondrial dysfunction and related disorders. Archives of Toxicology. 2015; 89(6):923-39. [DOI:10.1007/s00204-015-1475-z] [PMID]

Aranda ML, Fleitas MFG, Dieguez H, Iaquinandi A, Sande PH, Dorfman D, et al. Melatonin as a therapeutic resource for inflammatory visual diseases. Current Neuropharmacology. 2017; 15(7):951-962. [DOI:10.2174/1570159X15666170113122120] [PMID] [PMCID]

Korkmaz A, Reiter RJ, Topal T, Manchester LC, Oter S, Tan DX. Melatonin: An established antioxidant worthy of use in clinical trials. Molecular Medicine (Cambridge, Mass.). 2009; 15(1-2):43-50. [DOI:10.2119/molmed.2008.00117] [PMID]

Carrascal L, Nunez-Abades P, Ayala A, Cano M. Role of melatonin in the inflammatory process and its therapeutic potential. Current Pharmaceutical Design. 2018; 24(14):1563-88. [DOI:10.2174/1381612824666180426112832] [PMID]

Del Valle Bessone C, Fajreldines HD, de Barboza GED, Tolosa de Talamoni NG, Allemandi DA, Carpentieri AR, et al. Protective role of melatonin on retinal ganglionar cell: In vitro an in vivo evidences. Life Sciences. 2019; 218:233-40. [DOI:10.1016/j.lfs.2018.12.053] [PMID]

Wei J, Ma LS, Liu DJ, Guo J, Jiang WK, Yu HJ. Melatonin regulates traumatic optic neuropathy via targeting autophagy. European Review for Medical & Pharmacological Sciences. 2017; 21(21):4946-51. [Link]

Zhang R, Wang X, Ni L, Di X, Ma B, Niu S, et al. COVID-19: Melatonin as a potential adjuvant treatment. Life Sciences. 2020; 250:117583. [DOI:10.1016/j.lfs.2020.117583] [PMID] [PMCID]

Gagné AM, Danilenko KV, Rosolen SG, Hébert M. Impact of oral melatonin on the electroretinogram cone response. Journal of Circadian Rhythms. 2009; 7:14. [DOI:10.1186/1740-3391-7-14] [PMID] [PMCID]

Emser W, Dechoux R, Weiland M, Wirz-Justice A. Melatonin decreases the amplitude of the b-wave of the human electroretinogram. Experientia. 1993; 49(8):686-7. [DOI:10.1007/BF01923951] [PMID]

Govender J, Loos B, Marais E, Engelbrecht AM. Mitochondrial catastrophe during doxorubicin-induced cardiotoxicity: A review of the protective role of melatonin. Journal of Pineal Research. 2014; 57(4):367-80. [DOI:10.1111/jpi.12176] [PMID]

Yang Y, Sun Y, Yi W, Li Y, Fan C, Xin Z, et al. A review of melatonin as a suitable antioxidant against myocardial ischemia-reperfusion injury and clinical heart diseases. Journal of Pineal Research. 2014; 57(4):357-66. [DOI:10.1111/jpi.12175] [PMID]

Asghari MH, Abdollahi M, de Oliveira MR, Nabavi SM. A review of the protective role of melatonin during phosphine-induced cardiotoxicity: Focus on mitochondrial dysfunction, oxidative stress and apoptosis. The Journal of Pharmacy and Pharmacology. 2017; 69(3):236-43. [DOI:10.1111/jphp.12682] [PMID]

  • Abstract Viewed: 365 times
  • pdf Downloaded: 266 times

Download Statastics

  • Linkedin
  • Twitter
  • Facebook
  • Google Plus
  • Telegram

Developed By

Open Journal Systems

Information

  • For Readers
  • For Authors
  • For Librarians

Browse

Make a Submission

Make a Submission
  • Home
  • Archives
  • Submissions
  • About the Journal
  • Editorial Team
  • Contact

 

Copyright  The Author(s); This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

       

Powered by OJSPlus