Blind Child Melatonin Treatment Study

Not Applicable

Terminated

Brief Summary: The primary focus of this five-year study will be to optimize the melatonin dosing regimen for synchronizing the body clocks of blind children to the 24-hour day.

Detailed Description: We intend to study as many as 26 blind children through up to three melatonin treatment regimens, all of which involve a dose step-down in which the melatonin dose will be reduced gradually to find the lowest effective dose. The 3 treatment plans differ only in the start dose. Successfully treated subjects (of one treatment plan) will enter a one-year intensive assessment of the safety and efficacy of melatonin treatment in which the subject will take the same dose for one year and complete biweekly assessments of efficacy and side-effects. The final phase of the study involves a placebo discontinuation, in which the subject's circadian rhythm will be returned to the baseline rhythm (this may take up to 6 months for some subjects).

Recruitment & Eligibility

Inclusion Criteria

Children and adults 5 to 20 years old
Blindness for at least one year, verified by an ophthalmologic exam
Ability to comply with the requirements of the experimental protocol
And no clinically significant abnormalities (other than blindness) on a general physical examination.
Subjects must be competent to sign informed consent if age 18 or older. Parents and subjects will be interviewed together and, when appropriate (for example, subject is age 18 or older), separately as well.

Exclusion Criteria

Abnormal heart, liver or kidney function; intractable seizure disorders
Significant laboratory abnormalities on CBC, Comprehensive Metabolic set, or UA (dip stick method)
Pregnancy; sexual activity in post-pubertal females not using a recognized and valid contraceptive method
A current Axis I psychiatric or substance abuse disorder according to the DSM-IV Manual ; OR
External demands that limit the ability to maintain a regular schedule, e.g. night shift work.

Arm && Interventions

Group	Intervention	Description
1	Melatonin	Subjects will be given up to 0.5 mg daily. If the treatment works, the dose will be reduced gradually until the lowest, effective dose is identified. If the treatment is unsuccessful, the subject will be taken off treatment and later enrolled in a different treatment plan.
2	Melatonin	Subjects will be given up to 10 mg daily. If the treatment works, the dose will be reduced gradually until the lowest, effective dose is identified. If the treatment is unsuccessful, the subject will be taken off treatment and later enrolled in a different treatment plan.
3	Melatonin	Subjects will be given up to 20 mg daily. If the treatment works, the dose will be reduced gradually until the lowest, effective dose is identified. If the treatment is unsuccessful, the subject will be taken off treatment and later enrolled in a different treatment plan.

Primary Outcome Measures