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A similar analysis<ref name="pmid16423108">{{cite journal | author = Buscemi N, Vandermeer B, Hooton N, Pandya R, Tjosvold L, Hartling L, Baker G, Klassen TP, Vohra S | title = The efficacy and safety of exogenous melatonin for primary sleep disorders. A meta-analysis | journal = J Gen Intern Med | volume = 20 | issue = 12 | pages = 1151–8 | year = 2005 | month = December | pmid = 16423108 | pmc = 1490287 | doi = 10.1111/j.1525-1497.2005.0243.x }}</ref> by the same team a year earlier on the efficacy and safety of exogenous melatonin in the management of ''primary'' sleep disorders found that: ''There is evidence to suggest that melatonin is safe with short-term use (3 months or less).''
Unwanted effects in some people especially at high doses (~3 mg/day or more){{Failed verification}} may include headaches, nausea, next-day [[grogginess]], irritability, hormone fluctuations, vivid dreams, nightmares,<ref>{{cite web| title=Melatonin side effects: What are the risks?| publisher=Mayo Clinic| author=Brent Bauer, M.D.| accessdate=2011-08-17| url=http://www.mayoclinic.com/health/melatonin-side-effects/AN01717}}</ref> reduced blood flow and [[hypothermia]].<ref name="pmid11600532">{{cite journal | author = Zhdanova IV, Wurtman RJ, Regan MM, Taylor JA, Shi JP, Leclair OU | title = Melatonin treatment for age-related insomnia | journal = J. Clin. Endocrinol. Metab. | volume = 86 | issue = 10 | pages = 4727–30 | year = 2001 | month = October | pmid = 11600532 | doi = 10.1210/jc.86.10.4727 }}</ref>
While no large, long-term studies that might reveal side-effects have been conducted, there do exist case reports about patients having taken melatonin for months.<ref name="pmid11027741">{{cite journal | author = Sack RL, Brandes RW, Kendall AR, Lewy AJ | title = Entrainment of free-running circadian rhythms by melatonin in blind people | journal = N. Engl. J. Med. | volume = 343 | issue = 15 | pages = 1070–7 | year = 2000 | month = October | pmid = 11027741 | doi = 10.1056/NEJM200010123431503 }}</ref>
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