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Smith-Magenis syndrome (a congenital disorder due to a haplo-insufficiency of the retinoic acid-induced 1 gene, involved in the regulation of the expression of circadian genes) patients present with an inverted rhythmic melatonin secretion and sleep difficulties that can be managed with melatonin administration in the evening and -adrenergic blockers during the day to reduce melatonin secretion (82)

10.1074/jbc.M305838200 151 ShoupD.PriolaS

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This can indicate microbial contamination or peptide degradation

It is given to women with fertility issues in the initial stages of pregnancy if the benefits outweigh the risks