Questions Related to Jet Lag

In order to prescribe treatments for Jet lag our doctor needs some information regarding this specific condition. Please complete the following as accurately as possible.

Which country are you departing from?

What is your travel destination?

Is your liver or kidney function impaired?

Yes No

Have you been diagnosed with liver, kidney or autoimmune disease (E.g. Rheumatoid arthritis, Lupus)?

Yes No

Are you epileptic?

Yes No

Are you taking fluvoxamine or any other antidepressant?

Yes No

I understand that melatonin might not alleviate or cure the symptoms of jet lag and that although there is evidence suggesting it is an effective remedy for this purpose, it is currently not licensed as a treatment against jet lag thus will be prescribed off-label.

I understand that melatonin may cause drowsiness and impair my ability to drive or operate machinery safely.

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