What are common adverse effects of melatonin receptor agonists like ramelteon?

• A. Headache and nausea
• B. Dry mouth and constipation
• C. Palpitations and tremor
• D. Dizziness, fatigue, and rare sleep-related complex behaviors

Answer: (D)

Melatonin receptor agonists like ramelteon commonly cause dizziness and fatigue, reflecting their sedating effect on the sleep-wake system. In rare cases, patients may exhibit sleep-related complex behaviors such as sleepwalking or performing activities while not fully awake. This combination—dizziness, fatigue, and rare sleep-related complex behaviors—best captures the typical adverse effect profile of this drug class. Other listed effects (headache, nausea; dry mouth, constipation; palpitations, tremor) are not the characteristic pattern for melatonin receptor agonists.