Zinc and melatonin have been suggested in the
treatment of hepatic encephalopathy. Cirrhotic patients with
encephalopathy have zinc deficiency.141 Zinc supplementto improve encephalopathy has been described in case
reports,142,143 but has not been proven in a double-blind trial.144
Cirrhotic patients have elevated daytime melatonin levels
which may contribute to the disturbances of the sleep–wake
cycle.145 Melatonin supplement may be an option to alter the
sleep–wake cycle in these patients.146