2 The pattern was similar in the United States from 1996 to 2003, with up to 70% of prescriptions for second-generation antipsychotics being written for conditions other than psychosis. 1 In Canada, prescriptions written by family physicians for quetiapine increased 300% from 2005 to 2012, with a 10-fold increase in its use for sleep disorders. Second-generation antipsychotic use has increased worldwide, with quetiapine, risperidone, and olanzapine being the most frequently prescribed. This article focuses on the use of quetiapine for treating insomnia, its basic pharmacology, evidence of efficacy, and adverse effects, and it provides recommendations for clinical monitoring of patients receiving the drug. However, its cardiometabolic effects and potential for abuse warrant caution for its off-label use. 4 It is generally regarded as being nonaddictive and having a good safety profile. Rather, quetiapine is increasingly being used off-label, including for insomnia, anxiety, agitation, and posttraumatic stress disorder (PTSD). 1, 2 Despite its approval by the US Food and Drug Administration (FDA) only for the treatment of schizophrenia, bipolar disorder (depression, acute mania, and maintenance), and major depressive disorder (as an adjunct medication), 3 only a minority of patients filling prescriptions for quetiapine have these diagnoses. Prescriptions for quetiapine (Seroquel), a second-generation antipsychotic medication, have risen sharply in recent years.
Quetiapine carries particular risks for elderly patients. The use of quetiapine to treat insomnia should be confined primarily to patients with comorbid mood or schizophrenia spectrum disorders.Ĭompared with many other antipsychotic drugs, quetiapine is less associated with dystonia and extrapyramidal side effects but tends to cause weight gain, metabolic syndrome, and QTc prolongation.īody mass index, weight, blood pressure, fasting glucose, and lipid levels should be measured before starting treatment and then regularly monitored, even for low doses.ĭespite having no euphoric effects, quetiapine is often abused to enhance or counter side effects of illicit drugs. Quetiapine affects multiple central nervous system receptors, resulting in a variety of effects, including sedation.
0 kommentar(er)
