Quetiapine for insomnia: A review of the literature.

@article{Anderson2014QuetiapineFI,
  title={Quetiapine for insomnia: A review of the literature.},
  author={Sarah L. Anderson and Joseph P. Vande Griend},
  journal={American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists},
  year={2014},
  volume={71 5},
  pages={
          394-402
        }
}
PURPOSE The safety and efficacy of quetiapine for the treatment of insomnia in adults are reviewed. SUMMARY Quetiapine was developed for the treatment of psychiatric disorders, but its antagonism of histamine H1- and serotonin type 2A receptors has the added effect of causing sedation. As such, quetiapine is widely used off-label as a treatment for insomnia. Due to quetiapine's potential adverse effects, guidelines for the treatment of insomnia have recommended the drug's use only in patients… 
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76 Citations
Background Citations
12
Methods Citations
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76 Citations

Citation Type

Citation Type

Prescription Dose Analysis of Quetiapine in the Elderly and Insomnia
  • Ki Yong Lee, S. Ryu, Jee Hyun Ha, H. Jeon, Doo-Heum Park
  • Chronobiology in Medicine
  • 2021
Objective: The purpose of this study is to investigate the appropriate dose of quetiapine in clinical psychiatric diseases by examining the drug prescription dose in the elderly and insomnia group…
Evaluation of the use of low-dose quetiapine and the risk of metabolic consequences: A retrospective review
TLDR
There may be negative metabolic consequences with the use of low-dose quetiapine in patients with sleep disturbances and routine prescribing of low doses for sleep as a first-line medication should be avoided.
Does Combining Aripiprazole With Other Antipsychotics Worsen Psychosis?
  • N. Mahgoub
  • Medicine
    Journal of clinical psychopharmacology
  • 2015
TLDR
There is a clear rise in the OL use of low doses of quetiapine and mirtazapine in psychiatric patients and in individuals without serious psychiatric comorbidity, presumably to improve night-time sleep.
Pharmacologic Treatment Options for Insomnia in Patients with Schizophrenia
TLDR
Overall, this review confirmed that there are a few evidence-based options to treat insomnia in patients with schizophrenia, including selecting a more sedating second-generation antipsychotic such as paliperidone, or adding melatonin or eszopiclone.
Atypical antipsychotics for insomnia: a systematic review.
TLDR
Very low quality evidence suggests that quetiapine does not significantly improve sleep parameters compared with placebo in primary insomnia, despite a trend towards clinical improvements.
Quetiapine withdrawal: A systematic review
TLDR
Clinicians should be alert to the possibility of quetiapine withdrawal in individuals who present with somatic symptoms or choreiform movements, and large prospective studies are required to clarify this association.
Pharmacotherapeutic options for treatment of insomnia
TLDR
The pharmacotherapy of insomnia and the drugs under development for the treatment of insomnia are described and potential agents under investigations are targeting mechanisms and pathways including histamine (H 1 ) receptor, melatonin, and orexin receptors.
Off-Label Prescriptions of Low-Dose Quetiapine and Mirtazapine for Insomnia in The Netherlands
TLDR
There are only limited data supporting the use of low doses of quetiapine in patients suffering from insomnia, and case reports describe restless legs syndrome, akathisia, and hepatotoxicity for low-dose quetuapine and mirtazapine.
Treatment of chronic insomnia disorder in menopause: evaluation of literature
TLDR
Although a variety of interventions are shown to be helpful in improving sleep in menopause, there is a need for well-designed head-to-head trials with uniform outcome measures.
Review of Safety and Efficacy of Sleep Medicines in Older Adults.
TLDR
The future direction of insomnia treatment should have an emphasis on nonpharmacologic interventions, treating comorbid conditions, and focusing therapy on using benzodiazepines and non-BzRAs as last resorts.
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References

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TLDR
Using low-dose quetiapine for insomnia is not recommended based on limited data and potential safety concerns, and serious adverse events identified included fatal hepatotoxicity, restless legs syndrome, akathisia, and weight gain.
Quetiapine for Insomnia in Parkinson Disease: Results From an Open-Label Trial
TLDR
It is suggested that quetiapine may be a safe and effective treatment of insomnia in PD patients and double-blind studies will probably confirm these findings.
Metabolic Consequences of Using Low-Dose Quetiapine for Insomnia in Psychiatric Patients
TLDR
Despite the low doses typically used when quetiapine is prescribed for insomnia, metabolic adverse effects can occur and should be considered in the overall benefit to risk analysis.
Quetiapine for primary insomnia: a double blind, randomized controlled trial.
TLDR
Quetiapine at 25 mg at night did show a trend for improvement of TST and reduced SL in primary insomnia with few side effects but not reaching statistical significance, and a study with a larger sample size is needed to demonstrate its efficacy.
Quetiapine in the Treatment of Sleep Disturbances Associated with Addictive Conditions: A Retrospective Study
TLDR
The classical option of using sedating–hypnotic drugs to treat insomnia in polydrug users presents objections: the tolerance associated to high doses of benzodiacepines chronic abuse in many drug addicts obliges the clinician to use high doses in acute detoxificaton and the following de-habituation.
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TLDR
Preliminary data indicate that quetiapine add-on therapy appears to have beneficial effects in the treatment of patients with TRD.
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TLDR
Mixed-effects regression showed that quetiapine plus fluoxetine did not achieve 50% reduction in the Montgomery–Åsberg Depression Rating Scale score or improvement in Hamilton Anxiety Scale, Clinical Global Improvement (CGI)-Severity, and CGI-Improvement scores sooner than the fluxetine plus placebo group; however both groups improved in all scores over time.
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TLDR
The most common diagnoses in patients receiving standing dose quetiapine were depressive disorders, followed by substance-related, bipolar, and psychotic disorders, and the most common prn dose was 50 mg, given for agitation or insomnia.
Quetiapine monotherapy in the treatment of depressive episodes of bipolar I and II disorder: Improvements in quality of life and quality of sleep.
TLDR
Quetiapine monotherapy is effective in improving impairment in important aspects of life that accompany improvements in depressive symptoms in patients with acute bipolar depression.
A double-blind, placebo-controlled study of quetiapine and paroxetine as monotherapy in adults with bipolar depression (EMBOLDEN II).
TLDR
Quetiapine (300 or 600 mg/d), but not paroxetine, was more effective than placebo for treating acute depressive episodes in bipolar I and II disorder.
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