Safety of Low Doses of Quetiapine When Used for Insomnia

@article{Coe2012SafetyOL,
  title={Safety of Low Doses of Quetiapine When Used for Insomnia},
  author={Holly V Coe and Irene Seunghyun Hong},
  journal={Annals of Pharmacotherapy},
  year={2012},
  volume={46},
  pages={718 - 722}
}
Objective: To evaluate the safety of low doses of quetiapine when used for insomnia. Data Sources: A literature search was performed using PubMed and EMBASE (January 1990-November 2011) using the terms quetiapine, insomnia, sleep, low-dose, subtherapeutic, safety, and weight gain. Study Selection And Data Extraction:: Two prospective trials were identified that evaluated the effect of quetiapine in primary insomnia. In addition, 2 retrospective cohort studies were identified that evaluated the… 
Quetiapine for insomnia: A review of the literature.
TLDR
Given its limited efficacy data, its adverse-effect profile, and the availability of agents approved by the Food and Drug Administration for the treatment of insomnia, quetiapine's benefit in the Treatment of insomnia has not been proven to outweigh potential risks, even in patients with a comorbid labeled indication.
Efficacy of quetiapine off-label uses: data synthesis.
  • A. C. Carney
  • Psychology, Medicine
    Journal of psychosocial nursing and mental health services
  • 2013
TLDR
Moderate evidence exists for quetiapine as a pharmacological intervention for insomnia, dementia, and specific personality disorders and more data are needed to establish specific dosing regimens for off-label uses and to examine the dose relationship to metabolic side effects and extrapyramidal side effects.
Current and Emerging Pharmacotherapies in the Management of Insomnia in Adults
TLDR
This review primarily focuses on the pharmacotherapy for insomnia, including current and emerging pharmacotherapy on the basis of FDA-approved drugs, as well as medications that are frequently used without established clinical evidence.
Effect of Quetiapine, from Low to High Dose, on Weight and Metabolic Traits: Results from a Prospective Cohort Study.
TLDR
The dose-dependent effect highlighted for weight gain and lipid alterations emphasizes the importance of prescribing the minimal effective dose, as the effect size of a dose increase on metabolic worsening is low and the potential harm of low-dose quetiapine should not be dismissed.
Prescription Drugs Used in Insomnia.
Prescription Drugs Used in Insomnia.
Current Pharmacological and Nonpharmacological Options for the Management of Insomnia
TLDR
Novel hypnotics being developed by the pharmaceutical industry show promise in addressing insomnia with fewer side effects, and a combination of these approaches (eg, cognitive-behavioral therapy for insomnia) also enjoy strong empirical support.
Assessing and Treating Insomnia Related to Alcohol Use Disorders
  • K. Brower
  • Psychology, Medicine
    Current Addiction Reports
  • 2016
TLDR
Sleep will improve in most patients with sobriety, which remains the first line of treatment, Nevertheless, insomnia may also be thought of as a comorbid disorder with AUDs, requiring its own treatment for many patients.
Quetiapine extended-release (Seroquel-XR) versus amitriptyline monotherapy for treating patients with fibromyalgia: a 16-week, randomized, flexible-dose, open-label trial
TLDR
The results appear to indicate that quetiapine XR does not provide similar efficacy to amitriptyline for treating patients with fibromyalgia.
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References

SHOWING 1-10 OF 35 REFERENCES
Effects of Quetiapine on Sleep in Nonpsychiatric and Psychiatric Conditions
TLDR
Current data do not appear to support quetiapine's use as first-line treatment for sleep complications, however, it may be useful for treatment of insomnia in patients with psychiatric disorders who do not respond to primary or secondary treatments.
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.
Patterns of quetiapine use in psychiatric inpatients: an examination of off-label use.
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 for sleep in patients with dementia.
  • C. Dolder, J. McKinsey
  • Medicine, Psychology
    The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists
  • 2010
TLDR
Quetiapine prescribed as a sedative-hypnotic in patients with dementia, while common, is understudied and not without risk.
Quetiapine for tamoxifen-induced insomnia in women with breast cancer.
TLDR
Five of the six patients treated with quetiapine for tamoxifen-related insomnia without depression showed a prompt improvement of their insomnia; this effect was maintained after 6 weeks of treatment.
Clinical guideline for the evaluation and management of chronic insomnia in adults.
TLDR
This clinical guideline is to provide clinicians with a practical framework for the assessment and disease management of chronic adult insomnia, using existing evidence-based insomnia practice parameters where available, and consensus-based recommendations to bridge areas where such parameters do not exist.
Patterns of atypical antipsychotic subtherapeutic dosing among Oregon Medicaid patients.
TLDR
The results suggest that there is extensive use of expensive atypical antipsychotic medications for off-label purposes such as sedation or for other practice patterns that should be explored further.
Acute akathisia associated with quetiapine use.
TLDR
The cases of two patients who developed akathisia after treatment with quetiapine for insomnia are reported, and previously reported cases of akath isia induced by atypical antipsychotic agents are considered.
Is seroquel developing an illicit reputation for misuse/abuse?
TLDR
Clinicians in psychiatric and primary care settings can only remain alert to a potential risk of misuse/abuse with quetiapine, particularly in patients who meet the current demographic profile.
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