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Chronobiol Med > Volume 4(2); 2022 > Article
Cho: Quetiapine as a Potential Treatment for Insomnia: The Road Ahead
Because of its specific method of action, such as antagonism of histamine H1 and serotonin type 2A receptors, quetiapine has a sedative effect [1]. Quetiapine is chosen as a therapeutic alternative for treating individuals with schizophrenia or bipolar disorder who require sedation among other antipsychotics because of its sedative properties. In therapeutic practice, quetiapine is used to treat insomnia in people suffering from a variety of psychiatric conditions.
Lee et al. [2] looked at clinical data from Korea and reported on the prescription status of quetiapine for insomnia treatment. Quetiapine is commonly used to treat a variety of mental conditions, including schizophrenia, bipolar disorder, depression, and insomnia. Quetiapine is the favored therapeutic approach for treating primary insomnia in the elderly, according to reports.
When atypical antipsychotics like quetiapine are used to treat insomnia symptoms in actual clinical settings, they are chosen for various concomitant therapeutic goals in addition to insomnia [3]. According to the findings from the study reported by Lee et al. [2], quetiapine is recommended for treating insomnia in the elderly not only because of the vulnerability and risk of side effects associated with sedative-hypnotics, but also because of its sedative action. In the elderly, the administration of sedative-hypnotics may raise the risk of dementia or delirium and may result in long-term use, which is problematic.
For the elderly who suffer from insomnia, non-pharmacological treatment options such as cognitive-behavioral therapy or light therapy may be a viable choice. However, there is a population that necessitates medication, and quetiapine is a promising alternative in the clinical setting. When treating older patients with insomnia, practitioners should avoid using sedative-hypnotics as the first-line therapy choice. As a result, quetiapine can be regarded an effective treatment for insomnia symptoms in the elderly.
What is certain is that quetiapine has not been approved by the FDA as an insomnia therapy. When a drug is licensed and prescribed for a certain ailment, doctors and patients can be confident in its safety and effectiveness. Although quetiapine has some advantages in this regard, its efficacy is limited because it is not an FDA-approved medicine for the treatment of insomnia. There have been concerns raised about possible negative effects associated with the use of quetiapine to treat insomnia. When quetiapine is used to treat primary insomnia, dosage escalation has also been reported [4,5].
Well-designed study is needed to verify the effectiveness of quetiapine for insomnia in order to maximize the therapeutic effect and avoid side effects in clinical fields. It would also be beneficial to look into the impacts on specific demographics, such as the elderly, delirium, and sedative addiction. Until sufficient data accumulates, quetiapine should be used cautiously and in moderation for the treatment of insomnia.

NOTES

Conflicts of Interest

The author has no potential conflicts of interest to disclose.

REFERENCES

1. Anderson SL, Vande Griend JP. Quetiapine for insomnia: a review of the literature. Am J Health Syst Pharm 2014;71:394–402.
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2. Lee KY, Ryu SH, Ha JH, Jeon HJ, Park DH. Prescription dose analysis of quetiapine in the elderly and insomnia. Chronobiol Med 2021;3:149–156.
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3. Hermes ED, Sernyak M, Rosenheck R. Use of second-generation antipsychotic agents for sleep and sedation: a provider survey. Sleep 2013;36:597–600.
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4. Cornelis C, Van Gastel A, Dumont G, Coppens V, Sabbe B, Morrens M, et al. A case of dose escalation of quetiapine in persistent insomnia disorder. Acta Clin Belg 2017;72:346–348.
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5. Gugger JJ, Cassagnol M. Low-dose quetiapine is not a benign sedative-hypnotic agent. Am J Addict 2008;17:454–455.
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