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Quetiapine for Sleep in Patients with Dementia

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Objective: To examine the use of quetiapine for sleep in patients with dementia admitted to a geriatric psychiatry ward.

Design: Retrospective cross-sectional study (January 2007 to December 2009).

Setting: Geriatric psychiatric unit located near a metropolitan city in North Carolina.

Participants: All patients admitted with a diagnosis of dementia who were also receiving quetiapine were eligible. One hundred one patients met the criteria and were included in the study.

Intervention: None.

Main Outcome Measures: Descriptive statistics defining quetiapine prescribing. Based on a priori criteria, quetiapine was considered to be used for sleep if it were prescribed: 1) only at bedtime, as needed, for sleep, 2) once daily, only at bedtime, or 3) multiple times daily, but with at least 75% of the daily dose administered at bedtime.

Results: Forty-three of the 101 patients included in the study were prescribed quetiapine, probably for sleep. Quetiapine, when used as a sedative-hypnotic, was generally employed at doses between 50 mg and 100 mg nightly. Several published studies report beneficial sleep-promoting effects of quetiapine and other atypical antipsychotics for primary and secondary sleep complaints; however, most of these trials involve young and middle-aged adults, have diagnostic variability, and are limited methodologically.

Conclusion: Quetiapine prescribed as a sedative-hypnotic in patients with dementia, while common, is understudied and not without risk.
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Keywords: Alzheimer's disease; Atypical antipsychotic; Dementia; Insomnia; Off-label; Quetiapine. Sedativehypnotic; Sleep; Sundowning

Document Type: Research Article

Publication date: 2010-10-01

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  • The Consultant Pharmacist® is the official peer-reviewed journal of the American Society of Consultant Pharmacists. It is dedicated exclusively to the medication needs of the elderly in all settings, including adult day care, ambulatory care, assisted living, community, hospice, and nursing facilities. This award-winning journal is a member benefit of ASCP. Individuals who are not members and wish to receive The Consultant Pharmacist® will want to consider joining ASCP.
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