Quetiapine for sleep in patients with dementia.

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.