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.