Is Seroquel Good for Sleep?

Key Takeaways

• A recent study investigated the effectiveness of quetiapine (Seroquel) as a sleep aid, particularly its impact on sleep latency and duration, in patients with primary insomnia. The results indicated that quetiapine significantly reduced sleep latency and increased total sleep duration compared to placebo. Specifically, patients taking quetiapine experienced a reduction in sleep latency by approximately 17 minutes and an increase in total sleep duration by approximately 34 minutes. These findings suggest that quetiapine may be an effective option for improving sleep parameters in individuals with primary insomnia.

• Trazodone and Doxepin are two other antidepressants that are often used as an alternative sleep aid. Other benzodiazepines are often used such as Temazepam (Restoril), Estazolam (Prosom), and Triazolam (Halcion).

Is Seroquel Prescribed for Sleep?

Yes, Seroquel can get prescribed to patients as a sleep-aid.

It’s not often prescribed as a sleep-aid by a primary care physician for very common sleep disorders. However, a doctor may prescribe Seroquel for insomnia if you have multiple health conditions that could benefit from the drug's effects. As an example if you’re struggling with both schizophrenia and insomnia, your primary care doctor may recommend Seroquel as a potential path for you.

Seroquel for Sleep (Facts)

In short, Seroquel (or quetiapine) is still relatively under-tested in terms of its effective treatment of those suffering with sleep issues. Consider some of the following based on indirect studies performed with quetiapine:

An early study that we have for quetiapine used as a sleep aid is one performed by Vania Modesto-Lowe, MD, MPH, Agata K. Harabasz, MD and Sophia A. Walker, MD (https://www.ccjm.org/content/88/5/286). The study concludes some of the following:

The increasing off-label use of quetiapine (Seroquel), a second-generation antipsychotic, for treating insomnia, despite its approval only for psychiatric conditions like schizophrenia and bipolar disorder. Quetiapine's sedative effects at low doses make it attractive for this purpose, but its off-label use lacks robust evidence and poses risks, including metabolic effects like weight gain and potential for abuse. 

While it affects multiple central nervous system receptors, primarily histaminergic, its use for insomnia should be limited to patients with comorbid mood or schizophrenia spectrum disorders. Despite its popularity, particularly in correctional facilities, quetiapine misuse is associated with significant adverse effects and even fatal overdoses. 

Therefore, caution and appropriate monitoring are crucial when prescribing quetiapine off-label for insomnia.

Seroquel Dosage Amounts for Sleep

Since Seroquel in “low doses” is often prescribed, we can see the typical prescription amounts being somewhere in the 25mg to 100mg range. With some restrictions and guidelines applying, such as:

• Caution advised for elderly patients due to increased risk of cardiovascular events, stroke, and death.

• Risk of orthostatic hypotension (dizziness or lightheadedness when standing up) leading to falls and trauma.

• Clearance reduced by up to 50% in patients 65 years and older; lower starting dose and careful monitoring recommended.

Off-Brand Medications as Sleep Aids

It’s not uncommon for off-brand medications to be used as sleep aids. In the following table, some of these other antidepressants and benzodiazepines are used as prescribed sleep aids: