Off-label use of antipsychotic medication is increasing, particularly the use of quetiapine for sleep, owing to its sedating properties. 1 This is a cause for concern given important adverse effects, including drug-induced diabetes and parkinsonism, weight gain, neuroleptic malignant syndrome, oversedation, and risk of arrhythmia. 2 We describe quetiapine use in a prospective cohort of medical inpatients and the proportion of inhospital use that is perpetuated on discharge. Methods | In our 52-bed medical clinical teaching unit (CTU) (Royal Victoria Hospital; 417 beds, Montreal, Quebec, Canada), we prospectively enrolled all consecutive inpatients 60 years or older between December 2013 and April 2015. There were no exclusion criteria. Patient data were abstracted from medical records at discharge or death, and were analyzed in March 2016. One of us (P.D.) retrospectively reviewed all medical records for quetiapine dose and indication. In the absence of a documented comorbid psychiatric condition (eg, schizophrenia, major depressive, or bipolar affective disorder) or evidence of delirium it was inferred that once-nightly quetiapine was being given for sleep. Categorical variables were compared using χ 2 and continuous variables using Wilcoxon rank-sum or the Kruskal-Wallis test as appropriate. The study was approved by the McGill University Health Centre research ethics board.
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