Is It Safe to Take Quetiapine to Help You Sleep?

Quetiapine hasn’t been approved by the Food and Drug Administration (FDA) to treat insomnia. However, due to its sedative effects, it’s still sometimes prescribed off-label as a short-term sleep aid.

Although it’s difficult to pinpoint exactly how often quetiapine is prescribed for insomnia and related sleep disorders, research suggests that it’s prescribed fairly often.

A 2017 study examining quetiapine prescriptions among adolescents at a psychiatric inpatient center found that out of 720 admissions, 11.5 percent were prescribed quetiapine for nighttime use. Of those prescriptions, 57 percent were solely for insomnia.

A 2012 review reported that the typical dosage for quetiapine ranges from 25 to 200 milligrams (mg) per day when prescribed off-label for insomnia.

Very few high-quality studies have focused specifically on whether quetiapine actually helps with sleep.

Available research suggests that quetiapine’s effectiveness may depend on whether insomnia occurs independently (primary insomnia) or alongside another health condition (secondary insomnia).

The 2012 review identified two studies that evaluated the use of quetiapine in the treatment of primary insomnia. The authors mentioned several potential health concerns, such as weight gain and metabolic changes, even with low doses.

Similarly, a 2014 review identified only two small clinical trials assessing the use of quetiapine for insomnia in adults without other health conditions. The authors concluded that, based on a lack of safety and effectiveness information, quetiapine isn’t recommended for insomnia.

Another literature review from 2016 came to a similar conclusion. They cited only one study, which concluded that quetiapine doesn’t significantly improve sleep.

A comprehensive 2018 review also concluded that quetiapine doesn’t improve primary insomnia. However, the authors suggested that based on limited evidence, quetiapine may be useful in treating secondary insomnia caused by depression associated with bipolar disorder.

Based on the available evidence, the general consensus at this time is that quetiapine isn’t recommended for insomnia.

Given the lack of research, we don’t have a complete picture of the risks associated with taking a low dose of quetiapine as a sleep aid, especially over the long-term.

The 2014 review cited above found that the most commonly reported side effects were dry mouth and daytime sleepiness. However, the authors also indicated that even low doses of quetiapine can cause significant weight gain.

Other undesirable side effects that have been reported in clinical trials of quetiapine for insomnia include:

• dizziness after standing up
• muscle spasms
• repetitive body movements
• restlessness and fidgeting
• restless leg syndrome

Side effects associated with higher doses of quetiapine used to treat bipolar disorder and schizophrenia are more well-known. They can include:

• dizziness
• dry mouth
• heart problems
• high cholesterol
• high triglycerides
• insulin resistance
• drowsiness
• stroke
• suicidal thoughts and behavior
• weight gain

Less common side effects include the following conditions that can be life threatening:

• neutropenia, a condition that affects your white blood cells
• neuroleptic malignant syndrome (NMS), a rare drug reaction

Quetiapine also presents serious risks to people who have dementia, such as increased cognitive decline and death.

There are several types of of treatment options for primary insomnia. These include:

• prescription medication
• over-the-counter (OTC) medication
• supplements
• behavioral and complementary therapies
• lifestyle changes

While some of these treatments do have risks, especially if they’re used long-term, other options are known to be safe and carry little to no risk of side effects.

Let’s take a closer look at these options.

Prescription medication

Prescription sleep aids can make it easier for you to fall asleep or stay asleep. Prescription options include benzodiazepines and drugs with sedative effects, like antidepressants.

Some examples of prescription sleep medication include:

• doxepin (Silenor)
• ramelteon (Rozerem)
• triazolam (Halcion)
• zaleplon (Sonata)
• zolpidem (Ambien)

Many of these drugs aren’t recommended for long-term use, since they can be habit-forming. In addition, prescription sleeping pills can cause side effects like daytime drowsiness.

It’s important to discuss the risks and benefits of prescription sleep medication with your doctor.

OTC medication

Some people use nonprescription drugs that cause drowsiness to help them sleep. These include antihistamines and nausea drugs, such as dimenhydrinate.

These aren’t intended to treat insomnia. They may cause side effects, such as:

• confusion
• dizziness
• daytime drowsiness

It’s important to talk to your doctor before taking OTC medications to help you sleep.

Supplements

Melatonin is a dietary supplement that is frequently used as a sleep aid. Other natural sleep aids include:

• valerian root
• magnesium
• lavender

Be sure to talk with your doctor or pharmacist before taking a supplement.

While supplements may carry a lower risk of serious side effects, they can interfere with other medications you may be taking.

Behavioral and complementary therapies

There are a wide variety of tools and techniques that may help with insomnia. These include:

• Cognitive behavioral therapy (CBT). With CBT, you work with a trained therapist to change thought patterns that may interfere with your ability to get good quality sleep.
• Relaxation techniques. Guided meditation, yoga, tai chi, biofeedback, and breathing exercises can help you relax when it’s time to sleep.
• Sleep restriction. This technique involves temporarily limiting the amount of time you sleep, so that you’ll feel more tired the next night.
• Light therapy. Using a light box may help you adjust your sleep patterns, particularly during the winter months.
• Acupuncture. According to a 2012 review, acupuncture may improve sleep quality.

Lifestyle changes

Sometimes, making small changes to your daily routine can help improve your sleep. Try the following:

• Get regular exercise during the day or within a couple of hours of going to bed. Avoid doing vigorous exercise too close to your bedtime.
• Avoid napping for too long or in the afternoon.
• Limit your caffeine and alcohol intake, particularly in the hours before you go to bed.
• Avoid eating a large meal before you go to bed.
• If you smoke, try to quit.
• Try to relax before going to bed. You may want to do stretches, meditation, or yoga poses. Or, you could take a warm bath, read, or listen to soothing music.
• Try to stick to a regular sleep schedule by going to bed and waking up around the same time each day.
• Only use your bedroom for sleep and sex. Try to avoid working or watching TV while you’re lying in bed.
• Talk to your doctor about medications or health conditions that may be interfering with your sleep.

If you continue to have difficulty sleeping, there are other resources that may help you.

Insomnia apps can help you track your sleep patterns. Some apps also offer relaxation techniques and hypnosis to help you fall asleep.

Similarly, insomnia podcasts can help you wind down before bed. They incorporate:

• bedtime stories designed to make you drowsy
• soothing nature sounds
• white noise

If your insomnia persists, talk to your doctor about it. Your doctor can help address any underlying issues that might be contributing to your sleep issues.

Quetiapine isn’t recommended for insomnia and related sleep disorders. There’s not enough high-quality research on its safety and effectiveness.

There are a variety of other treatments available for primary insomnia, including medication, supplements, and lifestyle changes.

Speak to a healthcare professional to find out what types of treatments might be right for you.