Research cautions against the use of Seroquel for sleep amid other safer, more effective options.
Difficulty falling or staying asleep can be frustrating. You may find yourself tossing and turning at night or contacting to a doctor for a prescription.
Over the past few decades, there’s been a rise in the number of off-label prescriptions for Seroquel, which may leave you wondering if it’s effective for insomnia.
Research has yet to catch up with the increasing trend in prescriptions, making Seroquel a weak and potentially dangerous choice for insomnia.
But other medications are both safe and effective for sleep. You may also find some relief from natural medicines, supplements, and lifestyle changes.
Seroquel (quetiapine) is considered a second-generation antipsychotic drug. It has not been approved by the Food and Drug Administration (FDA) for insomnia.
Like other antipsychotic medications, it has been approved for mental health disorders, such as:
- psychosis in dementia
- bipolar disorder
Mental health professionals also sometimes prescribe it as a supplementary medication for major depressive disorder.
Seroquel is thought to work by modifying levels of chemicals like dopamine, serotonin, and histamine. Each of these chemicals interacts with the nervous system to regulate mood and other important body functions. Each also has the potential for considerable side effects.
Effectiveness for sleep
Health professionals commonly prescribe Seroquel off-label when insomnia is caused by another psychiatric disorder (secondary insomnia). Seroquel has also been increasingly prescribed for stand-alone (primary) insomnia due to its sedating properties.
Research from 2016 found that there is limited evidence of the effectiveness and safety of Seroquel for primary insomnia. The researchers concluded that Seroquel should be reserved for people with psychiatric disorders that occur alongside insomnia.
More research is needed before we know how safe and effective Seroquel is for primary insomnia. This medication carries the risk of various side effects that could be harmful.
Seroquel dosage for sleep
The appropriate dosage of Seroquel for sleep has yet to be determined. Its sedative effects are thought to be the most apparent at lower doses. Between 25 mg and 150 mg is considered a low dose, according to a 2014 study.
Existing data advises against the use of Seroquel as a sleep aid, citing additional risks beyond a lack of evidence. These risks include:
- multiple side effects
- potential for misuse
- problems for older adults
Known side effects of Seroquel include:
- daytime sleepiness
- low blood pressure
- dry mouth
- restless leg syndrome
- involuntary body movements
- weight gain
- neuroleptic malignant syndrome
- irregular changes in heart rate and rhythm
- reduced concentration
Seroquel may have side effects even at low dosages of 200 mg or lower, according to a 2021 study.
Dosages used for mood disorders range from 300 to 600 mg. Dosages for schizophrenia may be over 800 mg. Healthcare professionals have to monitor high doses of Seroquel carefully.
A 2016 review looked at the effects of Seroquel in over 400 individuals. These participants took around 116 mg per day for 44 months.
At this dose, reported side effects mainly involved undesirable changes in:
- blood pressure
- body mass index (BMI)
- blood sugar
- blood lipids
You and your healthcare professional can work together to decide whether the risks outweigh the benefits. This will determine whether or not off-label use is appropriate based on your individual circumstances.
Considerations for older adults
The rate of insomnia in older adults is
Official guidance strongly recommends against antipsychotics for primary insomnia in older adults, as medications like Seroquel are known to
- heart attack
- cognitive impairment
There are other options to help with falling or staying asleep. These can include prescription medications, herbs, supplements, and lifestyle practices.
Prescription sleep medications
Prescription medications for sleep include:
- zolpidem (Ambien)
- tasmeltion (Hetiloz)
- eszopiclone (Lunesta)
- zaleplon (Sonata)
Prescription sleep medications safe for older adults include:
- doxepin (Silenor)
- tasmeltion (Hetiloz)
- ramelteon (Rozerem)
Supplements for sleep
As one of the most important hormones directly involved in the regulation and promotion of sleep, melatonin is a popular supplement. It’s naturally released in higher amounts by the pineal gland once it gets dark outside.
Research, including a
Many people talk about the sleep-inducing properties of valerian, which has historically been considered a hypnotic. Its effects on molecules that participate in relaxation have been well-studied, according to a
Some of these molecules include GABA, serotonin, and adenosine, each of which plays a role in promoting sleep.
The active ingredients in coffee are known to block adenosine receptors, which results in increased wakefulness. Valerian works in the opposite manner by activating these receptors.
After 8 weeks, researchers concluded that Ashwagandha improved sleep quality and helped manage insomnia for both groups. They also found that the effect was greater for those living with insomnia.
Routine evening and nighttime practices are an important part of overall sleep quality. Your habits around bedtime are referred to as sleep hygiene.
Best practices for sleep hygiene include:
- making sure your room is cool, dark, and quiet
- avoiding eating several hours before bed
- avoiding napping during the day for longer than 30 minutes
- trying to sleep at the same time every night and wake up at the same time every morning
- avoiding light from cell phones, television, and other sources before bed
There are many options available to help you find relief and fall asleep. Remember that well-studied medications are always the safest option.
Due to a lack of research, Seroquel is not the first-line choice for insomnia. A healthcare professional can help you decide if the benefits outweigh the risks and talk through other choices.
For more information about sleep health and best practices, the National Institutes of Health offers