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DOI: 10.1055/s-2005-918876
Quetiapine in primary insomnia: a pilot study
In the treatment of primary insomnia, benzodiazepine receptor agonists are not a first-line medication, mainly due to the dependency risk. Antidepressants as an alternative treatment often lead to side effects. Therefore, antipsychotics play an increasing role in the management of this disorder. Among the atypical compounds, quetiapine appears to be a specially promising candidate. A sleep-inducing effect can be expected from its receptor binding profile (blockade of 5-HT2 receptors and H1 receptors) and is in line with data from a pilot study in healthy subjects performed by Cohrs et al. (2004). In an ongoing open study, 16 outpatients with primary insomnia were treated so far with quetiapine 25mg at bedtime for six weeks; in 5 of them, the dose was increased to 50mg during treatment. Sleep quality was measured by repeated polysomnography as well as the Pittsburgh Sleep Quality Inventory (PSQI) and sleep diaries. The treatment with quetiapine led to a considerable improvement in both objective and subjective measures of sleep quality. Additionally, there was an improvement in several neuropsychological parameters. Quetiapine was well tolerated, there were no reports of substantial side effects. We conclude that low-dose quetiapine may be a promising option in the treatment of primary insomnia.