Off‐label use of quetiapine in nursing homes: Does medical specialty of prescribing physicians play a role?

Müller, Laura; Noseda, Roberta; Bertoli, Raffaela; Bissig, Marco; Ceschi, Alessandro

doi:10.1111/bcp.14232

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…Considerable off‐label use has also been documented in other European countries, e.g. in Norway 17 and among nursing home‐residents in Switzerland 18 . Off‐label use of other psychotropic medications has also been observed (e.g., pregabalin 19 ), and the attention to off‐label use of psychotropic drugs could be considered as more general trend.…”

Section: Discussionmentioning

confidence: 99%

Who prescribes quetiapine in Denmark?

Rasmussen

Olesen

Munk‐Olsen

et al. 2022

Brit J Clinical Pharma

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The second-generation antipsychotic quetiapine is commonly used off-label for its anxiolytic and hypnotic properties. However, quetiapine is associated with problematic side-effects. We used Danish Medicinal Product Statistics and a 20% random sample of the Danish population's prescription fills (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020) to describe the utilization of quetiapine and proportion of various prescriber types (general practitioner [GP], specialist in private practice, hospital physician and other prescribers) both in connection to first-time and subsequent prescriptions. In 2020, 92% of all quetiapine was dispensed outside hospitals and the average daily dispensed quantity of quetiapine per user corresponded to 100 mg/user/d. A GP issued 53% of first-time prescriptions and 75% of subsequent prescriptions for quetiapine in 2020. The proportion of quetiapine prescriptions issued by GPs varied by age group-from 14% among 0-17-year-olds to 93% among the ≥80-year-olds. Future initiatives on the rational use of quetiapine and related drugs, especially among adults, should target GPs.

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Section: Discussionmentioning

confidence: 99%

Who prescribes quetiapine in Denmark?

Rasmussen

Olesen

Munk‐Olsen

et al. 2022

Brit J Clinical Pharma

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“…Therefore, the higher value of the disproportionality found for quetiapine cannot be understood as a greater risk of somnambulism or SRED with that drug. Indeed, as it is widely used to treat sleep disorders in North America, it is possible that the higher reporting of these events with quetiapine is due to the fact that it is prescribed to a population that has a higher prevalence of these disorders, as also are benzodiazepines and sodium oxybate 31,32 . People with insomnia may wake up at night in a confused state but not remember it, leading to a suspicion of somnambulism or SRED.…”

Section: Discussionmentioning

confidence: 99%

A safety signal of somnambulism with the use of antipsychotics and lithium: A pharmacovigilance disproportionality analysis

Gouverneur

Ferreira

Morival

et al. 2021

Brit J Clinical Pharma

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Aims Antipsychotics and lithium are widely used in psychiatry, particularly in schizophrenia and bipolar disorders. Recently, some cases of somnambulism or sleep‐related eating disorder (SRED) have been reported in patients treated with these drugs. This study investigated the risk of reporting somnambulism or SRED associated with the use of antipsychotics and lithium. Methods The World Health Organization pharmacovigilance database (VigiBase), comprising >18 million adverse events, was queried. All somnambulism or SRED reports related to antipsychotics or lithium were identified. The association between antipsychotics or lithium and somnambulism or SRED was computed using the proportional reporting ratio (PRR) and information component. Results Among the 5784 cases reporting somnambulism or SRED, 508 suspected at least 1 antipsychotic or lithium. Most patients were aged 18–64 years (62.0%), and 37.0% were men. In most cases (77.6%), antipsychotic or lithium were the only drug class involved, and 53.3% of cases suspected quetiapine. Somnambulism was reported in 88.6% of cases and SRED in 18.1%. A significant association was found for second‐generation antipsychotics (PRR 3.44, 95% confidence interval 3.13) and lithium (PRR 2.03, [1.22; 3.37]), but not for first‐generation antipsychotics (PRR 0.99, [0.68; 1.44]). Conclusions We found a significant signal of somnambulism or SRED related to second‐generation antipsychotics and lithium. While case reports mentioned mostly quetiapine and olanzapine, almost all second‐generation antipsychotics were associated with somnambulism or SRED.

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“…Contraintuitivamente, neste estudo, não se identificou associação entre polifarmácia excessiva e multimorbidade. Esse achado contrasta com a literatura acerca do tema 5,6 e pode ser justificado pelo fato de que, na população estudada, as principais substâncias responsáveis pela polifarmácia excessiva foram o omeprazol e a quetiapina, e o uso desses medicamentos não indica, necessariamente, a presença de condição crônica 26,27 .…”

Section: Discussionunclassified

Prevalência e fatores associados à polifarmácia excessiva em pessoas idosas institucionalizadas do Sul do Brasil

Mascarelo

Bortoluzzi

Hahn

et al. 2021

Rev. bras. geriatr. gerontol.

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Resumo Objetivo Verificar a prevalência e os fatores associados à polifarmácia excessiva em pessoas idosas institucionalizadas. Método Estudo transversal com 478 pessoas idosas residentes em instituições de longa permanência para idosos. A variável dependente foi polifarmácia excessiva, definida como o uso concomitante de dez ou mais medicamentos. As variáveis independentes incluíram informações sociodemográficas e de saúde. Utilizou-se a regressão de Poisson com variância robusta para analisar o efeito das variáveis independentes em relação ao desfecho. Resultados A prevalência de polifarmácia excessiva foi de 29,3%, associada à cardiopatia (RP=1,40; IC95% 1,03-1,91), diabetes mellitus (RP=1,52; IC95% 1,15-2,01), depressão (RP=1,42; IC95% 1,08-1,87), internação hospitalar no último ano (RP=1,36; IC95% 1,02-1,80) e ao uso de medicamento potencialmente inapropriado para idosos (RP=2,13; IC95% 1,60-2,83). Conclusão A polifarmácia excessiva foi frequente entre pessoas idosas institucionalizadas. Os resultados sugerem que as doenças prevalentes entre pessoas idosas, a hospitalização e o uso de medicamentos potencialmente inapropriados são fatores para o uso de polifarmácia excessiva nessa população. Esses achados podem instruir ações com vistas à otimização da farmacoterapia prescrita às pessoas idosas.

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Off‐label use of quetiapine in nursing homes: Does medical specialty of prescribing physicians play a role?

Cited by 7 publications

References 10 publications

Who prescribes quetiapine in Denmark?

Who prescribes quetiapine in Denmark?

A safety signal of somnambulism with the use of antipsychotics and lithium: A pharmacovigilance disproportionality analysis

Prevalência e fatores associados à polifarmácia excessiva em pessoas idosas institucionalizadas do Sul do Brasil

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