Who prescribes quetiapine in Denmark?

Abstract

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.

Use of benzodiazepines and benzodiazepine‐related drugs in the Nordic countries between 2000 and 2020

“…It is of note that following the decreasing use of BZ and related drugs in countries like Denmark, Norway, and Sweden, an increase has been observed in use of other psychotropic drugs, such as quetiapine 33 . This increase in the use of quetiapine is likely to reflect a “clinical vacuum” from the increased attention to adverse effects with BZ and related drugs as a large proportion of new users of quetiapine have no records of psychotic disorders (or any psychiatric diagnosis) and the treatment is commonly installed in general practice 34,35 . Therefore, caution should be exerted when reducing use of BZ and BZRD and it should be investigated if reductions in BZ/BZRD use are converted to off‐label use of, for example, antipsychotics for anxiolytic/hypnotic purposes.…”

Impact of low‐dose quetiapine‐use on glycosylated hemoglobin, triglyceride and cholesterol levels

“…Efforts to ensure appropriate monitoring of risk factors for cardiometabolic disease should be directed toward all types of health‐care providers, given the increasing number of users and prescriptions for quetiapine issued in general practice and other medical specialities 11,25,26 . While, this study is concerned with quetiapine, similar recommendations should likely be made for other antipsychotics when used off‐label for anxiolytic or hypnotic purposes (e.g.…”

“…Efforts to ensure appropriate monitoring of risk factors for cardiometabolic disease should be directed toward all types of health-care providers, given the increasing number of users and prescriptions for quetiapine issued in general practice and other medical specialities. 11,25,26 While, this study is concerned with quetiapine, similar recommendations should likely be made for other antipsychotics when used off-label for anxiolytic or hypnotic purposes (e.g. chlorprothixene 27 ), as the antihistaminergic properties responsible the anxiolytic and hypnotic effects of antipsychotics, used in low doses, are likely to be involved in the pathophysiology of metabolic disturbances.…”

Characteristics and predictors of off‐label use of antipsychotics in general population sample

“…The doses of APs in off‐label use are usually relatively small 27,35,37 . However, safety concerns have been presented regarding the off‐label use of APs 9,11 and small doses of quetiapine 38–40 .…”

“…The doses of APs in off-label use are usually relatively small. 27,35,37 However, safety concerns have been presented regarding the off-label use of APs 9,11 and small doses of quetiapine. [38][39][40] For example, in a clinical trial in an adult sample, a relatively low dose of quetiapine of ca.…”