Patterns of quetiapine use in psychiatric inpatients: an examination of off-label use.
BACKGROUND
Despite emerging recognition that off-label use of atypical antipsychotics is widespread, there is little data concerning patterns of such use. To investigate such usage of quetiapine, we evaluated prescribing practices of this drug at our acute-care psychiatric hospital.


METHODS
Inpatient orders for quetiapine were obtained from October 2004 to March 2006 and divided into standing or prn (as needed) dose regimens. For patients receiving standing dose regimens, diagnosis, total daily dose, and dosing adequacy were ascertained. For patients receiving prn dosing, diagnosis, behavioral indication, dose, and frequency were determined.


RESULTS
The most common diagnoses in patients receiving standing dose quetiapine were depressive disorders, followed by substance-related, bipolar, and psychotic disorders. Mean dose was 169 +/- 154 mg/day (median = 200 mg/day), with 29.8% of patients receiving > or = 300 mg/day. Only 28.5% of patients had one of the diagnoses for which quetiapine is approved; in these patients, 46.4% received > or = 300 mg/day. Patients receiving prn dosing had a similar distribution of diagnoses. The most common prn dose was 50 mg, given for agitation or insomnia.


CONCLUSIONS
We found extensive off-label use of quetiapine. Further research is needed on the safety and efficacy of quetiapine in non-approved doses and diagnoses.
Philip
Noah S
NS
Butler Hospital and Department of Psychiatry and Human Behavior, The Warren Alpert Medical School at Brown University, Providence, RI 02906, USA.
Mello
Kerry
K
Carpenter
Linda L
LL
Tyrka
Audrey R
AR
Price
Lawrence H
LH
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000523:psychology; D003987:Dibenzothiazepines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D017277:Drug Approval; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D010343:Patient Admission; D010607:Pharmacy Service, Hospital; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology; D000069348:Quetiapine Fumarate; D012237:Rhode Island; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate