title: Use of second-generation antipsychotic agents for sleep and sedation: a provider survey.
abstract: OBJECTIVE
  Anecdotal evidence suggests that second-generation antipsychotic agents are increasingly used to treat sleep problems. This study sought to quantify the proportion of new prescriptions for second-generation antipsychotic agents started for sleep/sedation and the correlates of such use.
  
  
  METHODS
  A cross-sectional survey of provider decision making at the time second-generation antipsychotic agents were prescribed, documenting the reasons for the medication, patient demographics, psychiatric and medical diagnoses, patient health characteristics, and provider background.
  
  
  METHODS
  A single Veterans Affairs Medical Center over a 20-month period.
  
  
  METHODS
  Prescribers of second-generation antipsychotic agents.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Seven hundred seven (32.2%) of 2,613 surveys indicated sleep/sedation was at least one reason for using a second-generation anti-psychotic agent, whereas for 266 (12.1%) it was the only reason. Quetiapine was most frequently prescribed overall as well as for sleep/sedation (47.0% and 73.6% respectively). Second-generation antipsychotic agent use for sleep/sedation was unrelated to sociodemographic characteristics, least likely in patients with schizophrenia or bipolar disorder, and most likely as a newly started second-generation antipsychotic agent.
  
  
  CONCLUSIONS
  Sleep/sedation is a common reason given for new prescriptions of second-generation antipsychotic agents. Quetiapine is most frequently used for this purpose. A greater understanding of why providers use second-generation antipsychotic agents rather than safer and less costly alternatives for sleep problems may advance the development of interventions to reduce adverse effects.
authors.affiliation: Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA. eric.hermes@yale.edu
authors.forename: Eric D A
authors.initials: ED
authors.lastname: Hermes
authors.forename: Michael
authors.initials: M
authors.lastname: Sernyak
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenheck
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003987:Dibenzothiazepines / Q000627:therapeutic use; D005260:Female; D019538:Health Care Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D000069348:Quetiapine Fumarate; D012890:Sleep / Q000187:drug effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D006993:Hypnotics and Sedatives; D000069348:Quetiapine Fumarate
keywords: Atypical antipsychotics; decision-making; hypnotic; off-label; pharmacoepidemiology
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