Concerns about quetiapine

Quetiapine is subsidised by the Pharmaceutical Benefits Scheme to treat schizophrenia and bipolar disorder. An extended-release formulation is also approved for use, but not subsidised, for treatment-resistant depression and generalised anxiety disorder. There is increasing off-label prescribing of quetiapine for indications such as insomnia that have little evidence to support them. This prescribing is often for at-risk patients, such as people with personality or social vulnerabilities and those at risk of metabolic complications or cardiovascularyevents. More evidence is required to support prescribing decisions regarding these off-label indications. In the meantime prescribers should be supported with alternatives to prescribing for these conditions, such as psychological therapies that have a better evidence base and safety record.