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Seroquel is quetiapine. People are calling it an anti=psychotic because it is an anti-psychotic. That's its main use, and that's what it's licensed for.

https://bnf.nice.org.uk/drug/quetiapine.html

https://www.nami.org/About-Mental-Illness/Treatments/Mental-...

> Quetiapine is a medication that works in the brain to treat schizophrenia. It is also known as a second generation antipsychotic (SGA) or atypical antipsychotic.

If doctors are prescribing seroquel for sleep problems i) that's pretty scary and ii) it's an off label use.

EDIT: here's the FA information showing that seroquel is an antipsychotic and is not licensed to treat sleep problems. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/02...




Quetiapine is labaled an anti-psychotic yes, but its pharmacological characteristics are not that straight forward. It has a much higher affinity for H1 (histamine) receptors than for D2 (dopamine) receptors. Meaning that in low doses it acts like an anti-histaminergic drug, having a very limited effect on dopaminergic systems. Around 60% of D2-receptors need to be blocked for a typical anti-psychotic effect, and that is nowhere near what is happening with say 50mg of quetiapine, which is a normal dose for sleeping aid. In those low doses it mainly acts on H1, alpha-1, M3, M1, and some 5HT type receptors. At a minimum of 300mg per day, it pharmacologically starts to act as an anti psychotic.

There is a nice brief summary of this in Stahl's Essential Psychopharmacology.

To be clear, I am very much against prescribing anti-psychotics as sleeping aids. But I don't think there is a strong case for calling quetiapine anti-psychotic in low doses.




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