An article is making social media rounds again because off-label use of this drug remains a pressing issue in Canada, the US and other European countries. Natural health products (NHPs) are frequently attacked for “a lack of scientific evidence”, while both prescription and over-the-counter chemical drugs are often prescribed off-label without the same level of scrutiny. Seroquel is an antipsychotic drug intended for the treatment of bipolar disorder and schizophrenia but is widely recommended for patients with insomnia. The June 14, 2017 article (3 minute read) by Sharon Kirkly for the National Post, “Sleeping with Seroquel: Drug Safety Expert Urges Doctors to Stop Prescribing Antipsychotic for Insomnia” (3 minute read) outlines the reason for concern with this off-label drug use.
Quetiapine, the active ingredient in Seroquel and other generics is sedating because it’s a tranquillizer. The article notes, “drug safety experts are growing increasingly alarmed by the drug’s use as a doctor-prescribed nightcap for insomnia, with a 10-fold increase in quetiapine prescriptions for sleep problems in Canada between 2005 and 2012 alone.” As NHPPA President and constitutional lawyer Shawn Buckley wrote within the 2015 NHPPA Censorship Compendium, “It might surprise you that many doctors do not put much weight on the expensive double-blind clinical trials conducted to get drugs approved by Health Canada.” His opinion is supported by the fact that “of the 33 million prescriptions for tranquilizers dispensed by Canadian retail drug stores in 2016, one quarter – 8.3 million – were for quetiapine”, all of which were prescribed off-label, which means no clinical trial data is available to support using the drug in that way.
The article also makes several cogent points about the inconsistency of scientific application and collective biases. One expert interviewed stated, “it’s hard to explain the ‘inherent hypocrisy’ of the massive prescribing of an antipsychotic for insomnia, while medical leaders are warning doctors to be wary of prescribing marijuana for sleep.” We see the same hypocrisy is alive and well in much of the medical and scientific communities’ views on NHPs.
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