Also, why is seroquel handed out like candy?
IMHO, Seroquel being handed out like candy is ridiculous. It's been found to be the least effective antipsychotic in the CATIE trial, and it does not have a relatively favorable side effect profile.
1-it causes weight gain, among several other adverse metabolic effects such as increased cholesterol
2-it knocks people out and often zonks them during the daytime
3-Out of the atypicals, per the CATIE trial, it had the longest QT prolongation
4-The manufacturer's guidelines state that someone on Seroquel needs to be seen by an opthalmologist. (Whoever did that?)
5-It has abuse potential. It has a street value and there are published studies that it is being abused.
The only times I give it out as a first line are when, 1-the person is already on it and does not want off of it, 2-the person is extremely sensitive to the d2 side effects of antipsychotics (e.g. TD, EPS, or they have Parkinson's).
Why it's being given out is IMHO it's become the lazy doctor's panacea for any psychiatric problem. This is a product of our medical culture where doctors do not explain the real medical issues with the patient and simply hand them a pill.
For example, on the issue of problems falling asleep, the standard that we are supposed too follow it to find out what's going on with the patient's sleep. Are they having problems falling asleep and or staying asleep? How many hours do they sleep? etc. We are supposed to recommend good sleep hygiene first. From my own experience, most people who complain of sleep, well, it's due to their lifetsyle. One patient for example (and I am not kidding drank 28 cups of coffee a day and did not know why she could not sleep. I told her I would not give her any sleep medication, and she had to cut down on her coffee consumption. She was not happy with me ("Doctor, every other doctor gave me Seroquel, why don't you?)
Most doctors I've seen simply give out a sleep med without the above discussion. Why is IMHO a mixture of laziness and trying to get the patient out the door as quick as possible to make more money. In defense of some doctors, most patients don't want to learn about their problem. They just want a pill.
In any case, Seroquel has become the med I've seen doctors give to everyone. Anxiety disorder? Seroquel, Mood disorder? Seroquel, sleep disorder? Seroquel, psychotic disorder?, Seroquel.
It's gotten on the order of ridiculous. Add to the equation that drug reps are mucking it up quite a bit.
