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Recently, after morning rounds seeing patients admitted to his hospital through emergency, Dr. David Juurlink tweeted: “Can the next doctor wanting to prescribe Seroquel for sleep,” he said, “just not?”

Of the roughly 20 patients he saw that morning, four had been prescribed Seroquel, an antipsychotic, for insomnia.

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Seroquel and its generics aren’t approved as sleeping pills. Quetiapine, the active ingredient, has been officially approved in Canada for schizophrenia, bipolar disorder and major depression only. Yet 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.

Quetiapine is sedating. Like over-the-counter sleep aids, it makes people drowsy. But it also comes with a multitude of potential side effects, experts say, including an odd sensation of tension and restlessness (akathisia), Parkinson’s-like tremors and movement abnormalities, weight-gain, high blood sugar, new or worsening diabetes and, in rare cases, heart arrhythmia that can cause sudden cardiac death. A recent Health Canada review linked quetiapine and other so-called “atypical” antipsychotics to an increased risk of sleep apnea —breaks in breathing during sleep.

Juurlink, a clinical toxicologist at Sunnybrook Health Sciences Centre in Toronto, said quetiapine could also cause a particularly nasty complication known as neuroleptic malignant syndrome, a rare but potentially life-threatening reaction to antipsychotics or major tranquilizers. “Over the last decade, I have seen several patients who have had quetiapine as part of, or one of the contributing causes to NMS,” said Juurlink, whose frustrated tweet to doctors last week was a repeat of one he has sent before.