ArticleCMAJ open2018
The lesser of two evils: a qualitative study of quetiapine prescribing by family physicians.
Article in CMAJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Antipsychotic off-label use in the 21st century: An enduring public health concern.Dialogues in clinical neuroscience · 2025Review
- Complex mental health difficulties in primary care: a scoping review with thematic synthesis.BJGP open · 2025Article
- Patterns and indications for quetiapine prescribing in Dutch primary care: a retrospective database study.BJGP open · 2025Article
- Twenty-five year trend in antipsychotic medication prescribing in England: challenges and opportunities.BJPsych open · 2025Article
- Medical Professionals and Pharmacological Intervention for the Treatment of Insomnia: A Cross-Sectional Study.Sleep science (Sao Paulo, Brazil) · 2025Article
- Medical practitioners' experiences and considerations when managing sleep medication for adolescents and young adults.Scandinavian journal of primary health care · 2025Article
- An investigation of psychoactive polypharmacy and related gender-differences in older adults with dementia: a retrospective cohort study.BMC geriatrics · 2023Article
- Adverse events with quetiapine and clarithromycin coprescription: A population-based retrospective cohort study.Health science reports · 2023Article
- Inappropriate quetiapine use at a large academic medical center: frequency of misuse and associated costs of adverse effects.Therapeutic advances in drug safety · 2023Article
- Who prescribes quetiapine in Denmark?British journal of clinical pharmacology · 2022Article
- Characteristics and predictors of off-label use of antipsychotics in general population sample.Acta psychiatrica Scandinavica · 2022Article
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Authors and funding
3 authors.
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Abstract
backgroundQuetiapine is an antipsychotic that is widely prescribed off-label by family physicians despite evidence that safer alternatives exist. The aim of this research was to explore, in-depth, family physicians' reasons for this behaviour.
methodsWe conducted qualitative interviews with 15 urban family physicians in Alberta between October 2015 and April 2016. Participants were purposively selected based on sex, years of experience and practice type. Interviews explored participants' experiences prescribing quetiapine. Interviews were recorded, transcribed verbatim and coded with the use of thematic analysis.
resultsA wish to support day-to-day function of patients with complex psychosocial needs without causing benzodiazepine addiction motivated participants to prescribe quetiapine. The indications were varied and included incomplete symptom resolution, unclear or multiple mental health diagnoses, and complicated psychosocial problems. Family physicians benchmarked their prescribing against peers and were reluctant to stop medication started by colleagues. Limited knowledge of quetiapine's adverse effects led prescribers to choose low dosages.
interpretationQuetiapine helped family physicians treat patients with complex mental health problems without prescribing benzodiazepines, but awareness of quetiapine's adverse effects was poor. Education about quetiapine should combine psychopharmacology with multidisciplinary educational initiatives that focus on symptom resolution, comorbidity and nondrug options to promote more appropriate prescribing.
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