Between 2005 and 2012, the sedating properties of certain atypical antipsychotics have led to a 300% increase in their off-label use for insomnia. Guidelines report a lack of evidence of benefit for atypical antipsychotics as first-line therapy and warn against their possible adverse effects, including weight gain and metabolic disorders. While antipsychotics may be appropriate in some patients with insomnia who have not benefited from other treatments, the use of these medications as first-line therapy for insomnia is discouraged due to the lack of evidence of benefit and potential for harmful adverse effects.
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