CENTCOM defends unapproved-use of Seroquel as a sleep aid

A November 2006 Pentagon policy memo precludes troops from deployment to combat if they have prescriptions for drugs to control chronic insomnia.

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Although the Food and Drug Administration has not approved use of the antipsychotic drug Seroquel as a sleep aid, the top surgeon at U.S. Central Command deemed 25-milligram doses of the drug for sleep "an appropriate use . . . that did not place the service member or others at increased risk."

A November 2006 Pentagon policy memo precludes troops from deployment to combat if they have prescriptions for drugs to control chronic insomnia. But a Nextgov investigation revealed that CENTCOM allows troops to deploy with a 180-day supply of Seroquel in 25-milligram doses.

Read the entire Broken Warriors series. CENTCOM said in an e-mailed statement that its policy prohibits the deployment of troops with psychotic and bipolar disorders, noting that doses of the drug to treat such conditions -- 300 to 800 milligrams a day -- are "many times the dose used for sleep." Low-dose usage of the drug for sleep is in compliance with the policy, according to its statement.

The CENTCOM command surgeon has waiver authority to approve deployment of troops prescribed a range of drugs, the statement said, noting there is a "lack of an absolute prohibition" against the use of low-dose Seroquel as a sleep aid.

The command "does not direct how [medical] providers practice medicine, but does enforce policy to ensure individuals are not placed at undue risk in the deployed environment. It is up to the individual provider and patient to determine what is best for them -- low-dose Seroquel is one of many viable options," the statement said.

Dr. Grace Jackson, a former Navy psychiatrist who said she resigned her commission in 2002 because she did not want to be a "pill pusher," said CENTCOM's policy fails to address several key considerations in the use of Seroquel in a combat environment, namely the short-term and long-term risks of using it as a sedative.

Jackson, who now has a civilian practice in Greensboro, N.C., questioned who would monitor whether troops took the prescribe dosage of Seroquel and determine the appropriate duration of the drug therapy.

She pointed out that in November 2009, the Massachusetts Health and Human Services Department warned clinicians in a letter that "The use of low-dose quetiapine [the generic name for Seroquel] for sleep carries the potential risk of diabetes, [high blood cholesterol], weight gain and tardive dyskinesia."

The letter also said, "Law enforcement reports indicate that quetiapine

has become a drug of abuse that is often diverted and misused by the public."

Officials at the Drug Use Research and Management Program of the College of Pharmacy in Salem, Ore., echoed this warning when they noted in a June 2010 evaluation of Seroquel that the drug, known as "baby heroin," has been abused by prison inmates and patients with a history of substance abuse.

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