Medications That Could Be Contributing to Your Weight Gain

53. Atypical Antipsychotics for Insomnia (Off-Label Use): The Nighttime Hunger Switch

Certain atypical antipsychotics, such as quetiapine (Seroquel), are frequently prescribed off-label at low doses for chronic insomnia due to their sedating effects. While they aren't being used to treat psychosis, their side effect profile remains active. These drugs are potent histamine H1 receptor antagonists, and blocking these receptors is strongly linked to increased appetite and cravings, often manifesting intensely late at night when patients take the medication. This can lead to uncontrolled, high-calorie "sleep-eating" episodes and a slowed metabolism, causing rapid, significant weight gain. Patients are often unaware of the connection, assuming the weight gain is due to age or reduced activity. If you rely on these medications for sleep, discuss switching to a weight-neutral sleep aid or a lower-risk antihistamine with your provider.

54. Atypical Antipsychotics for Insomnia (Off-Label Use): The Nighttime Hunger Switch

Certain atypical antipsychotics, such as quetiapine (Seroquel), are frequently prescribed off-label at low doses for chronic insomnia due to their powerful sedating effects. While they aren't being used to treat psychosis, their side effect profile remains active. These drugs are potent histamine $\text{H}_1$ receptor antagonists, and blocking these receptors is strongly linked to significantly increased appetite and cravings, often manifesting intensely late at night when patients take the medication. This can lead to uncontrolled, high-calorie "sleep-eating" episodes and a slowed metabolism, causing rapid, significant weight gain. Patients are often unaware of the connection, assuming the weight gain is due to age or reduced activity. If you rely on these medications for sleep, discuss switching to a weight-neutral sleep aid, a lower-risk antihistamine, or exploring cognitive behavioral therapy for insomnia (CBT-I) with your provider.