Good question! :D
The use of antipsychotics for off label uses (especially second generation/atypical antipsychotics) has exploded in the last decade.
This trend has been increasing due to the fact that many of the atypical antipsychotics like quetiapine (Seroquel), risperidone (Riaperidal), olanzapine (Zyprexa) and so on are also powerful centrally acting antihistamines. Meaning that at low doses (below 'antipsychotic dosages) these medications cause quite marked sedation. Because of these sedative effects and the perceived safety of low dose antipsychotics, they've become quite popular for use as an off label hypnotic. This is further supported by the fact that in the short term, they cause less overdose, dependence and loss of efficacy than traditional sleeping tablets like benzodiazepines and z-drugs.
Are they a good option? Ask a million doctors and you'll get a very mixed bag of answers.
I personally don't think they're a suitable choice of medication when insomnia is the primary of sole symptom being treated, due to the potential long term side effects such as metabolic syndromes (weight gain and Diabetes Miletus) and movement disorders (EPS, Tardive Dyskinesia, dystonia etc).
Personally, I certainly won't be prescribing them to my patients for insomnia alone. But as long as the doctor and the patient are making an informed decision about the long and short term risks and benefits... they may be a suitable option for certain patients.
Hope this helps.
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