How do you approach the use of antipsychotics, such as Seroquel/Zyprexa, for insomnia in patients unresponsive to standard treatments?  

I still avoid sedating antipsychotics, including quetiapine, unless there is a compelling comorbid indication. I prefer advancing to eszopiclone, higher dose pregabalin, and/or an orexin antagonist at the higher end of the dose range, given that the lower doses were not as dramatically effective ove...