However, there is potential for abuse and possibly dependence. (4) Sodium oxybate improves both excessive daytime sleepiness and cataplexy. Life effects of narcolepsy in 180 patients from North America, Asia and Europe compared to matched controls. Broughton R, Ghanem Q, Hishikawa Y, et al. In both studies, pitolisant demonstrated a statistically significant improvement in the Epworth Sleepiness Scale (EDS) score. double-blind, placebo-controlled studies in patients (n261) with narcolepsy with or without cataplexy. Modafinil and armodafinil improve excessive daytime sleepiness symptoms and have little abuse potential, but have no effect on cataplexy, so other drugs, such as antidepressants, are required to control cataplexy attacks. The clinical features of cataplexy: a questionnaire study in narcolepsy patients with and without hypocretin-1 deficiency. Treatment of narcolepsy has both nonpharmacologic and pharmacologic components. (3) To date, there is clear evidence of the efficacy of modafinil, armodafinil and sodium oxybate in patients with narcolepsy. (2) Although the sympathomimetic stimulants, such as amphetamines or methylphenidate, are effective in improving excessive daytime sleepiness in patients with narcolepsy, they have the potential for dependence, have sometimes disabling sympathomimetic side-effects and are associated with tolerance.
Currently there is no cure for narcolepsy, so treatment focuses on control of symptoms.
It is extremely incapacitating, and frequently results in impaired psychosocial functioning and reduced work performance. 2006) for more details.(1) Narcolepsy is a rare disorder of unknown aetiology characterized by excessive daytime sleepiness and typically associated with cataplexy. See Narcolepsy: NHS Choices and the EFNS guidelines on management of narcolepsy (Billiard et al. Many of these medicines are not licensed for the treatment of narcolepsy and they vary in the evidence available for their effectiveness in treating narcolepsy. These include stimulants such as modafinil, dexamfetamine or methylphenidate sodium oxybate or antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin–noradrenaline reuptake inhibitors (SNRIs) or tricyclic antidepressants. Pitolisant has been shown to be as effective in treating daytime sleepiness 32, 33 as modafinil, and it is also efficacious in decreasing cataplexy. Several medicines are used to treat the symptoms of narcolepsy. Accessing counselling and support may also be important for people to come to terms with the sleep disorder and its implications. Managing narcolepsy involves implementing good sleep hygiene, which may include taking brief planned naps and sticking to a strict bedtime routine. Sleep paralysis: a temporary inability to move or speak when waking up or falling asleepĮxcessive dreaming: dreams often come when falling asleep (hypnogogic hallucinations) or just before or during waking (hypnopompic hallucinations)ĭisturbed nocturnal sleep: frequent waking in the night. strategies in narcolepsy.15 We proposed a decision tree for adapting the therapy for sleepiness and Dose adjustment, switching to another drug, and cataplexy (Figure 1). Sleep attacks: falling asleep suddenly and without warningĬataplexy: temporary loss of muscle control resulting in weakness and possible collapse, often in response to emotions such as laughter and anger Several recent with narcolepsy however, this drug has been reviews provide recommended management withdrawn from the market, for the moment. As the symptoms and lab findings of Na-2 can be nonspecific, one must thoroughly search. Excessive daytime sleepiness: feeling very sleepy throughout the day, and having difficulty concentrating and staying awake Ruling out other sleep disorders is a major aspect of diagnosing Na-2.
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