There are several treatments for narcolepsy. The severity of symptoms, as well as medical history, will dictate which therapy options are best for the narcolepsy patient.
Narcolepsy can be described as a neurological condition involving a person’s reduced ability to manage the sleep-wake cycle.
Although people suffering from narcolepsy can’t be cured, they can be helped. Treatment for this disorder is tailored to each individual and is based on the person’s symptoms and therapeutic response. It could well take months, or even longer, to achieve effective control of symptoms. It’s extremely difficult to fully control the symptoms of narcolepsy, and medication adjustments are often necessary. Lifestyle changes are also very important for people suffering from narcolepsy, with oral medications being the mainstay of treatment.
Central nervous system stimulants are the main treatments used for excessive daytime sleepiness in narcolepsy, and these stimulants include Amphetamine, Methylphenidate, Modafinil, Dextroamphetamine and Armodafinil. (It should be noted that the FDA issued an alert in 2007 for Modafinil, citing severe adverse skin reactions). Another drug used to treat narcolepsy is Atomoxetine, an NRI (Norepinephrine Reuptake Inhibitor) and non-stimulant, which has no recreational effects or addiction liability.
Sodium Oxybate, or SGH (Sodium Gamma Hydroxybutyrate) is another approved treatment option for narcolepsy. This treatment can be used for excessive daytime sleepiness and cataplexy associated with narcolepsy. Specific serotonin reuptake inhibitors and tricyclic antidepressants are often used to treat narcolepsy, and these include Imipramine, Clomipramine, or Protriptyline, in addition to other drugs that suppress REM sleep. An antidepressant known to block the reuptake of norepinephrine and serotonin, known as Venlafaxine, has also shown some usefulness in managing the symptoms of cataplexy; however, sleep disruption is just one of its notable side-effects.
A new medication, Pitolisant, has gained approval in some countries and offers a unique approach to treating narcolepsy.
Napping Can Help!
In certain cases of narcolepsy, regular planned short naps can reduce the requirement for pharmacological treatments, but this will only improve symptoms in the short term. Interesting fact: A nap for 120 minutes provided patient alertness for three hours, while a 15-minute nap offered no benefit at all. Having a daytime nap is not meant to be a replacement for night-time sleep. For optimal management of a patient with narcolepsy it’s vitally important that there be ongoing communication between the healthcare provider, the patient, and the patient’s family members.
It’s estimated that, in the United States alone, this condition afflicts up to 200,000 Americans, but less than 50,000 are diagnosed. In fact, narcolepsy is as prevalent as Multiple Sclerosis and Parkinson’s disease, and more common than Cystic Fibrosis, but unfortunately it’s just not as well known. The reason for this is that narcolepsy can often be confused with epilepsy, depression, or the side-effect of medications. It’s also been mistaken for laziness, recreational drug use, and poor sleeping habits.
The symptoms of narcolepsy are generally first noticed in young adults or teenagers, but narcolepsy can occur in both women and men at any age. In fact, there’s strong evidence that narcolepsy could run in families, because approximately 10% of people diagnosed with narcolepsy with cataplexy already have a close family member with this neurological disorder. As mentioned previously, narcolepsy can be confused with depression, and it’s true that there is a link between these two disorders. The co-occurrence of depression in narcolepsy patients has produced mixed results, though, with different studies producing numbers anywhere between 6% and 50%.
© 2020 American Sleep Association.