Narcolepsy.
Narcolepsy is a neurological condition with a prevalence of up to 1 per 1,000 that is characterized by irresistible bouts of sleep. Associated features include the pathological manifestations of rapid-eye-movement (REM) sleep: cataplexy, sleep paralysis, hypnagogic hallucinations, and abnormal sleep-onset REM periods and disturbed nocturnal sleep. The condition is strongly associated with the HLA-DR2 and DQw1 phenotype. The phenomenology of narcolepsy is discussed, and diagnostic procedures are reviewed. Treatment modalities involving central nervous system stimulants for somnolence and tricyclic drugs for REM-sleep abnormalities are discussed. Sleep laboratory studies on the treatment efficacy of methylphenidate, pemoline, dextroamphetamine, protriptyline, and viloxazine are presented. Data suggest that: (1) methylphenidate and dextroamphetamine objectively improve somnolence; (2) pemoline, at doses up to 112.5 mg, is less effective in controlling somnolence but may improve certain aspects of performance; and (3) protriptyline and viloxazine are effective anticataplectic agents that produce little improvement in somnolence.
Mitler
M M
MM
Sleep Disorders Center, Scripps Clinic and Research Foundation, La Jolla, California 92037.
Hajdukovic
R
R
Erman
M
M
Koziol
J A
JA
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002940:Circadian Rhythm / Q000187:drug effects; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D010375:Pedigree; D012894:Sleep Stages / Q000187:drug effects
D000928:Antidepressive Agents; D000697:Central Nervous System Stimulants