Narcolepsy: treatment issues.
Pharmacologic management of patients with narcolepsy is usually based on treating the separate symptoms of cataplexy and excessive daytime sleepiness (EDS). For treating cataplexy, the most widely used medications include the antidepressants venlafaxine, imipramine, and protriptyline, usually at lower doses than prescribed with depression, and sodium oxybate. Monoamine oxidase inhibitors are also sometimes used, but much less frequently. The U.S. Food and Drug Administration has approved 4 medications for EDS: dextroamphetamine, methylphenidate, modafinil, and sodium oxybate. Sodium oxybate is the only drug approved for treating both cataplexy and EDS. Modafinil and sodium oxybate have similar, long-term efficacies in treating EDS at prescribed doses.
Roth
Thomas
T
Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI 48202, USA. Troth1@hfhs.org
D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D001559:Benzhydryl Compounds / Q000009:adverse effects / Q000627:therapeutic use; D002385:Cataplexy / Q000175:diagnosis / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use; D002940:Circadian Rhythm / Q000187:drug effects; D003131:Combined Modality Therapy; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D017277:Drug Approval; D006266:Health Education; D006801:Humans; D008134:Long-Term Care; D000077408:Modafinil; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D009290:Narcolepsy / Q000175:diagnosis / Q000188:drug therapy*; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D012978:Sodium Oxybate / Q000009:adverse effects / Q000627:therapeutic use
D000928:Antidepressive Agents; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D008996:Monoamine Oxidase Inhibitors; D011619:Psychotropic Drugs; D012978:Sodium Oxybate; D000077408:Modafinil