Treatments for Narcolepsy
Lifestyle changes are sometimes all that is needed to maintain alertness for mild sufferers of narcolepsy. These can include taking three or more scheduled naps throughout the day and avoiding heavy meals and alcohol
There are three main drug treatments for narcolepsy. Modafinil (Provigil) and Armodafinil (Nuvigil) are used to treat excessive, uncontrollable, daytime sleepiness. Both of these drugs significantly improve the ability to stay awake, and reduce the number of involuntary sleep episodes. Both of these drugs have the added benefit that they do not affect the natural hormones important for normal sleep, do not cause anxiety or do not have a rebound affect. However, there are some potential side effects, including headaches, nausea, dizziness, skin reactions and potential psychiatric side effects (especially in those with a history of psychosis or depression).
Sodium oxybate (Xyrem) or gamma hydroxygutyrate (GHB) is useful for treating the daytime sleepiness as well as cataplexy. When used correctly, this drug is effective and safe. However, GHB can be used illegally and has been abused for “date-rape” use. Very serious side-effects, including seizures, coma, respiratory arrest or even death can occur when used incorrectly.
Other drugs, known as stimulants, can also be used to treat narcolepsy. These include methylphenidate (Ritalin) and Dextroamphetamine (Dexedrine) but can have serious side effects and should not be prescribed to people with heart disease, anxiety disorder or high blood pressure.
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Dauvilliers Y, Arnulf I, Mignot E. (2007). Narcolepsy with cataplexy. Lancet. 369(9560): 499-511.