Narcolepsy is a long-term neurological disorder that involves a decreased ability to regulate sleep–wake cycles. Modafinil, sodium oxybate, Wakix, methylphenidate, amphetamine, stimulants, antidepressant Medication, Regular short naps, sleep hygiene Sleep apnea, major depressive disorder, anemia, heart failure, drinking alcohol, idiopathic hypersomnia, not getting enough sleep
Our objective was to reinforce the use of those drugs evaluated in randomized placebo-controlled trials and to reach a consensus, as much as possible, on the use of other available medications.Excessive daytime sleepiness, involuntary sleep episodes, sudden loss of muscle strength, hallucinations īased on the symptoms and sleep studies Others, in particular the more recently developed substances, such as modafinil or sodium oxybate, are evaluated in large randomized placebo-controlled trials. Several treatments are used on an empirical basis, specially antidepressants for cataplexy, due to the fact that these medications are already used widely in depressed patients, leaving little motivation from the manufacturers to investigate efficacy in relatively rare indications. However the quality of the published clinical evidences supporting them varies widely and studies comparing the efficacy of different substances are lacking. The treatments used for narcolepsy, either pharmacological or behavioral, are diverse. As for disturbed nocturnal sleep the best option is still hypnotics until sodium oxybate is registered for narcolepsy. Second-line treatments are antidepressants, either tricyclics or newer antidepressants, the later being increasingly used these past years despite few or no randomized placebo-controlled clinical trials.
#CATAPLEXY MEDICATION REGISTRATION#
Since its recent registration cataplexy sodium oxybate has now become the first-line treatment of cataplexy. Given the availability of modafinil and methylphenidate, and the forseen registration of sodium oxybate for narcolepsy (including excessive daytime sleepiness, cataplexy, disturbed nocturnal sleep) in Europe, the place of other compounds will become fairly limited. However, based on several large randomized controlled trials showing the activity of sodium oxybate, not only on cataplexy but also on excessive daytime sleepiness and irresistible episodes of sleep, there is a growing practice in the USA to use it for the later indications. Modafinil is the first-line pharmacological treatment of excessive daytime sleepiness and irresistible episodes of sleep in association with behavioral measures. Recommendations concerning the treatment of each single symptom of narcolepsy as well as general recommendations were made. All trials were analyzed according to their class evidence.
This task force conducted an extensive review of pharmacological and behavioral trials available in the literature. A task force composed of the leading specialists of narcolepsy in Europe has been appointed. However contemporary guidelines are necessary given the growing use of modafinil to treat excessive daytime sleepiness in Europe within the last 5-10 years, and the decreasing need for amphetamines and amphetamine-like stimulants the extensive use of new antidepressants in the treatment of cataplexy, apart from consistent randomized placebo-controlled clinical trials and the present re-emergence of gamma-hydroxybutyrate under the name sodium oxybate, as a treatment of all major symptoms of narcolepsy. Guidelines on the management of narcolepsy have already been published. In addition, behavioral measures can be of notable value. Management of narcolepsy with or without cataplexy relies on several classes of drugs, namely stimulants for excessive daytime sleepiness and irresistible episodes of sleep, antidepressants for cataplexy and hypnosedative drugs for disturbed nocturnal sleep.
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