First-line options include Modafinil/Armodafinil (for excessive daytime sleepiness, EDS), Sodium Oxybate (for EDS and/with cataplexy), Pitolisant (for EDS and cataplexy) and Venlafaxine (for cataplexy (off-label) and co-morbid depression). FDA approved lower-sodium oxybate as a treatment for cataplexy or excessive daytime sleepiness in people 7 years and older with. Non-pharmacological approaches are important in the management of narcolepsy but will not be covered in this review.Įxpert opinion: Concise evaluation of symptoms and type of narcolepsy, coexisting co-morbidities and patients´ distinct needs is mandatory in order to identify a suitable, individual pharmacological treatment. Finally, this review considers potential future management strategies. The incidence of narcolepsy is 0.2-1/1000 individuals. In addition, treatment options for frequent coexisting co-morbidities and different phenotypes of narcolepsy are presented. Narcolepsy with/without cataplexy This is a medical condition associated with excessive daytime sleepiness, hypnagogic hallucinations, sleep paralysis, cataplexy and poor night time sleep. First- and second-line options are discussed as well as combination therapies.
It involves a neurologic defect in the regulation of sleep and wakefulness. Narcolepsy has a major impact on workableness and quality of life.Īreas covered: This review provides an overview of the temporal available treatment options for narcolepsy (type 1 and 2) in adults, including authorization status by regulatory agencies. Narcolepsy may affect as many as 250,000 Americans. Narcolepsy with cataplexy is most commonly caused by an immune-mediated process including genetic and environmental factors, resulting in the selective loss of hypocretin-producing neurons. Introduction: Narcolepsy is an orphan neurological disease and presents with sleep-wake, motoric, neuropsychiatric and metabolic symptoms.
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