Treatments Of Narcolepsy:
Narcolepsy cannot yet be cured, but some of the symptoms can be treated with medicines and lifestyle changes. When cataplexy is present, the loss of hypocretin is believed to be irreversible and life-long. But EDS and cataplexy can be controlled in most individuals with drug treatment. Modafinil and sodium oxybate are two drugs that have been approved by the U.S. Food and Drug Administration for the treatment of narcolepsy.
Doctors prescribe central nervous system alerting agents such as modafinil and amphetamine-like stimulants such as methylphenidate to alleviate EDS and reduce the incidence of sleep attacks. For most people these medications are generally quite effective at reducing daytime drowsiness and improving levels of alertness. However, use of these medications may be associated with several undesirable side effects and must be carefully monitored. Common side effects include irritability and nervousness, shakiness, disturbances in heart rhythm, stomach upset, nighttime sleep disruption, and anorexia. Individuals may also develop tolerance with long-term use, leading to the need for increased dosages to maintain effectiveness. In addition, doctors should be careful when prescribing these drugs and people should be careful using them because the potential for abuse is high with any amphetamine.
Two classes of antidepressant drugs have proved effective in controlling cataplexy in many individuals: tricyclics (including imipramine, desipramine, clomipramine, and protriptyline) and selective serotonin and noradrenergic reuptake inhibitors (including venlafaxine, fluoxetine and atomoxetine). In general, antidepressants produce fewer adverse effects than do amphetamines. But troublesome side effects still occur in some individuals, including impotence, high blood pressure, and heart rhythm irregularities.
In addition to central nervous system alerting agents and antidepressants, sodium oxybate or gamma hydroxybutyrate, also known as GHB or Xyrem®, can be used to treat narcolepsy. Sodium oxybate is a strong sedative that must be taken during the night. Sodium oxybate induces sleep and reduces the symptoms of daytime sleepiness and cataplexy. Due to safety concerns associated with the use of this drug, the distribution of sodium oxybate is tightly restricted.