Narcolepsy

behavioral modification and Methylphenidate hydrochloride,10 mg ., and time-release methylphenidatehydrochloride, 18 mg

Treatment Summary: Because of the diverse symptoms that can affect patients with narcolepsy, the treatment of this sleep disorder can be complex. Patient education should emphasize the importance of optimal sleep hygiene, including a consistent sleep-wake schedule to facilitate adequate sleep. In addition to behavioral interventions, a stimulant is typically used. Modafinil, 200 to 400 mg/day, is a treatment approved by the FDA for excessive daytime sleepiness associated with narcolepsy. Sodium oxybate received FDA approval in 2002 for its use in the treatment of cataplexy . This novel hypnotic agent has an unknown mechanism of action but is believed to act through the mechanism of aminobutyric acid (GABA). The main clinical finding is a pronounced increase in slow-wave sleep. Thus, GABA appears to consolidate sleep and is associated with a reduction in cataplectic episodes. To reduce the chance of injuries resulting from the rapid onset of sleepiness, this liquid medication is taken after the patient has gotten into bed at night.

• Reference: Caputo, F., & Zoli, G.; Treatment of narcolepsy with cataplexy. The Lancet, 1080-1081. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60522-4/fulltext
• Submitter: Tonja Dulin