Medications for Narcolepsy.
Medications for Narcolepsy.
Stimulants: Drugs which stimulate the central nervous system are the main treatment to help people with narcolepsy stay awake during the day. Modafinil (Provigil), a newer stimulant, is not as addictive and does not produce the highs and lows often associated with older stimulants.
Antidepressants: These suppress REM sleep, help alleviate the symptoms of cataplexy, hypnagogic hallucinations and sleep paralysis.
Sodium oxybate (Xyrem): This controls cataplexy in people with narcolepsy. Sodium oxybate helps to improve nighttime sleep, which is often poor in narcolepsy. In high doses it may also help control daytime sleepiness, even though you take it only at night.
Modafinil (Provigil, Cephalon) Modafinil is a new well tolerated and effective medication for narcolepsy patients. It promotes alertness, in the same way that traditional stimulants have done but without the negative side effects common to stimulant therapy. It also tends to have a longer lasting effect. In fact this new drug is first choice for all newly diagnosed narcolepsy patients or for those people who are bothered by negative side effects from the older medications. It can be prescribed alongside traditional stimulants if necessary.
Traditional stimulantsThese include methylphenidate and dextroamphetamine. Other amphetamines, amphetamine-analog agents, and sustained-release preparations are available. Many people experience negative effects with these stimulants. It also may aggravate sleepiness ( rebound hypersomnia) as the dose wears off. Also a tolerance may develop (tachyphylaxis) to the alerting effect in cases of repeated dosing. AmphetaminesWhile amphetamines are often used to treat narcolepsy and are generally very effective they do carry the following side effects of headache, gastrointestinal disturbance, anxiety, irritability, increased pulse, and increased blood pressure
Methylphenidate This is also generally effective but carries the same side effects as above. However they tend to be milder than in the case of amphetamines.
Pemoline (Cylert. Abbott) This is less effective in maintaining daytime alertness than methylphenidate, dextroamphetamine, or methamphetamine. Pemoline may also lead to hepatotoxicity. It is generally a second or third-line agent which if used must be accompanied by regular liver function checks due to its potential for hepatic failure. However its side effects are milder than those of amphetamines.
Mazindol This is considered a less effective stimulant. The usual initial dose is 1-2 mg once or twice daily with a maximal dose of 8 mg in divided doses. All higher doses are carefully monitored.
Before using any of the stated medications for Narcolepsy,seek medical consent.
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