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Narcolepsy - Treatment

Alternative Names

Daytime sleep disorder; Cataplexy

Treatment:

There is no known cure for narcolepsy. The goal of treatment is to control symptoms.

Lifestyle adjustments and learning to cope with the emotional and other effects of the disorder may help you function better in work and social activities. This involves:

  • Eating light or vegetarian meals during the day and avoiding heavy meals before important activities
  • Scheduling a brief nap (10 to 15 minutes) after meals, if possible
  • Planning naps to control daytime sleep and reduce the number of unplanned, sudden sleep attacks
  • Informing teachers and supervisors about the condition so you are not punished for being "lazy" at school or work

You may need to take prescription medications. The stimulant drug modafinil (Provigil) is the first choice of treatment for narcolepsy. It is much less likely to be abused than other stimulants. The medicine also helps you stay awake. Other stimulants include dextroamphetamine (Dexedrine, DextroStat) and methylphenidate (Ritalin).

Antidepressant medications can help reduce episodes of cataplexy, sleep paralysis, and hallucinations. Antidepressants include:

  • Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, paroxetine, sertraline, and venlafaxine
  • Tricyclic antidepressants such as protriptyline, clomipramine, imipramine, and desipramine

Sodium oxybate (Xyrem) is prescribed to certain patients for use at night.

If you have narcolepsy, you may have driving restrictions. Restrictions vary from state to state.

Expectations (prognosis):

Narcolepsy is a chronic, lifelong condition. It is not a deadly illness, but it may be dangerous if episodes occur during driving, operating machinery, or similar activities. Narcolepsy can usually be controlled with treatment. Treating other underlying sleep disorders can improve symptoms of narcolepsy.

Complications:

  • Injuries and accidents, if attacks occur during activities
  • Impairment of functioning at work
  • Impairment of social activities
  • Side effects of medications used to treat the disorder

Calling your health care provider:

Call your health care provider if:

  • You have symptoms of narcolepsy
  • Narcolepsy does not respond to treatment, or you develop other symptoms
  • Reviewed last on: 9/2/2009
  • Luc Jasmin, MD, PhD, Departments of Anatomy Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Dauvilliers Y, Arnulf I, Mignot E. Narcolepsy with cataplexy. Lancet. 2007;369(9560):499-511.

Morgenthaler TI, Kapur VK, Brown T, Swick TJ, Alessi C, Aurora RN, et al. Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. Sleep. 2007;30(12):1705-1711.

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