Narcolepsy
Description
An in-depth report on the causes, diagnosis, and treatment of narcolepsy.
Highlights
Is Narcolepsy Hereditary?
People whose close relatives have narcolepsy are more likely to have the sleep disorder themselves. The risk is highest for first-degree relatives (parents or siblings). According to a 2005 study in the
Journal of Sleep Research
, narcolepsy is 105 times higher among male first-degree relatives, and 54 times higher among female first-degree relatives, than the general population.
Narcolepsy in Children
Although narcolepsy typically begins in adolescence or young adulthood, it can occur at any age. Even young children can have narcolepsy. According to a small study in
Pediatric Neurology
, children who have headaches are more likely to have narcolepsy than their healthy peers. The researchers recommended that pediatricians ask patients with headaches whether they have experienced daytime sleepiness, narcolepsy, or insomnia.
Drug Treatments for Daytime Sleepiness
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Modafinil (Provigil) is the only drug approved to treat the daytime sleepiness associated with narcolepsy.
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At the time this report was written, the FDA was considering approving a similar drug, armodafinil (NuVigil). A 2006 study published in
Current Medical Research and Opinion
suggested that armodafinil helps improve wakefulness, memory, attention, and fatigue in patients with narcolepsy.
Drug Treatments for Cataplexy
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Sodium oxybate (Xyrem) is the only approved treatment for narcolepsy-associated cataplexy. (Cataplexy is the sudden muscle weakness that often accompanies narcolepsy; it is usually provoked by intense emotions.) Recent studies report that Xyrem is very helpful for treating this condition.
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Antidepressant drugs such as tricyclics, selective serotonin reuptake inhibitors (SSRIs), and selective serotonin and norepinephrine reuptake inhibitors (SSNRIs) are also prescribed for cataplexy. However, a 2006 review in the
Cochrane Database
found there was little medical evidence to support their use. The researchers called for more clinical trials to determine how well antidepressants work for narcolepsy treatment, and which types of antidepressants work the best.
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Review Date: 7/13/2006
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Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital
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