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Narcolepsy Treatment


Several treatments are available for the sleep disorder narcolepsy, one of the most puzzling sleep disorders. These treat the symptoms, not the underlying cause of narcolepsy. The drowsiness is normally treated using stimulants such as methylphenidate, amphetamines, dextroamphetamine, methamphetamine, modafinil, etc. Other medications used are codeine and selegiline. Another drug that is used is atomoxetine (Strattera), a non-stimulant and Norepinephrine uptake inhibitor (NRI), that has little or no abuse potential.

In many cases, planned regular short naps can reduce the need for pharmacological treatment of the EDS to a low or non-existent level.

Cataplexy is frequently treated with tricyclic antidepressants such as clomipramine, imipramine, or protriptyline. Venlafaxine, a newer antidepressant which blocks the reuptake of serotonin and norepinephrine, has shown usefulness in managing symptoms of cataplexy. Gamma-hydroxybutyrate (GHB), a medication recently approved by the US Food and Drug Administration, is the only medication specifically indicated for cataplexy. Gamma-hydroxybutyrate has also been shown to reduce symptoms of EDS associated with narcolepsy. While the exact mechanism of action is unknown, GHB is thought to improve the quality of nocturnal sleep.

However all drugs have side effects and adverse reactions.  Make sure you know what they are before you even think about taking any of these drugs. Any drug that has not been on the market for five years should be  given a lot of thought before taking.

Treatment is tailored to the individual based on symptoms and therapeutic response. The time required to achieve optimal control of symptoms is highly variable, and may take several months or longer. Medication adjustments are also frequently necessary, and complete control of symptoms is seldom possible. While oral medications are the mainstay of narcolepsy treatment, lifestyle changes are also important. The main treatment of excessive daytime sleepiness in narcolepsy is with a group of drugs called central nervous system stimulants. For cataplexy and other REM-sleep symptoms, antidepressant medications and other drugs that suppress REM sleep are prescribed.

In addition to drug therapy, an important part of treatment is scheduling short naps (10 to 15 minutes) two to three times per day to help control excessive daytime sleepiness and help the person stay as alert as possible. Daytime naps are not a replacement for nighttime sleep.

Ongoing communication between the doctor, patient, and the patient's family members is important for optimal management of narcolepsy. With proper narcolepsy treatment the sleep disorder patient should show improvement and live a fairly normal life.

 

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