Disorders narcolepsy

The sleep disorder narcolepsy, which affects around 1 in every 2000 people, is characterized by a tetrad of symptoms excessive daytime sleepiness, cataplexy (loss of muscle tone triggered by emotional arousal), hypnagogic hallucinations,... 

Seizure Disorders. Narcolepsy is not a form of epilepsy. Although the sleep attacks and cataplexy resemble certain forms of seizures, narcolepsy can easily be distinguished from epilepsy. In particular, those with narcolepsy remain aware of their surroundings during an attack of cataplexy, whereas the epilepsy patient has no recall of events associated with a seizure. Furthermore, the EEC recording during a sleep study typically distinguishes narcolepsy from seizures. 

Although most of this chapter has focused on prescription sleep aids, there are a few prescription medications available to help you stay awake. The most commonly used OTC stimulant is caffeine. However, people with the sleep disorder narcolepsy are very sleepy during the day (no matter how much sleep they get) and often require prescription stimulants to alleviate their sleepiness. Stimulants are also prescribed for the treatment of attention deficit/hyperactivity disorder (ADHD, sometimes called ADD), asthma, and obesity. 

In June 2001, a government advisory panel convened by the FDA concluded that GHB could be useful as a treatment for cataplexy, a rare but dangerous complication of the sleep disorder narcolepsy. This panel was asked to consider whether prescription sales should be permitted for GHB under the brand name Xyrem . The committee concluded that the manufacturer of the drug (Orphan Medical) had shown that Xyrem is useful in treating cataplexy, a complication that can cause people to collapse suddenly when their muscles lose strength. 

Indications Attention deficit disorder, narcolepsy Category Amphetamine Half-life 2 4 hours... 

Amphetamine (3) is orally active and, through an indirect mechanism, causes a general activation of the adrenergic nervous system. Unlike (l)and (2), amphetamine readily crosses the blood-brain barrier to activate a number of adrenergic pathways in the central nervous system (CNS). Amphetamine s CNS activity is the basis of its clinical utility in treating attention-deficit disorder, narcolepsy, and use as an anorexiant. These therapeutic areas are treated elsewhere in this volume. 

Methylphenidate (Ritalin) Mild CNS stimulant. Actions similar to d-amphetamine. Attention deficit disorder. Narcolepsy. n H... 

Describe the mechanisms of the sleep disorders covered in this chapter, including insomnia, narcolepsy, restless-legs syndrome, obstructive sleep apnea, and parasomnias. 

Treatment of excessive daytime sleepiness in narcolepsy and other sleep disorders may require the use of sustained- and immediate-release stimulants to effectively promote wakefulness throughout the day and at key times that require alertness. 

Brown, R. E. (2003). Involvement of hypocretins/orexins in sleep disorders and narcolepsy. Drug News Perspect. 16, 75-9. 

Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and cataplexy, may be caused by the lack of hypocretin mRNA and peptides in humans (Peyron et al., 2000) or a disruption of the hypocretin receptor 2 or its ligand in dogs and mice (Lin et al., 1999 Chemelli et al., 1999). Hypocretin-containing neurons are located exclusively in the dorsomedial, lateral, and perifornical hypothalamic areas (Peyron et al., 1998). Two hypocretin sequences, Hcrt-1 (orexin-A) and Hcrt-2 (orexin-B), are generated from a single preprohypocretin (De Lecea et al., 1998 Peyron et al, 1998 Sakurai et al, 1998). Axons from these neurons are found in the hypothalamus, locus coeruleus (LC), raphe nuclei, tuberomamillary nucleus, midline thalamus, all levels of spinal cord, sympathetic and parasympathetic centers, and many other brain regions... 

Parkinsonism with excessive daytime sleepiness - a narcolepsy like disorder ... 

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