Narcolepsy, management

Dauvilliers, Y., Carlander, B., Rivier, F., Touchon, J. 8r Tafti, M. (2004). Successful management of cataplexy with intravenous immunoglobulins at narcolepsy onset. Ann. Neurol. 56, 905-8. 

As of 2001, the U.S. Food and Drug Administration (FDA) approved the use of stimulants for treating atten-tion-deficit/hyperactivity disorder (ADHD), narcolepsy, and Parkinson s disease. These drugs are also used in combination with other medications to manage pain, and to treat depression and other psychiatric disorders. 

In 2001, Orphan Medical filed a new drug application with the FDA for a drug called Xyrem (sodium oxy-bate, oral solution), which uses GHB as the active ingredient. In clinical trials, Xyrem has been shown to reduce cataplexy and restore normal sleep patterns. If approved, Xyrem would be the only treatment approved by the FDA as effective in managing cataplexy in people with narcolepsy. 

Methylphenidate is marketed in the United States under the prescription names Concerta, Metadate, Methylin, and Ritalin (26). It is available in immediate and sustained-release formulations for the treatment of attention deficit/hyperactivity disorder (ADHD) and the symptomatic management of narcolepsy (a disorder characterized by excessive daytime sleepiness). 

McClellan KJ, Spencer CM. Modafinil a review of its pharmacology and clinical efficacy in the management of narcolepsy. CNS Drugs 1998 9(4) 311-324. 

Because tricyclic antidepressants suppress REM sleep, they have been used in the management of narcolepsy and cataplexy when amphetamines fail or abuse potential is high. Clomipramine is the most effective, possibly because it has more pronounced actions on serotonergic mechanisms (61). 

Doses of medications used to treat narcolepsy are summarized in Table 71-5. Pharmacologic management of narcolepsy is focused on two primary areas treatment of excessive daytime sleepiness (EDS) and treatment of cataplexy. 

There is a good appetite (again, 2C-B like), and I managed to sleep for a few hours, and all the next day I was spacey and probably still a plus one. The day yet following, I was finally at a believable baseline. Both of these days were filled with what might be called micro doze-offs, almost like narcolepsy. Maybe I am just sleep deprived. 

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