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Narcolepsy pp 251–265Cite as

Overview of Management of Narcolepsy

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Abstract

Narcolepsy is a chronic sleep disorder that is characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis. Since these symptoms are often disabling, most patients need lifelong treatments. Non-pharmacological treatments (i.e., behavioral modification) are often helpful for the clinical management of narcoleptic patients. However, over 90% of diagnosed narcoleptic patients are reported to take medications to control their symptoms. Traditionally, the amphetamine-like CNS stimulants have been used for clinical management to improve EDS, and trycyclic antidepressants as anticataplectics, but the treatment has evolved recently with new and better-tolerated compounds such as modafinil (and its r-enantiomer, armodafinil) for EDS and adrenergic/serotonergic selective reuptake inhibitors as anticataplectics. Nighttime administration of a short-acting sedative, gamma-hydroxybutyrate (sodium oxybate in the USA) has also been used for the treatment for EDS and cataplexy. Since a large majority of human narcolepsy patients are hypocretin peptide-deficient, hypocretin replacement therapy may also be a new therapeutic option, but this is still not available for human patients. If hypocretin replacement is effective in hypocretin-deficient narcolepsy, cell transplantation and/or gene therapy may be developed in the near future. In this review, we first describe clinical symptoms of narcolepsy, and then the state-of-the-art knowledge about both pharmacological and non-pharmacological treatments of narcolepsy.

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Authors and Affiliations

  1. Sleep and Circadian Neurobiology Laboratory, Center for Narcolepsy, Stanford University School of Medicine, 1201 Welch Road, MSLS, P213, Palo Alto, CA, 94304, USA

    Seiji Nishino

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  1. Seiji Nishino
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  2. Nozomu Kotorii
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Correspondence to Seiji Nishino .

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Editors and Affiliations

  1. Narcolepsy Institute, Montefiore Medical Center, East 210 Street 111, Bronx, 10467, U.S.A.

    Meeta Goswami

  2. Dept. Pharmacology, Columbia University, West 168th St. 630, New York, 10032, U.S.A.

    S. R. Pandi-Perumal

  3. Sleep-Wake Disorders Center, Montefiore Hospital, East 210th Street 111, Bronx, 10467, U.S.A.

    Michael J. Thorpy

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Nishino, S., Kotorii, N. (2010). Overview of Management of Narcolepsy. In: Goswami, M., Pandi-Perumal, S., Thorpy, M. (eds) Narcolepsy. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0854-4_23

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