How is narcolepsy treated?
Treatment objectives for narcolepsy should include control of sleepiness and other sleep-related symptoms such as cataplexy.
Nonpharmacological options include maintaining an appropriate sleep–wake schedule that promotes developmentally appropriate amounts of nighttime sleep and scheduled daytime naps.
Scheduled 15- to 20-minute naps in conjunction with medical therapy can be beneficial in controlling the degree of daytime sleepiness.
Modafinil is an effective pharmacologic treatment of daytime sleepiness in adults. Alternately, stimulant medications (e.g., methylphenidate, dextroamphetamine) are effective and are the standard therapy for children with narcolepsy.
Sodium oxybate (a derivative of gamma-hydroxybutyrate) is effective for the treatment of daytime sleepiness, cataplexy, and disrupted sleep due to narcolepsy.
It is administered at night at sleep onset and again midway through the sleep period.
Alternately, cataplexy and sleep paralysis are often treated successfully with either tricyclic antidepressants (e.g., imipramine, protriptyline) or selective serotonin reuptake inhibitors (e.g., venlafaxine).
