Narcolepsy treatments – Part 1

Although there is no cure for narcolepsy, a sleep disorder that can cause sudden attacks of daytime sleepiness to cataplexy (a symptom of abnormal rapid-eye movement sleep involving sudden muscle weakness), treatment options as well as changes in lifestyle can help a patients condition greatly. Current treatment options available, however, only deal with the symptoms of narcolepsy and narcolepsy/cataplexy, and do not address the core problem as to the cause of narcolepsy, which is still under investigation when narcolepsy occurs without additional disorders. However, scientists believe that they have found

the cause of narcolepsy and cataplexy in conjunction, and that is undetectable levels of hypocretin 1 and 2 peptides (although measured in the cerebrospinal fluid via a spinal tap, hypocretin cells are located in the hypothalami of the brain). The fact that our knowledge with regard to the core cause of narcolepsy and cataplexy and the undetectable hypocretin, and the fact that scientists did not make this discovery this until 2000 along with the minimal amount of information we have as to how to address this issue in patients and whether hypocretin replacement therapy could be possible or even beneficial, makes a cure for narcolepsy and

cataplexy a remote possibility for a very distant future.

The symptoms of narcolepsy, however, can be addressed and can be treated with different classes of medications. For sleepiness, the narcoleptic symptoms are treated with amphetamine-like stimulants. The current stimulants used in treatment for sleepiness are:

Medication (Brand) / Recommended Prescription Strength / [Notes]

Modafinil (Provigil) /100-400mg / [Newest Medication - may be used in conjunction with another due to low potency.]

Methylphenidate HCI (Ritalin) / 10-60mg / [Short duration, also available in extended release tablets.]

Dextrophetamine-Sulfate (Dexedrine) / 5-60 mg / [Used in the United States - variable duration.]

Methamphetamine-HCI (Desoxyn) / 5-60 mg / [Used in the United States - better brain

distribution of the drug in comparison to the periphery and more effective than amphetamine.]

Pemoline (Cylert) / 20-115mg / [*Toxic and can cause liver damage* and long duration.]

Mazindol (Sanorex) / .5 – 6mg / [Not very effective and rarely used except in the United Kingdom.]

There are different notes on each of the medications and in which circumstances they might be preferable in treating a patient for narcolepsy versus using