Definition
Narcolepsy is a chronic neurological condition that causes sudden sleep attacks during the day. Individuals with this disease can fall asleep at any time, even if they are engaging in engaging activities, such as working or talking.
Also, once narcolepsy develops, it persists throughout the patient's life. It is therefore clear how much this disease can negatively affect the lives of patients who suffer from it.
Causes
The exact triggering cause of narcolepsy has not yet been fully identified, but it seems that a genetic predisposition is necessary for it to develop. In addition to genetic factors, it also seems that the intervention of environmental factors can also favor the appearance of pathology.
Symptoms
As mentioned, narcolepsy patients experience repeated and sudden sleep attacks throughout the day. In addition, narcolepsy is often accompanied by cataplexy, which is a "sudden and transient loss of muscle tone, similar to that which occurs during REM sleep.
Other symptoms that may occur are fatigue, hallucinations in sleep, disturbed sleep at night or insomnia, sleep paralysis, depression and difficulty concentrating.
The first symptoms of narcolepsy can occur following pathologies, traumatic events, stress or as a result of sleep deprivation. In other cases, however, the symptoms can arise in patients even spontaneously, even in the absence of pre-existing pathologies or traumas.
The information on Narcolepsy - Drugs for the Treatment of Narcolepsy is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Narcolepsy - Drugs to Treat Narcolepsy.
Medicines
Unfortunately, there are no specific drugs for the treatment of narcolepsy. Available drug therapies aim to reduce symptoms and improve the quality of life of patients who suffer from them.
First of all, patients are advised to always go to bed at the same time and to sleep at least eight hours a night, in order to give regular night sleep. To prevent fatigue, then, it is advisable to take several naps lasting 15 minutes throughout the day. It is then advisable to carry out regular physical activity and to adopt a balanced diet, avoiding too heavy meals and alcohol. to these behaviors, the doctor can prescribe drugs to stimulate the central nervous system, in order to counteract sleepiness, and drugs to combat cataplexy.
The following are the drugs most used in the therapy against narcolepsy and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and dosage most suitable for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment.
Modafinil
Modafinil (Provigil ®) is a drug capable of stimulating the central nervous system, which works by increasing the release of different types of neurotransmitters, including histamine.
Modafinil helps to maintain wakefulness, which is why it is useful in the treatment of narcolepsy and associated symptoms.
The dose of drug usually administered in adults is 200 mg per day, to be taken as a single dose in the morning, or in two divided doses (one in the morning and one at noon).
In elderly patients and in patients with liver and / or kidney disease, the dose of drug usually administered is lowered to 100 mg per day.
Methylphenidate
Methylphenidate (Ritalin ®) is a drug that is normally used for the treatment of attention deficit hyperactivity syndrome (ADHD), but which can also be used to treat the typical daytime symptoms of narcolepsy. In fact, methylphenidate is able to perform a stimulating action on the central nervous system. The amount of drug that must be used will be established by the doctor on an individual basis for each patient.
Sodium oxybate
Sodium oxybate (Xyrem ®) is a drug used for the treatment of cataplexy which is often associated with narcolepsy.
The usual dose of sodium oxybate is 4.5 grams per night, to be taken orally in two divided doses (one before bedtime and one after 2-4 hours).
If the doctor deems it necessary, he may decide to increase the amount of the drug up to a maximum of 9 grams per night, always to be taken in two divided doses.
Antidepressants
Some types of antidepressant drugs can also be used in the treatment of narcolepsy. More precisely, they are used as off-label drugs against cataplexy.
The term "off-label" refers to the "use of drugs known and already used for some time, for which scientific evidence suggests their use in clinical situations not expressly approved and reported on the package leaflet of the drug itself.
In fact, in Italy, antidepressants do not have specific therapeutic indications for the treatment of narcolepsy, but - since their use seems to help patients suffering from this disease - they are used, in fact, as off-label drugs.
Among the most used active ingredients, we remember:
- Clomipramine (Anafranil ®): Clomipramine is a drug belonging to the class of tricyclic antidepressants. It is available in different pharmaceutical formulations suitable for different routes of administration. When given orally, the usual dose of clomipramine is 25 mg 1-2 times a day, or as directed by a doctor. Subsequently, the doctor may decide to gradually increase the dosage, up to a maximum of 200-250 mg of active ingredient per day.
- Fluoxetine (Prozac ®): Fluoxetine is an antidepressant belonging to the class of selective serotonin reuptake inhibitors (otherwise known as SSRIs). This drug is available in several pharmaceutical formulations suitable for oral administration. The usual dose of fluoxetine used is 10-20 mg per day which - if necessary - can be gradually increased. In any case, the exact dosage of the medicinal product must always be determined by the physician on an individual basis.
- Venlafaxine (Efexor ®): Venlafaxine is an antidepressant drug belonging to the class of serotonin and norepinephrine reuptake inhibitors (or SNRIs). It is available for oral administration. The usual starting dose of venlafaxine with which treatment is initiated is 37.5-75 mg per day. Thereafter, the dose can be gradually increased to a maximum of 300-375 mg of the drug per day. Even in this case, however, the exact amount of active ingredient to be taken must be established by the doctor, according to the conditions of each patient.
