Narcolepsy Treatment: Medication and Lifestyle Changes

No cure for narcolepsy exists. Treatments for narcolepsy only relieve symptoms of the disorder. Narcolepsy medication provides relief from daytime sleepiness, cataplexy (loss of muscle tone that leads to sudden weakness) and other symptoms. Lifestyle changes can make it easier to achieve a restful night's sleep.

Stimulants and Narcolepsy Medication

Stimulants are a first-line narcolepsy treatment. However, stimulants can be habit-forming and should only be used as narcolepsy medication under a doctor's supervision. Preventing daytime sleepiness is the primary goal of stimulant narcolepsy treatment.
Stimulant treatments for narcolepsy include methylphenidate and dextroamphetamine. While an effective treatment for daytime sleepiness, stimulants can disrupt nighttime sleep patterns, cause heart palpitations and increase anxiety.

Provigil® Medication (Modafinil)

Provigil® medication, or modafinil, is a newer stimulant that is typically the first choice for narcolepsy treatment. Modafinil is a medication approved by the U.S. Food and Drug Administration (FDA) as a narcolepsy treatment. Provigil® medication does not cause anxiety or irritability as often as stimulants, and is less likely to be habit forming.
As a narcolepsy treatment, modafinil can significantly improve wakefulness. It does not interfere with brain chemicals that regulate sleep, so people taking the drug can nap during the day.
This type of medication has fewer drug dependency risks than stimulants and is less likely to produce a "rebound" effect. A rebound effect occurs when people "crash" after the effects of narcolepsy medication wears off.
Modafinil's safety during pregnancy remains undetermined. In rare cases, Provigil® medication can cause serious skin conditions, psychiatric side effects or suicidal thoughts. People already suffering from mental disorders may not be suitable candidates for Provigil®.

Treatment for Cataplexy

Treatments for narcolepsy that reduce daytime sleepiness do nothing to reduce cataplexy symptoms. Cataplexy, a sudden loss of muscle tone, often accompanies narcolepsy. People with narcolepsy-related cataplexy may suddenly feel their knees or neck buckle, their jaw slacken or their head fall.
Sodium oxybate is an FDA-approved cataplexy treatment. While effective, sodium oxybate can cause serious side effects. High doses of sodium oxybate can cause respiratory distress, seizures and coma. In rare cases, excessive doses can be fatal.
Antidepressants can also reduce cataplexy symptoms. Selective serotonin reuptake inhibitors (SSRIs) suppress REM sleep activity, which helps reduce a number of narcolepsy symptoms, including cataplexy, sleep paralysis and hypnagogic hallucinations.
Side effects of SSRIs include reduced sex drive, headaches, and insomnia and digestive problems. Selective norepinephrine reuptake inhibitors are also used as treatments for narcolepsy, with benefits and drawbacks similar to SSRIs.
Older-generation tricyclic antidepressants are also sometimes prescribed as treatments for cataplexy. However, side effects associated with this family of antidepressants may make another medication a preferable choice.

Lifestyle Treatments for Narcolepsy

Lifestyle changes can provide treatments of narcolepsy. Mild cases of narcolepsy may respond to behavioral changes alone, although more severe cases require a combination of lifestyle modification and narcolepsy medication.
Proper sleep hygiene helps with narcolepsy treatment. Sleep hygiene describes set of behaviors that promote a restful night's sleep, such as maintaining a regular sleep schedule.
Short scheduled naps during the day help combat daytime sleepiness, thus, they are sometimes recommended as treatments for narcolepsy. Avoiding medication that causes drowsiness, such as cold or allergy medication, is also recommended.

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