Narcolepsy: treatment of cataplexy
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Narcolepsy: treatment of cataplexy. This is the first line treatment. Fully referenced neurology checklist.
Sodium oxybate
- This is the first line treatment
- The dose is 4.5g daily in two divided doses before 2.5 to 4 hours apart
- It may cause weight loss
Tricyclics
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Selective serotonin receptor inhibitors (SSRIs)
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Serotonin norepinephrine reuptake inhibitors (SNRIs)
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Histamine H3 receptor inverse agonist
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Investigational drugs
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References
- Billiard M, Bassetti C, Dauvilliers Y, et al; EFNS Task Force. EFNS guidelines on management of narcolepsy. Eur J Neurol 2006; 13:1035-1048.
- Barateau L, Lopez R, Dauvilliers Y. Management of narcolepsy. Curr Treat Options Neurol 2016; 18:43.
- Schinkelshoek MS, Smolders IM, Donjacour CE, et al. Decreased body mass index during treatment with sodium oxybate in narcolepsy type 1. J Sleep Res 2019; 28:e12684.
- Husain AM, Ristanovic RK, Bogan RK. Weight loss in narcolepsy patients treated with sodium oxybate. Sleep Med 2009; 10:661-663.
- Dauvilliers Y, Bassetti C, Lammers GJ, et al. Pitolisant versus placebo or modafinil in patients with narcolepsy: a double-blind, randomised trial. Lancet Neurol 2013; 12:1068-1075.
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