Advances in the Treatment of NARCOLEPSY
Narcolepsy
In people with narcolepsy the brain does not properly regulate sleep and wake cycles, so they experience episodes of frequent, uncontrollable daytime sleeping. It is estimated that narcolepsy, which is generally a lifelong condition, affects 135,000 people in the United States.114,115 For these patients, falling asleep in unlikely situations is much more than an inconvenience; it can jeopardize their education, ruin relationships, or endanger their lives when driving.
Excessive Daytime Sleepiness (EDS) is the most common symptom of narcolepsy patients, but they can also have cataplexy (sudden loss of muscle tone), sleep paralysis (temporary inability to use muscles), and hallucinations before and/or after sleep episodes.116 A cataplexy episode is often triggered by emotions such as surprise or anger, causing a range of effects, from a simple slumping of the head or a more dramatic collapse of the body. An estimated 20,000 to 50,000 narcolepsy patients experience cataplexy.117
Currently, there is no medicine available that allows narcolepsy patients to maintain a normal level of awareness consistently, but some of the most severe symptoms, such as EDS and cataplexy, can usually be controlled with medications.118 The cause of narcolepsy remains unknown, but genetic factors may play a role.119
PHARMACEUTICAL ADVANCES
Easing Worst Symptoms of Sleep Disorder
Modafinil was approved in 1998 for the treatment of narcolepsy and is the first new stimulant for treatment in the last 20 years. Modafinil promotes wakefulness without affecting memory, concentration, or learning.120 It also has a lower habituation potential than other stimulants that are often used for treatment of narcolepsy.121 In clinical trials, modafinil proved to be effective in alleviating EDS while producing fewer, less serious side effects than other medications.122
Sodium oxybate is the first approved treatment for cataplexy. Available
since 2002, it reduces the number of cataplexy attacks,123 which can
cause a patient's muscles to feel weak or paralyzed.
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Endnotes:
114 National Institute of Neurological Disorders and Stroke, Narcolepsy, fact sheet, http://www.ninds.nih.gov/disorders/narcolepsy/detail_narcolepsy.htm (accessed 24 August 2005).
115 National Organization for Rare Disorders, "Narcolepsy," Rare Disease Database, http://www.rarediseases.org/search/rdblist.html (accessed 13 June, 2005).
116 National Library of Medicine, MedlinePlus Medical Encyclopedia, Cataplexy, http://www.nlm.nih.gov/medlineplus/print/ency/article/000802.htm (accessed 26 August 2005).
117 Food and Drug Administration, "FDA Approves Xyren for Cataplexy Attacks in Patients with Narcolepsy," 17 July 2002, http://www.fda.gov/bbs/topics/ANSWERS/2002/ANS01157.html (accessed 28 July 2005).
118 National Institute of Neurological Disorders and Stroke, Narcolepsy Information Page, http://www.ninds.nih.gov/disorders/narcolepsy/narcolepsy.htm (accessed 12 May 2005).
119 National Organization for Rare Disorders, "Narcolepsy," op. cit.
120 S. Reents et al., Clinical Pharmacology, Gold Standard Multi-media, Inc., Provigil®, http://cp.gsm.com (accessed 12 May 2005).
121 HealthCommunities.com, SleepChannel, "Narcolepsy," http://www.sleepdisorderchannel.net/narcolepsy (accessed 12 May 2005).
122 National Institute of Neurological Disorders and Stroke, Narcolepsy, op. cit.
123 Food and Drug Administration, "FDA Approves Xyren for Cataplexy Attacks in Patients with Narcolepsy," op. cit.
