![]() Narcolepsy cataplexy co-morbidities excessive daytime sleepiness hypocretin management pharmacological treatment. New symptomatic and causal treatment most probably will be completed by hypocretin-replacement and immune-modifying strategies. First-line options include Modafinil/Armodafinil (for excessive daytime sleepiness, EDS), Sodium Oxybate (for EDS and/with cataplexy), Pitolisant (for EDS and cataplexy) and Venlafaxine (for cataplexy (off-label) and co-morbid depression). ![]() Expert opinion: Concise evaluation of symptoms and type of narcolepsy, coexisting co-morbidities and patients´ distinct needs is mandatory in order to identify a suitable, individual pharmacological treatment. Non-pharmacological approaches are important in the management of narcolepsy but will not be covered in this review. Some people need treatment with methylphenidate (Ritalin, Concerta, others) or amphetamines (Adderall XR 10, Dexedrine, others). Pitolisant also may be helpful for cataplexy. Finally, this review considers potential future management strategies. Solriamfetol (Sunosi) and pitolisant (Wakix) are newer stimulants used for narcolepsy. A person receives a diagnosis of type 1 narcolepsy if they have cataplexy episodes or. The former type is where cataplexy comes into play. In addition, treatment options for frequent coexisting co-morbidities and different phenotypes of narcolepsy are presented. There are two primary forms of narcolepsy, types 1 and 2. First- and second-line options are discussed as well as combination therapies. Narcolepsy type 1 is a neurologic disorder caused by the loss of hypocretin-1 neurons in the lateral hypothalamus. Pitolisant is started at 8.9 mg orally once a day (taken on awakening) and increased to 17.8 mg once a day at week 2. The dosage varies between 8.9 to 35.6 mg in the morning. Patients need to be on medications for life to manage symptoms that impair QOL, productivity and social functioning, Dr. Pitolisant is a histamine-3 receptor inverse agonist, which is indicated for treatment of EDS and cataplexy in patients with narcolepsy. Areas covered: This review provides an overview of the temporal available treatment options for narcolepsy (type 1 and 2) in adults, including authorization status by regulatory agencies. Associated cataplexy, or sudden muscle weakening, affects about 70 of people with narcolepsy and typically presents in the teens or 20s. Narcolepsy has a major impact on workableness and quality of life. seeking help with obtaining medications and. Narcolepsy with cataplexy is most commonly caused by an immune-mediated process including genetic and environmental factors, resulting in the selective loss of hypocretin-producing neurons. Narcolepsy is a chronic sleep disorder wherein the brain cannot regulate the bodys sleep-wake cycles. ![]() Narcolepsy is an orphan neurological disease and presents with sleep-wake, motoric, neuropsychiatric and metabolic symptoms. ![]()
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