Because there is at present no cure for narcolepsy, the medication that is prescribed for the treatment of narcolepsy aims to control the major symptoms of the condition, particularly excessive daytime sleepiness and cataplexy.
Some people with narcolepsy are prescribed only one medicine, but for many the best results are obtained using a combination of two or more different drugs. What works best for one patient does not necessarily also work best for another, and your doctor will try to find the treatment that is most suitable for you. This may involve just one drug, or it may involve two or more. Following your diagnosis, you may find that your doctor tries several different drugs or combinations of drugs before settling on the optimal treatment regime. Similarly, it may take some time for your doctor to work out the best dose of each drug.
Some of the drugs that are used are licensed for the treatment of one or more symptoms of narcolepsy. Others, on the other hand, are not licensed for that use but, because there is evidence that they are effective, they can nonetheless be prescribed by a specialist physician.
In this resource article, we list many of the medications most commonly used to treat narcolepsy. For many of these, you can find more information by following the link to our webpage devoted specifically to that drug, where in many cases you will also find links to the relevant British National Formulary (BNF) page on the website of NICE, the National Institute for Health and Care Excellence, and - where available - to the relevant Patient Information Leaflet produced by The Pharmacy Department at Guy's and St Thomas' Hospital for their patients.
DRUGS FOR TREATMENT OF EXCESSIVE DAYTIME SLEEPINESS (EDS)
The drugs used for the treatment of excessive daytime sleepiness are generally "stimulants", which promote wakefulness by stimulating your brain to increase alertness and reduce excessive sleepiness during the day. Slightly different is the newer medication pitolisant, which acts as a wake promoting agent, but is not technically a stimulant in the same way as the others.
Some of the medications used in the treatment of narcolepsy are:
- Methylphenidate hydrochloride (or just methylphenidate)
- Dexamfetamine sulfate (also spelt dexamphetamine sulphate, usually just called dexamfetamine)
DRUGS FOR THE TREATMENT OF CATAPLEXY
The drugs used for the treatment of cataplexy include a number that are most commonly used as anti-depressants (though that is not why they are used to treat narcolepsy) and sodium oxybate, which is only used for the treatment of narcolepsy with cataplexy. As above, although it works in a different manner to the others, Pitolisant is included as it has also been licenced for the treatment of cataplexy.
- Fluoxetine (also referred to as fluoxetine hydrochloride)
- Sodium oxybate
SIDE-EFFECTS - As with any medication, the drugs used to treat narcolepsy can have side-effects. These can take many forms. They may be relatively minor, such as mild headaches or a dry mouth, or much more serious, such as anxiety or depression. You should check the Patient Information Leaflet in the packaging of your medication for more details and if you experience any of these side-effects you should consult your doctor.