Sodium oxybate is used primarily to treat cataplexy.
Sodium oxybate is a powerful sedative that is sold under the brand name Xyrem. As it is still protected by a patent, it is produced by only one company and is therefore much more expensive than most of the other drugs that are used to treat narcolepsy. This unfortunately means that many patients who might benefit from this medication have been denied access to it.
Unlike the other drugs discussed here, Xyrem is a liquid. It is taken as two doses, one swallowed immediately before bedtime and the other around 3-4 hours later. It is therefore necessary to set an alarm to wake you in time to take the second dose. The two doses are prepared by measuring the appropriate amount of liquid into a cup using a special syringe. The cups and syringe are supplied with each box of Xyrem. The maximum dose of Xyrem is 9g (9 grams) per day, ie two doses of 4.5g each. This is a much, much higher amount of drug than is usual for most other medications, for which the doses are measured in milligrams, ie tens, hundreds or thousands of times less than grams. In practice, your doctor will initially prescribe a low dose, for instance 2 x 1.5g or 2 x 2.25g, and then gradually increase the dose until the optimum dose for you is found.
Sodium oxybate is a Schedule 2 Controlled Drug, which means that you may be required to prove your identity when collecting your prescription and you must store the drug securely.
Because sodium oxybate is a powerful sedative, it is vitally important that if you are taking it you do not drink alcohol, since the combined sedative effect of the drug and alcohol could be extremely dangerous.
Sodium oxybate is used to treat cataplexy but can also help with many of the other symptoms
of narcolepsy. Sodium oxybate promotes deep sleep and improves night-time sleep. It helps with EDS as well as helping to control cataplexy. Sodium oxybate is often thought of as the most effective treatment for narcolepsy with cataplexy, either on its own or in combination with one or more stimulants. However, not all patients find it beneficial.
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.