Narcolepsy
Treatment

Treatment for narcolepsy typically involves medications to increase daytime alertness and reduce cataplexy and other symptoms. Stimulants are usually prescribed to improve alertness. Antidepressants as well as a new drug called gammahydroxybutyrate, or Xyrem, may be used to control cataplexy, hypnagogic hallucinations and sleep paralysis.

Stimulants

Common stimulants include the following:

• Dextroamphetamine sulfate, or Dexedrine
• Methylphenidate hydrochloride, or Ritalin
• Pemoline, or Cylert
• Modafinil, or Provigil

There are a few common side effects of stimulants that you may experience when taking these medications. They include headache, irritability, nervousness, insomnia, irregular heartbeat and mood changes.

Antidepressants

Tricyclic antidepressants and serotonin reuptake inhibitors, which go by the brand names Vivactil and Tofranil, are typically used to control cataplexy, sleep paralysis and hypnagogic hallucinations.

Side effects of antidepressants vary, but you may experience drowsiness, sexual dysfunction and lowered blood pressure. Although uncommon, serotin reuptake inhibitors may cause overexcitement, anxiety, insomnia, nausea and sexual dysfunction.

Other Treatments

Medication is just one aspect of treatment for narcolepsy. There are other simple things you can do to improve your sleep habits, including:

• Taking several short naps, or one long nap, each day to control sleepiness and sleep attacks.
• Adopt a sleep routine in which you go to bed and wake up at the same time.
• Use your bed for sleep and sex only.
• Do not have caffeine, nicotine or alcohol in the late afternoon or evening.
• Exercise regularly, but at least three hours before bedtime.
• Try to avoid exciting or stressful situations that may trigger a cataplexy attack.

Reviewed by health care specialists at UCSF Medical Center.