There is currently no cure for narcolepsy. The illness is persistent and does not go away, but the appropriate combination of drugs and behavioral and lifestyle changes can assist.
Narcolepsy is a chronic neurological and sleeps illness that can be debilitating due to the sudden “sleep attacks” — and, in many cases, cataplectic attacks or rapid loss of muscle control — it produces.
According to the National Institute of Neurological Disorders and Stroke, everyday tasks such as driving, caring for children, working, and going to school can be much more difficult (and dangerous) for people with the disorder due to the risk of falling asleep or losing control of your muscles at any time.
Narcolepsy has no cure yet, and it is a chronic illness that does not go away. However, according to the Sleep Foundation, the appropriate combination of drugs and behavioral and lifestyle changes can help many people with narcolepsy manage their symptoms and live full and happy lives.
“We say we can get 80 percent of patients to 80 percent function,” says Emmanuel Mignot, MD, a Stanford University professor of sleep medicine in the psychiatry and behavioral sciences department and director of the Stanford Center for Narcolepsy in Palo Alto, California. “We can get a substantial percentage of patients to be functioning and do extremely well.”
Medications Can Assist in the Control of Narcolepsy Symptoms
According to Richard K. Bogan, MD, associate clinical professor at the University of South Carolina School of Medicine and Chief Medical Officer of the sleep diagnostic company SleepMed, based in Columbia, South Carolina, medications can help with some of the disorder’s most troubling symptoms for the majority of people with narcolepsy.
Your doctor may recommend the following to boost alertness and prevent daytime sleepiness:
The drug Provigil (modafinil) is a central nervous system stimulant that can help you feel more alert during the day by reducing daytime sleepiness. Modafinil is frequently administered before other stimulants because it is less addictive and has fewer adverse effects.
Wax (pitolisant) was licensed by the FDA in 2019 for excessive daytime sleepiness in adults with narcolepsy. Pitolisant, also known as an oral histamine H3 receptor inverse agonist, operates on histamine circuits in the brain to improve wakefulness, according to Dr. Bogan. Histamine activates brain cells that increase alertness and inhibits neurons that promote sleep in the brain. It can also aid in the reduction of cataplexy episodes.
Sunosi (solriamfetol) was also approved by the FDA in 2019 for adults with narcolepsy and excessive daytime sleepiness. It is considered to operate by keeping the brain chemicals dopamine and norepinephrine active.
Stimulants such as amphetamines and ecstasy can help promote wakefulness by boosting dopamine, serotonin, and norepinephrine levels in the brain. Some of the most regularly used narcolepsy medications are also used to treat ADHD, including Dexedrine (dextroamphetamine), Adderall (a combination of amphetamines and dextroamphetamine), and methylphenidate (Ritalin). However, according to Bogan, amphetamines and other stimulants are used less frequently now that newer narcolepsy medicines with fewer bad side effects are available. Amphetamines and stimulants can cause irregular heartbeat, agitation, nervousness, and the potential for addiction and abuse. “You may also develop tolerance and require greater and higher doses to reap the benefits,” explains Bogan. Therefore, when using these medications, it is important to keep a close eye on them.