Better Narcolepsy Treatment Options Are on the Horizon, According to Experts
According to the Stanford Medicine Center for Narcolepsy, the more common type of narcolepsy (type 1), in which people experience cataplexy as well as other symptoms, occurs when an individual has lower-than-normal levels of hypocretin (also known as orexin, a key brain chemical that regulates sleep and wakefulness).
According to the National Institutes of Health (NIH), research has not yet established what causes this hypocretin deficit. Still, there is very strong evidence that it is caused by the immune system wrongly attacking hypocretin-producing brain cells following an infection, according to Dr. Mignot.
Doctors presently have no method to restore this damage, but they are looking at ways to replace hypocretin and figure out which cells fight and destroy hypocretin in the first place.
“Can we halt the degradation of hypocretin before it’s too late?” “Because once it’s destroyed, it’s gone,” explains Mignot. Mignot describes the goal as “finding medications to stop the attack on hypocretin” (imagine putting chewing gum on an open lock so it can’t be closed shut). “We might be able to prevent narcolepsy in certain people,” adds Mignot.
“The Holy Grail is concentrating on orexin,” explains Bogan. “It’s the critical missing link in narcolepsy, just like insulin is for diabetics.” According to a study published in Frontiers in Endocrinology, several pharmaceutical companies are conducting early-stage research on medications known as orexin receptor agonists, which keep orexin molecules active in the brain for longer periods, according to a study published in Frontiers in Endocrinology in October 2019.
According to MedlinePlus, another therapy option could hack the same pharmacological mechanisms utilized in insomnia drugs like suvorexant.
Mignot adds that these drugs disrupt the hypocretin pathway to help patients sleep better.
However, according to a 2018 paper published in Expert Opinion on Investigational Drugs, researchers believe that a future narcolepsy treatment could do the opposite: activate the hypocretin system to replace what is missing in narcolepsy patients.
We’ll have better diagnostic tools and treatments as doctors learn more about narcolepsy, adds Mignot. “Right now, we can only treat symptoms; it would work much better if we could restore what’s lacking.”