Treaments Narcolepsy

Treatments

Narcolepsy treatment

Although no cure yet exists for narcolepsy, a combination of treatments can help to control your narcolepsy symptoms and enable you to enjoy many normal activities. The treatment that works best for you will vary according to your specific narcolepsy symptoms, but will likely include a combination of counseling, medication, and lifestyle changes.

Lifestyle changes to ease the symptoms of narcolepsy

Making healthy lifestyle changes can be effective at helping you manage narcolepsy symptoms, in conjunction with counseling and support, and any medications your doctor recommends. Daytime habits such as exercise, diet, and how you manage stress play a large role in helping you maintain a healthy sleep-wake cycle. It’s important to follow a regular sleep schedule, a relaxing bedtime routine, and take practical steps to counter the effects of narcolepsy during the day.
Combining the various self-help treatments can help to not only improve your daytime alertness but also help reduce the symptoms of narcolepsy.

Self-Help for Narcolepsy
Schedule your sleep periods	Take a few brief, scheduled naps during the daytime (10-15 minutes each). Try to get a good night’s sleep during the same hours each night. Planned naps can prevent unplanned lapses into sleep.
Avoid caffeine, alcohol, and nicotine	These substances interfere with sleep when you need it.
Avoid over-the-counter drugs that cause drowsiness	Some allergy and cold medications can cause drowsiness, so should be avoided.
Involve your employers, coworkers, and friends	Alert others so that they can help when needed.
Carry a tape recorder	Record important conversations and meetings, in case you fall asleep.
Break up larger tasks into small pieces	Focus on one small thing at a time.
Exercise on a regular basis	Exercise can make you feel more awake during the day and stimulate sleep at night. For example, take several short walks during the day.
Avoid activities that would be dangerous if you had a sudden sleep attack	If possible, don’t drive, climb ladders, or use dangerous machinery. Taking a nap before driving may help you to manage any possible sleepiness.
Wear a medical alert bracelet or necklace	A bracelet or necklace will alert others if you suddenly fall asleep or become unable to move or speak.
Eat a healthy diet	Aim for a diet rich in whole grains, vegetables, fruits, low fat dairy, and lean sources of protein. Eat light or vegetarian meals during the day and avoid heavy meals before important activities.
Relax and manage emotions	Narcolepsy symptoms can be triggered by intense emotions, so you may benefit from practicing relaxation techniques, such as breathing exercises, yoga, or massage.

Medications for the treatment of narcolepsy

Medication can be helpful in treating the major symptoms of narcolepsy: sleepiness and cataplexy. Commonly prescribed drugs for narcolepsy are stimulants, antidepressants, and sodium oxybate. All medications have side effects so talk with your doctor. Even if your narcolepsy symptoms require the use of prescription medication, experts recommended combining a drug regimen with lifestyle changes and counseling or therapy.
Common medications used to treat narcolepsy symptoms include:

• Stimulants. Stimulants are the mainstay of drug treatment for narcolepsy. These include modafinil (Provigil), a stimulant used during the day to promote wakefulness and alertness. Side effects of modafinil may include headache, nausea, dry mouth, and diarrhea. Psychiatric side effects, such as anxiety, mania, hallucinations, and suicidal thinking have also been reported, so the drug should be avoided if you have a history of depression, mania, or psychosis.
• Sodium oxybate (Xyrem). This strong drug may be prescribed if you have severe cataplexy. Sodium oxybate is also known as GHB, or the "date rape drug," but is considered safe for treating narcolepsy when used responsibly to promote sound sleep, diminish daytime sleepiness, and reduce incidences of cataplexy. However, the side effects can be serious and may include nausea, bed-wetting, and worsening of sleepwalking. Too high a dose can even lead to difficulty breathing, coma, and death.

•  Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) used to treat depression may also be used to help suppress REM sleep, and alleviate symptoms of cataplexy, hallucinations, and sleep paralysis. These include fluoxetine (Prozac), sertraline (Zoloft), and newer antidepressants such as venlafaxine (Effexor). While the most common side effects of antidepressants include decreased sexual desire, digestive problems, restlessness, headache, and insomnia, there can also be dangerous side effects.