Narcolepsy is a neurological sleep disorder that causes excessive daytime sleepiness, often with sudden, uncontrollable episodes of falling asleep during the day. It can also lead to sleep paralysis and other symptoms that affect your quality of life.
While there’s currently no cure for narcolepsy, medications can help manage your symptoms. Treatment for narcolepsy focuses on:
reducing daytime sleepiness
improving alertness
minimizing sleep episodes
Doctors may prescribe stimulants such as methylphenidate and amphetamine. However, these drugs can be habit-forming and may have side effects. It’s important to work closely with a doctor to find the most appropriate treatment plan for you.
The medication works by increasing the levels of dopamine and norepinephrine in the brain, which can improve wakefulness and reduce daytime sleepiness. It comes in both immediate-release and extended-release forms.
Side effects of amphetamine/dextroamphetamine can include:
headache
loss of appetite
insomnia
weight loss
mood shifts
dry mouth
dependence and addiction with long-term use
Amphetamine sulfate
Amphetamine sulfate (Evekeo) is a CNS stimulant that can improve alertness and reduce daytime sleepiness in people with narcolepsy.
Amphetamine sulfate works by increasing the levels of dopamine and norepinephrine in the brain. It comes in an orally disintegrating tablet (ODT) form, which means it dissolves quickly in the mouth.
Side effects of amphetamine sulfate can include:
nausea
irritability
difficulty sleeping
decreased appetite
dry mouth
insomnia
headache
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Methylphenidate (Concerta, Methylin, Ritalin) is a CNS stimulant commonly used to treat ADHD. It can also help improve alertness and reduce daytime sleepiness in people with narcolepsy.
Methylphenidate works by increasing the levels of dopamine and norepinephrine in the brain. It comes in several forms, including tablets and patches.
Side effects of methylphenidate include:
headache
restlessness
nausea and vomiting
loss of appetite
dependence and addiction in long-term use
Armodafinil and modafinil
Armodafinil (Nuvigil) appears to work by increasing the levels of dopamine and norepinephrine in the brain, but its exact mechanism of action is not yet known.
Armodafinil is a longer-acting version of modafinil, another medication doctors typically prescribe to treat narcolepsy. It is available in tablet form.
Side effects of armodafinil include:
headache
nausea
nervousness
insomnia
dry mouth
Protriptyline
Protriptyline (Vivactil) is a tricyclic antidepressant that can help treat narcolepsy. It works by increasing the levels of certain neurotransmitters in the brain, specifically norepinephrine and serotonin.
This can help to improve mood and relieve symptoms of depression. Protriptyline can also have sedative effects that may help with insomnia and anxiety.
Side effects of protriptyline include:
dry mouth
constipation
headache
restlessness
blurred vision
drowsiness
Methamphetamine
Methamphetamine (Desoxyn) is a CNS stimulant that can help improve alertness and reduce daytime sleepiness in people with narcolepsy. It works by increasing the release of dopamine and norepinephrine in the brain.
Side effects of methamphetamine include:
decreased appetite
difficulty sleeping
addiction with long-term use
headache
irritability
Solriamfetol
Solriamfetol (Sunosi) is a newer medication approved by the Food and Drug Administration (FDA) to treat excessive daytime sleepiness in adults with narcolepsy or obstructive sleep apnea.
It works by blocking the reuptake of dopamine and norepinephrine in the brain, which can improve wakefulness. Solriamfetol is available in tablet form.
Side effects of solriamfetol include:
headache
nausea
decreased appetite
irritability
palpitations
It’s important to note that narcolepsy drugs can have different side effects and risks. Consider talking with a doctor to help you develop the best treatment plan.
Can you treat narcolepsy without drugs?
Nondrug treatments and lifestyle modifications can also help manage the symptoms of narcolepsy, but they may not be effective for everyone. Options include:
Scheduled naps: Taking scheduled naps throughout the daycan help reduce excessive daytime sleepiness and improve alertness. Short naps may help to avoid disrupting nighttime sleep.
Regular sleep schedule: Maintaining a regular sleep schedule, including going to bed and waking up at the same time every day, can help improve nighttime sleep and reduce daytime sleepiness.
Relaxation techniques: Deep breathing, meditation, or yoga may help reduce stress and promote better sleep.
Exercise: Regular exercise can help improve overall health. This may promote better sleep and help manage symptoms of narcolepsy.
Dietary changes: Avoiding large meals, caffeine, and alcohol, if applicable, before bedtime may help improve nighttime sleep and reduce daytime sleepiness.
While nondrug treatments and lifestyle modifications may help manage the symptoms of narcolepsy, working with a doctor to determine the best treatment plan for you is important.
Summary
While there is currently no cure for narcolepsy, certain medications can help manage your symptoms. The most common are CNS stimulants, such as amphetamine/dextroamphetamine, methylphenidate, and armodafinil.
These medications work by increasing the levels of dopamine and norepinephrine in the brain, which can improve wakefulness and reduce daytime sleepiness.
Each medication can have different side effects and risks. It’s important to work with a doctor to determine the best treatment plan for you.
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