Fast Five Quiz: Narcolepsy

Heidi Moawad, MD


February 06, 2023

Narcolepsy treatment choice is based on symptoms, as only certain medications have been proven to manage cataplexy, the hallmark of narcolepsy type 1. CNS depressant sodium oxybate, considered the gold standard for narcolepsy management, is the only treatment approved by the US Food and Drug Administration to reduce the frequency of cataplexy. This therapy has proven effective in improving EDS and other narcoleptic symptoms, particularly disturbed nocturnal sleep. The wake-promoting agent modafinil is also a first-line treatment. Though it has been shown to increase quality of life, it has not proven effective in diminishing the frequency of cataplexy.

A treatment alternative, often prescribed for patients who are intolerant to sodium oxybate or prefer to take a daytime medication, is pitolisant, a nonscheduled, first-in-class H3 receptor antagonist/inverse agonist, indicated for EDS in adults with narcolepsy. It has shown to be as effective in treating EDS as modafinil, while also decreasing cataplexy.

Learn more about the differential diagnosis of narcolepsy.

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