Narcolepsy

Prevention

There is no way to prevent narcolepsy. For people who have the condition, avoiding conditions that bring on narcolepsy episodes may help to reduce their frequency. If you have narcolepsy and your symptoms are not controlled with medicines, you should never smoke because you could fall asleep with a lit cigarette, and you should never drive.

Treatment

The main symptom of narcolepsy, excessive daytime sleepiness, can be partially relieved with stimulants such as modafinil (Provigil), methylphenidate (Ritalin and other brand names) or dextroamphetamine (Dexedrine), as well as with regularly scheduled short naps during the day.

Cataplexy and sleep paralysis can be treated with a variety of medicines that can make you more resistant to entering REM sleep. Most of these medicines were developed for use as antidepressants. Examples of effective medications include protriptyline (Vivactil), clomipramine (Anafranil), venlafaxine (Effexor) and fluoxetine (Prozac). Cataplexy also can be treated with sodium oxybate (also called gamma hydroxybutyrate or Xyrem), although the use of this drug is tightly controlled because it has been abused recreationally. For reasons that are not well understood, a low dose of this medicine reduces cataplexy attacks and improves daytime sleepiness in people who have narcolepsy with cataplexy, even though the drug causes sedation in most people without narcolepsy.

Psychological counseling may be important for difficulties associated with self-esteem and for emotional support, especially since people with narcolepsy have difficulty doing tasks that require concentration, and may be regarded as unmotivated by family and peers.