Narcolepsy Treatment

Narcolepsy has no current cure, though it is still possible to improve symptoms and make living with the disorder much less challenging.

Narcolepsy has no current cure, though it is still possible to improve symptoms and make living with the disorder much less challenging. Medications and lifestyle changes can help relieve many of the symptoms. The type of treatment a narcoleptic patient receives will depend on the severity of their symptoms.

The treating physician may recommend lifestyle changes that can assist in the symptom management of narcolepsy. Keeping a consistent sleep schedule, getting regular exercise and avoiding the use of tobacco, alcohol or drugs can all help control the symptoms of narcolepsy.

Medications Used for Treating Narcolepsy

There are some medications used to treat the symptoms of narcolepsy. Based on research conducted by the National Sleep Foundation, a set of medications for narcolepsy is the most common treatment. While the type of medication may differ depending on the severity of the symptoms, the use of medication combined with other treatment styles is common. Narcolepsy medication may include:

• Sleeping pills
• Opiates
• Melatonin supplements
• Allergy or cold medication
• Medication for an underlying health problem
• Stimulant medications

Stimulant drugs decrease the effects of daytime sleepiness while antidepressants combat other narcolepsy symptoms like muscle weakness, sleep paralysis and hallucinations. Individuals with narcolepsy may use medicine to help prompt sleep to improve the quality of their sleep.

Stimulants

Drugs that stimulate the central nervous system are the primary treatment to help people with narcolepsy stay awake during the day. Doctors often try modafinil or armodafinil first for narcolepsy because they are not as addictive as other stimulants. These two stimulants don’t produce the highs and lows often associated with the more addictive stimulants, and harmful side effects are rare.

If these medications are not working for the patient, the physician may prescribe an amphetamine such as Ritalin to treat their symptoms. These types of medications are very effective but can be addictive. They may cause side effects such as nervousness and heart palpitations.

SSRIs

Doctors may prescribe selective serotonin reuptake inhibitors (SSRIs) to help alleviate the symptoms like cataplexy, hallucinations and sleep paralysis because they suppress REM sleep. These medications include Prozac, Sarafem and Effexor XR. Side effects can include weight gain, insomnia and digestive problems.

Tricyclic Antidepressants

Although there’s some uncertainty about how effective antidepressants are at treating narcolepsy, they’re sometimes used to treat symptoms such as cataplexy, hallucinations and sleep paralysis. Many individuals complain of side effects, such as dry mouth, upset stomach, weight gain, sexual issues and lightheadedness when using tricyclic antidepressants. Side effects of Prozac and the other SSRIs also include stomach pains and sexual dysfunction. However, side effects appear to be seen less often and may be less severe than the tricyclic antidepressants.

A few of the most commonly prescribed tricyclic antidepressants include:

• Amitriptyline
• Amoxapine
• Desipramine (Norpramin)
• Doxepin (Silenor)
• Protriptyline (Vivactil)
• Trimipramine (Surmontil)

Sodium Oxybate

Sodium oxybate is a highly effective medication for cataplexy and supports nighttime sleep, which is often poor in narcolepsy. In high doses, it may also help control daytime sleepiness. An individual must take sodium oxybate in two doses, one at bedtime and one up to four hours later. The most commonly prescribed sodium oxybate medication is Xyrem.

Sodium oxybate can have side effects, such as nausea, bed-wetting and sleepwalking. Sodium oxybate combined with other sleeping medications, narcotic pain relievers or combining SSRIs with alcohol can lead to difficulty breathing, coma and death.

Treating Narcolepsy and Co-Occurring Conditions

Individuals who are seeking treatment for their narcolepsy may struggle with co-occurring conditions, such as substance abuse, anxiety or depression. These individuals may find that self-medicating can cause more difficulty with sleep.

The most effective treatment may take a dual-diagnosis approach, treating both conditions simultaneously. Any time there is a co-existing condition, both disorders need to be the center focus of treatment for the best possible results. This kind of care will help individuals identify the origin of their struggles so that they can move forward in recovery.

Individuals with sleeping disorders like narcolepsy often overuse sleeping pills and prescription medications. When used continuously, the individual may become dependent on the drug. When addiction is present, it is important to treat the substance use disorder and sleep disorder simultaneously. Behavioral therapies are often the most useful to allow the individual to understand how their current self-destructive behaviors hinder their treatment and create worse symptoms. Treatment usually involves developing strategies to avoid drug use triggers, making positive lifestyle changes, finding new hobbies, relying on the support of loved ones and developing action plans in case of substance use.

If you or a loved one needs treatment for a substance use disorder and a co-occurring condition, The Recovery Village can help. You can receive help from one of the facilities located throughout the country. To learn more about treatment plans, call The Recovery Village to speak with a representative.

Editor – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more

Medically Reviewed By – Krisi Herron, LCDC

Krisi Herron is an Adjunct Psychology Professor, a Licensed Chemical Dependency Counselor and a freelance writer who contributes to several mental health blogs. Read more