adderall narcolepsy
Narcolepsy Medication
Narcolepsy is a relatively common sleep disorder that affects both women and men across a wide range of ages. The first signs of narcolepsy typically appear during your teenage years, or early twenties, although cases can develop in quite young children as well as in adults in later life. A particular characteristic of this condition it that it can well be a number of years after the onset of the disease (usually about fifteen years) before it is diagnosed. It is also one of today's most frequently under-diagnosed sleep disorders. Therefore, although about 50,000 sufferers in the US are diagnosed as having narcolepsy, it is judged that the true number of sufferers is nearer to 250,000. At present there is no cure for narcolepsy, which is a chronic and life-long condition. Despite this fact, doctors can treat the symptoms with a combination of behavioral therapy and narcolepsy medication. Two principle symptoms of narcolepsy are: - Excessive Daytime Sleepiness (EDS).
- An abnormal pattern of rapid eye movement (REM) sleep.
In instances of narcolepsy both the length and order of your sleep cycles are altered, with REM sleep appearing not long after falling asleep, as opposed to following a period of deep sleep. In particular three particular characteristics of REM sleep appear as symptoms of narcolepsy:
- Cataplexy. Witnessed in about two thirds of all cases of narcolepsy, cataplexy can appear together with excessive daytime sleepiness, or may not be seen until a number of years after the start of the disease.
Cataplexy is a irregular loss of muscle control that can range from relatively minor symptoms, such as weakness at the knees, to a total collapse resulting in your falling to the ground. Attacks can last from a few seconds to some minutes and could occur occasionally or numerous times daily. You remain conscious throughout these attacks, however typically you can't speak.
Cataplexy episodes are usually sparked off by events associated with strong emotions such as anger, surprise or laughing.
- Sleep paralysis. Approximately half of all narcolepsy sufferers have sleep paralysis during which there is a temporary loss of muscle control as they drift into, or out of, sleep. In this still partially conscious state between wakefulness and sleep you keep a general awareness of your surroundings, but you are unable to move or to speak.
Sleep paralysis may arise together with hypnagogic hallucinations and, for some sufferers, the resultant feelings of terror may be overwhelming.
- Hallucinations. Some half of all narcolepsy sufferers have graphic dream-like images, referred to as hypnagogic hallucinations, as they are falling asleep. Frequently these images are quite frightening, not least because you're still partially conscious in this phase between being awake and asleep, but are not able to control these images.
The nature of the images seen Frequently gives rise to a variety of feelings including absolute dread, anxiety and fear and it is not uncommon for these episodes to make you think that you are suffering from some form of mental illness.
Narcolepsy medication.Two separate forms of narcolepsy medication are normally used - one to lower daytime sleepiness and the second to reduce the effects of hallucinations, sleep paralysis and cataplexy.
Stimulants. Stimulants are commonly prescribed to reduce daytime sleepiness. The variety of drugs available is far too extensive to list them all here, but perhaps the 2 most frequently prescribed are Ritalin (Methylphenidate) and Provigil (Modafinil).
- Ritalin. Ritalin is one of a range of central nervous system stimulants often used in cases of narcolepsy but unfortunately, in common with other drugs in its class, Ritalin also raises activity in other parts of the nervous system, often creating uninvited side effects. These include headache, gastrointestinal problems, nervousness, irritability and further disturbed nighttime sleep.
Further, drugs of this nature can loose their effectiveness if taken for lengthy periods of time.
- Provigil. Provigil is a reasonably new drug that is quickly replacing Ritalin, and other central nervous system stimulants, as the drug of choice for treating daytime sleepiness in narcolepsy sleep disorder.
Different to other drugs, Provigil does not interfere with the hormones associated with sleep and so doesn't lead to disturbed nighttime sleep. It also stimulates far less nervousness and anxiety than many other choices and has fewer side-effects in general. The principal side-effects are nausea and headache, but these are normally short-lived.
There are five main categories of anti-cataplectic medication commonly in use today.
- Tricyclic Antidepressants. These are used to slow down the central nervous system and include such drugs as Tofranil (Imipramine) and Anafranil (Clomipramine). There are a range of side effects associated with this class of drugs, some of which can be extremely serious, and care should be exercised if using this form of medication.
- New Antidepressants. Two relatively new antidepressants are also being prescribed for cases of narcolepsy. The first, Edronax (Reboxetine) is known as a selective noradrenaline reuptake inhibitor (NARI) which is a unique form of antidepressant showing encouraging results in early use. The second, Effexor (Venlafaxine), is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) that has again shown promising results in early use.
- Gamma hydroxybutyrate (GHB). This particular drug, commonly referred to as Xyrem (Sodium oxybate), has been in use in Europe for some time now, but has only recently gained FDA approval for use in the United States (July 2002). Side effects, which tend to be mild, include nausea, headache, dizziness, urine leakage, and sleepwalking.
- Selective Serotonin Reuptake Inhibitors (SSRIs). These are again designed to slow down the central nervous system and include such drugs as Prozac (Fluoxetine). SSRIs display fewer side-effects than tricyclic antidepressants.
- Monoamine Oxidase Inhibitors (MAOIs). These drugs, which include Eldepryl (Selegiline), block monoamine oxidase B, an enzyme that degrades dopamine and is believed to play a role in narcolepsy. There can be some serious side-effects associated with these drugs, especially if used in conjunction with other antidepressant drugs. Further complications can arise from the interaction with certain foods.
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