cataplexy narcolepsy
Narcolepsy Medication
Narcolepsy afflicts both women and men across a wide range of ages. The first signs of narcolepsy typically appear during your teenage years, or in your early twenties, although cases can develop in young children as well as adults in later life. A specific characteristic of this disease it that it may be a number of years after the onset of the disease (normally about 15 years) before it is diagnosed. It is also one of today's most commonly under-diagnosed conditions. Thus, although about 50,000 sufferers in the USA are diagnosed with narcolepsy, it is believed that the true figure is nearer to 250,000. Right now there is no remedy for narcolepsy, which is a chronic and life-long condition. In spite of this fact, doctors can treat the symptoms with a mix of narcolepsy medication and behavioral therapy. The two most common symptoms of narcolepsy are: - Excessive Daytime Sleepiness (EDS).
- An abnormal pattern of rapid eye movement (REM) sleep.
In for those suffering from narcolepsy both the length and order of the sleep cycles are changed, with REM sleep appearing soon after falling asleep, rather than following a period of deep sleep. In particular three specific characteristics of REM sleep are seen as symptoms of narcolepsy:
- Cataplexy. Noticed in close to 2 out of 3 cases of narcolepsy, cataplexy might appear alongside excessive daytime sleepiness, or might not come out until some years after the onset of the disease.
Cataplexy is a impermanent loss of muscle control that can range from quite minor symptoms, such as weakness at the knees, to a total collapse causing you to fall to the ground. Attacks can last from only seconds to a few minutes and could occur occasionally or a number of times each day. You stay conscious throughout these attacks, however usually you can't speak.
Cataplexy episodes are usually sparked by events connected to strong emotions such as laughing, surprise or anger.
- Sleep paralysis. Nearly half of all narcolepsy sufferers will experience sleep paralysis in which they have a temporary loss of muscle control as they drift into, or out of, sleep. In this still partially conscious state between being awake and asleep you keep a general awareness of your surroundings, although you are unable to speak or to move.
Sleep paralysis can be seen alongside hypnagogic hallucinations and, for some sufferers, the resulting feelings of terror may be overwhelming.
- Hallucinations. Almost half of all narcolepsy sufferers see vivid dream-like images, known as hypnagogic hallucinations, as they drift into sleep. Usually these images can be quite frightening, particularly so because you're still partially conscious in this period between being awake and asleep, but are not able to control these images.
The nature of the images seen Frequently gives rise to a number of feelings including anxiety, absolute dread and fear and it is not uncommon for these episodes to make you believe that you are suffering from some type of mental illness.
Narcolepsy medication.There are two different types of narcolepsy medication that are usually used - one to lower daytime sleepiness and the other to lower the effects of hallucinations, cataplexy and sleep paralysis.
Stimulants. Stimulants are ordinarily prescribed to counteract daytime sleepiness. The range of possible drugs is too long to list them all here, however perhaps the two most frequently prescribed are Ritalin (Methylphenidate) and Provigil (Modafinil).
- Ritalin. Ritalin is one of several different central nervous system stimulants frequently used in cases of narcolepsy but unfortunately, along with other drugs in its class, Ritalin also increases activity in other parts of the nervous system, usually producing uninvited side effects. These include irritability, gastrointestinal problems, headache, nervousness and further disturbed nighttime sleep.
Additionally, drugs of this nature can loose their effectiveness if taken for lengthy periods of time.
- Provigil. Provigil is a reasonably new drug that is rapidly replacing Ritalin, and other central nervous system stimulants, as the drug of choice for handling daytime sleepiness in narcolepsy sleep disorder.
Unlike other drugs, Provigil doesn't interfere with the hormones linked to sleep and so does not lead to disturbed nighttime sleep. It also stimulates far less nervousness and anxiety than many other alternatives and has fewer side-effects in general. The primary side-effects are nausea and headache, but these are usually short-lived.
There are five main categories of anti-cataplectic medication commonly in use today.
- 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.
- 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.
- 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.
- 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.
- 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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