history of narcolepsy symptoms and narcolepsy
Narcolepsy Medication
Narcolepsy is a sleep disorder suffered by both men and women of all ages. Narcolepsy symptoms commonly appear in your teenage years, or in your early twenties, however cases can arise in quite young children as well as in adults in later life. A specific characteristic of this disease it that it can well be some years after the onset of the disease (ordinarily about 15 years) before it is diagnosed. It is also one of the most commonly under-diagnosed conditions today. For instance, although about 50,000 sufferers in the USA are diagnosed as having narcolepsy, it is approximated that the true number of sufferers is nearer to 250,000. As things stand today there is no cure for narcolepsy, which is a chronic and life-long condition. It is possible, however, to treat the symptoms with a mixture of narcolepsy medication and behavioral therapy. Two common symptoms of narcolepsy are: - Excessive Daytime Sleepiness (EDS).
- An abnormal pattern of rapid eye movement (REM) sleep.
In narcolepsy both the length and order of the sleep cycles are changed, with REM sleep coming not long after falling asleep, as opposed to following a period of deep sleep. Three particular characteristics of REM sleep are seen as symptoms of narcolepsy:
- Hallucinations. About half of all narcolepsy sufferers go through intense dream-like images, known as hypnagogic hallucinations, as they fall asleep. Commonly these images can be quite frightening, particularly so because you are still partially conscious in this stage between being awake and asleep, but are not able to control these images.
The nature of the images Frequently gives rise to several feelings including anxiety, absolute dread and fear and it is normal for these episodes to lead you to believe that you are suffering from some kind of mental illness.
- Sleep paralysis. Roughly 50% of all narcolepsy sufferers have sleep paralysis in which there is a temporary loss of muscle control as they drift into, or out of, sleep. In this still semi-consious state between being awake and asleep you keep a general awareness of your surroundings, however you're unable to move or to speak.
Sleep paralysis might arise at the same time as hypnagogic hallucinations and, for some sufferers, the resultant feelings of terror might be overwhelming.
- Cataplexy. Encountered in approximately two out of three cases of narcolepsy, cataplexy can appear alongside excessive daytime sleepiness, or might not be seen until a few years after the onset of the disease.
Cataplexy is a temporary loss of muscle control that can range from comparatively minor symptoms, such as weakness at the knees, to a total collapse causing you to fall to the ground. Attacks can last from only a few seconds to a few minutes and can occur infrequently or many times each day. You stay conscious throughout these attacks, however typically you cannot speak.
Cataplexy attacks are often touched off by events linked to strong emotions such as anger, laughing or surprise.
Narcolepsy medication.Two separate forms of narcolepsy medication are normally used - the first to cut down daytime sleepiness and the second to lower the effects of cataplexy, sleep paralysis and hallucinations.
Stimulants. Stimulants are often prescribed to lower daytime sleepiness. The range of drugs used is far too extensive to list them all here, but perhaps the two most frequently prescribed are Ritalin (Methylphenidate) and Provigil (Modafinil).
- Ritalin. Ritalin is one of several central nervous system stimulants often 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 bringing out undesirable side effects. These include irritability, headache, nervousness, gastrointestinal problems and further disturbed nighttime sleep.
Additionally, drugs of this nature can loose their effectiveness if they are taken for long 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 taking care of daytime sleepiness in cases of narcolepsy.
Different to other drugs, Provigil doesn't interfere with the hormones connected to sleep and so does not cause disturbed nighttime sleep. It also stimulates far less anxiety and nervousness than many other options and has fewer side-effects in general. The main side-effects are headache and nausea, but these are generally short-lived.
There are five main categories of anti-cataplectic medication commonly in use today.
- 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.
- 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.
- 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.
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