A randomized, double-blind cross-over trial was carried out in 10 patients with
narcolepsy to evaluate the effect of 600 mg
femoxetine versus placebo. In comparison to placebo,
femoxetine treatment resulted in a significant decrease in both the number and severity score of cataplectic attacks per day. There were also significantly fewer attacks of
sleep paralysis, whilst the effects on nightmare and hypnogenic
hallucinations were minor. The frequency of sleep attacks decreased slightly during
femoxetine treatment, but the overall estimated sleep time during the day and
excessive daytime sleepiness remained un-affected. An ambulatory sleep recording for 48 h one week after the start of the
femoxetine and placebo period showed that
femoxetine treatment resulted in a significant decrease in the total time spent in REM sleep. The side-effects of
femoxetine were restricted to transient
nausea in 2 patients. It is concluded that
femoxetine or other
selective serotonin reuptake inhibitors may be a useful alternative for narcoleptic patients who experience troublesome side-effects with
tricyclic antidepressants.