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Narcolepsy

A condition characterized by recurrent episodes of daytime somnolence and lapses in consciousness (microsomnias) that may be associated with automatic behaviors and AMNESIA. CATAPLEXY; SLEEP PARALYSIS, and hypnagogic HALLUCINATIONS frequently accompany narcolepsy. The pathophysiology of this disorder includes sleep-onset rapid eye movement (REM) sleep, which normally follows stage III or IV sleep. (From Neurology 1998 Feb;50(2 Suppl 1):S2-S7)

Also Known As:

Gelineau's Syndrome; Narcoleptic Syndrome; Gelineau's Syndromes; Gelineaus Syndrome; Narcolepsy Cataplexy Syndrome; Narcolepsy-Cataplexy Syndromes; Narcoleptic Syndromes; Sleep, Paroxysmal; Syndrome, Gelineau; Syndrome, Gelineau's; Syndrome, Narcolepsy-Cataplexy; Syndrome, Narcoleptic; Syndromes, Gelineau's; Syndromes, Narcolepsy-Cataplexy; Syndromes, Narcoleptic; Gelineau Syndrome; Narcolepsy-Cataplexy Syndrome; Paroxysmal Sleep

Networked: 1578 relevant articles (99 outcomes, 218 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Cataplexy
2.	Disorders of Excessive Somnolence (Hypersomnia)
3.	Obstructive Sleep Apnea
4.	Circadian Rhythm Sleep Disorders (Delayed Sleep Phase Syndrome)
5.	Idiopathic Hypersomnolence

Experts

1.	Mignot, Emmanuel: 92 articles (12/2015 - 01/2002)
2.	Nishino, Seiji: 50 articles (12/2013 - 03/2002)
3.	Dauvilliers, Yves: 49 articles (08/2015 - 01/2003)
4.	Plazzi, Giuseppe: 47 articles (10/2015 - 11/2005)
5.	Lin, Ling: 36 articles (10/2015 - 06/2002)
6.	Sakurai, Takeshi: 35 articles (06/2015 - 12/2002)
7.	Mignot, E: 32 articles (10/2012 - 01/2000)
8.	Lammers, Gert Jan: 31 articles (04/2015 - 10/2002)
9.	Overeem, Sebastiaan: 28 articles (10/2015 - 10/2002)
10.	Kanbayashi, Takashi: 27 articles (10/2015 - 03/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Narcolepsy:

1.	modafinil (armodafinil)FDA Link 01/01/2005 - "The clinical efficacy of modafinil, combined with improved safety over CNS stimulants, has made it the most prescribed medication for the treatment of ES associated with narcolepsy. " 10/01/2011 - "Because of its high safety and low side-effect profiles, modafinil has become the first-line treatment of choice for EDS associated with narcolepsy. " 09/01/2009 - "Compared with placebo, mean sleep latency (coprimary endpoint) was significantly improved with armodafinil 150 or 250 mg once daily in patients with OSA or narcolepsy, and with armodafinil 150 mg once daily in patients with SWSD, as assessed by the Multiple Sleep Latency Test (MSLT) or the Maintenance of Wakefulness Test (MWT). " 01/15/2007 - "In conclusion, modafinil did not influence thymopsychic variables in narcolepsy, but it significantly improved cognitive performance, which may be related to medial prefrontal activity processes identified by LORETA." 04/01/2006 - "Armodafinil significantly improved ability to sustain wakefulness throughout the day in patients with narcolepsy. "
2.	Sodium Oxybate (gamma Hydroxybutyrate)FDA Link 09/01/2009 - "The nightly administration of sodium oxybate results in significant reduction in the nocturnal sleep disruption of patients with narcolepsy." 02/01/2002 - "Sodium oxybate significantly improved symptoms in patients with narcolepsy and was well tolerated." 10/15/2005 - "When combined with its previously demonstrated anticataplectic effects, the results of the current study indicate sodium oxybate is the first drug to demonstrate efficacy for the 2 major symptoms of narcolepsy." 10/15/2005 - "A double-blind, placebo-controlled study demonstrates sodium oxybate is effective for the treatment of excessive daytime sleepiness in narcolepsy." 03/01/2008 - "Sodium oxybate appears to be an effective and well-tolerated treatment for all the key symptoms of the two forms of narcolepsy."
3.	Methylphenidate (Ritalin)FDA LinkGeneric 01/15/2012 - "Methylphenidate (MPH) is a drug that is licensed for treatment of ADHD and also narcolepsy. " 01/01/2012 - "Clinically, methylphenidate is prescribed for the symptomatic treatment of ADHD and narcolepsy; although lately, there has been an increased incidence of its use in individuals not meeting the criteria for these disorders. " 06/01/2009 - "When methylphenidate was used for disorders other than narcolepsy, such as depression, dependence on the drug and abuse became an issue, and methylphenidate is no longer available for depression. " 02/01/2001 - " (3) According to the results of our literature search, which includes a clinical expert report from Novartis Pharma, the file on methylphenidate in narcolepsy is mainly based on "clinical experience": only three case series, totalling fewer than 200 patients, have been published. " 02/01/2001 - " (2) After many years of off-license use in the treatment of narcolepsy, methylphenidate is now licensed for this indication in France. "
4.	Antidepressive Agents (Antidepressants)IBA 01/01/2008 - "There was no good quality evidence that antidepressants are effective for narcolepsy or improve quality of life. " 01/01/2005 - "There was no good quality evidence that antidepressants are effective for narcolepsy or improve quality of life. " 01/01/2008 - "There is a clear need for well-designed randomised controlled trials to assess the effect of antidepressants on narcolepsy." 01/01/2005 - "There is a clear need for well-designed randomised controlled trials to assess the effect of antidepressants on narcolepsy." 01/01/2008 - "Antidepressant drugs for narcolepsy."
5.	orexins (orexin)IBA 11/01/2003 - "It is very useful to measure CSF orexin for the diagnosis of early onset narcolepsy." 05/07/2014 - "Conditional ablation of orexin/hypocretin neurons: a new mouse model for the study of narcolepsy and orexin system function." 01/01/2013 - "Although studies on hypocretin-deficient mice have shown that hypocretin plays an essential role in reward-seeking, depression-like behavior and addiction, results in human narcolepsy remained subject to debate. " 01/01/2013 - "The current study determined the effects of orexin gene transfer into the dorsolateral pontine neurons in the orexin knockout (KO) mice model of narcolepsy. " 11/01/2012 - "Animal models and human studies concordantly show that the disturbed hypocretin system is the probable cause of narcolepsy. "
6.	AmphetaminesIBA 04/01/1993 - "Amphetamines and narcolepsy: use of the Stanford database." 02/28/1991 - "Narcolepsy--attitudes and amphetamines." 11/01/1975 - "Amphetamines had been given to 71 patients for periods of up to 33 years with adequate, but rarely complete, control of narcolepsy. " 02/01/2009 - "Although they have long been used effectively to treat attention deficit hyperactivity disorder (ADHD) in children and adolescents, amphetamines are now being prescribed increasingly as maintenance therapy for ADHD and narcolepsy in adults, considerably extending the period of potential exposure. " 02/01/1999 - "There is no cure for narcolepsy; however, symptomatic relief may be achieved through a trial-and-error combination of amphetamines and tricyclic antidepressants. "
7.	Intravenous Immunoglobulins (IVIG)FDA Link 12/01/2003 - "Clinical efficacy of high-dose intravenous immunoglobulins near the onset of narcolepsy in a 10-year-old boy." 09/01/2006 - "In another uncontrolled study, IVIg reduced the number of cataplectic attacks in narcolepsy patients. " 07/01/2006 - "Follow-up of four narcolepsy patients treated with intravenous immunoglobulins." 01/01/2006 - "Recent pilot open trials with intravenous immunoglobulins appear an effective treatment of cataplexy if applied at early stages of narcolepsy. " 10/01/2008 - "Our data partially support the recent report of the efficacy of IVIg treatment in early diagnosed narcolepsy with cataplexy and support the need for a controlled multicenter clinical trial on IVIg in narcolepsy."
8.	Baclofen FDA LinkGeneric 01/01/2015 - "A recent report of a murine model of narcolepsy-cataplexy suggests R-baclofen has potential efficacy against cataplexy. " 01/01/2015 - "Baclofen for narcolepsy with cataplexy: two cases." 06/01/2007 - "Differential involvement of GABA(B) receptor subtypes, or differential interactions with GABA(B) receptors, may possibly explain why GHB is effective for treating narcolepsy and is abused whereas baclofen is not." 01/01/2011 - "The aim of this paper is to provide a review of the human clinical studies of sodium oxybate and baclofen regarding sleep and the treatment of sleep disorders including narcolepsy and insomnia, as well as other disorders involving disrupted sleep such as fibromyalgia." 08/01/2008 - "Differential interactions of glutamate with the GABA(B) receptor mechanisms mediating the effects of GHB and baclofen may explain why GHB is effective for treating narcolepsy and is abused, whereas baclofen is not."
9.	Clomipramine (Anafranil)FDA LinkGeneric 02/01/2002 - "In patients with narcolepsy, abrupt withdrawal of chronic treatment with clomipramine may be associated with status cataplecticus. " 08/10/1981 - "[Treatment of associated symptoms in narcolepsy with clomipramine (Anafranil)]." 01/01/1980 - "Clomipramine is known to suppress REM sleep, and this property may be of value in treating certain features of narcolepsy. " 01/01/1980 - "The use of clomipramine as an REM sleep suppressant in narcolepsy." 07/01/1976 - "Clinical examinations, questionnaires, and 24- or 36-hour polygraphic recordings were performed on 21 adult patients with the narcolepsy syndrome to investigate the short- and long-term effects of clomipramine HCL. "
10.	GABA-B Receptors (Receptor, GABA-B)IBA 06/01/2007 - "Differential involvement of GABA(B) receptor subtypes, or differential interactions with GABA(B) receptors, may possibly explain why GHB is effective for treating narcolepsy and is abused whereas baclofen is not." 08/01/2008 - "Differential interactions of glutamate with the GABA(B) receptor mechanisms mediating the effects of GHB and baclofen may explain why GHB is effective for treating narcolepsy and is abused, whereas baclofen is not." 06/01/2005 - "gamma-Hydroxybutyrate (GHB), a therapeutic for narcolepsy and a drug of abuse, has several mechanisms of action that involve GHB and GABA(B) receptors, metabolism to GABA, and modulation of dopaminergic signaling. " 01/01/2002 - "Since the sensitivity of GABA(C) receptors for GABA is higher than that of GABA(A) and GABA(B) receptors, GABA(C) receptor agonists and antagonists, when available for clinical practice, could open up a new era for therapy of troubles such as insomnia, epilepsy and narcolepsy. "

Therapies and Procedures

1.	Drug Therapy (Chemotherapy) 12/01/2015 - "In narcolepsy, unlike OSA, drug therapy is the current mainstay of treatment. " 02/01/1997 - "While this study did not examine symptom ratings on and off drug therapy, these findings do suggest that narcoleptics may have to utilize behavioral strategies with their medication regimens to effectively cope with narcolepsy's adverse effects on daily life." 10/01/2010 - "We discuss some of the issues surrounding parturients with narcolepsy including drug therapy and choice of anaesthetic technique." 07/01/2010 - "Expert opinion on pharmacotherapy of narcolepsy." 04/01/2007 - "No previous research has examined the psychosocial adjustment of chronic narcolepsy patients following efficacious pharmacotherapy. "
2.	Transplantation (Transplant Recipients) 06/01/2005 - "In the future, for atypical cases(poorly responsive to therapy), genetic, CSF, and brain imaging studies, and possibly even neuronal transplantation may prove beneficial in the assessment and treatment of idiopathic narcolepsy."
3.	Immunotherapy 01/01/2013 - "Narcolepsy of recent onset in children or adolescents should be considered a therapeutic emergency, even though immunotherapy is still controversial." 06/01/2008 - "Careful titration up to an adequate level is essential both to obtain positive results and avoid adverse effects; 3) A series of new treatments are currently being tested, either in animal models or in humans, They include novel stimulant and anticataplectic drugs, endocrine therapy, and, more attractively, totally new approaches based on the present state of knowledge of the pathophysiology of narcolepsy with cataplexy, hypocretine-based therapies, and immunotherapy." 08/01/2011 - "Narcolepsy-cataplexy induced by a cow milk oral immunotherapy protocol?" 03/01/2010 - "These potential options include novel stimulant and anticataplectic drugs as well as immunotherapy, based on current knowledge of the pathophysiology of narcolepsy with cataplexy. "
4.	Aftercare (After-Treatment) 01/01/2014 - "SXB stimulated lipolysis in narcolepsy patients, possibly accounting for the weight loss after treatment. " 10/01/2012 - "The paper reviewed the related literature and reported a case of long-term drinking induced narcolepsy which was significantly improved after treatment with paroxetine and dexzopiclone." 01/01/2009 - "Increase in sleep-related breathing disturbances after treatment with sodium oxybate in patients with narcolepsy and mild obstructive sleep apnea syndrome: two case reports." 04/15/2009 - "Prospective evaluation of unselected traumatic brain injury patients with nocturnal polysomnography (NPSG), multiple sleep latency test (MSLT), Epworth Sleepiness Scale (ESS), and neuropsychological testing including Psychomotor Vigilance Test (PVT), Profile of Mood States (POMS), and Functional Outcome of Sleep Questionnaire (FOSQ) before and after treatment with continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA), modafinil (200 mg) for narcolepsy and posttraumatic hypersomnia (PTH), or pramipexole (0.375 mg) for periodic limb movements in sleep (PLMS). "
5.	Renal Dialysis (Hemodialysis) 07/01/2015 - "The percentage of sleep disorders in hemodialysis patients were as follows: insomnia (69%), followed by obstructive sleep apnea syndrome OSAS (24%), RLS and periodic limb movement PLM (18%), nightmares (13%), EDS (12%), sleepwalking (2%), possible rapid eye movement behavior disorders RED (2%), possible narcolepsy (1.4%). " 05/01/1996 - "Effective treatment of narcolepsy with codeine in a patient receiving hemodialysis."