Abstract | BACKGROUND:
Narcolepsy is a disorder of the central nervous system, the main symptoms of which are excessive daytime sleepiness (EDS) and cataplexy (an abrupt and reversible decrease in or loss of muscle tone, affecting the limbs and/or trunk, elicited by emotional stimuli). Narcolepsy has an adverse impact on people's quality of life. Together with stimulant drugs (used to control EDS), antidepressants are usually recommended to counteract cataplexy. In addition, some antidepressants are also reported to improve EDS. OBJECTIVES: SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2003), MEDLINE (1966 to 2003), EMBASE (1980 to 2003), PsycINFO (1872 to 2003), and CINAHL (1981 to 2003). Bibliographies of identified articles were reviewed to find additional references. Unpublished randomised trials were searched for by consulting governmental and non-governmental clinical trial registers, disease-specific websites, investigators and experts in the field, pharmaceutical companies/manufacturers. SELECTION CRITERIA: DATA COLLECTION AND ANALYSIS: Two reviewers independently selected trials for inclusion and extracted data. Outcomes were: (a) elimination of EDS; (b) mean reduction of EDS; (c) elimination of cataplexy; (d) 50% or greater reduction in cataplexy frequency; (e) mean reduction of cataplexy; (f) mean improvement in quality of life; (g) adverse events; (h) withdrawal from treatment. MAIN RESULTS: Two cross-over trials were included. The methodological quality of both studies was unclear and so the influence of common biases was impossible to define. As the trials tested two different comparisons (one femoxetine versus placebo, the other fluvoxamine versus clomipramine) meta-analysis was not performed. In the first trial (10 participants) femoxetine had no significant effect in eliminating or reducing EDS; a significant reduction of cataplexy was in favour of femoxetine. Mild and transient side effects were reported in the femoxetine treatment period by two participants. In the second trial the authors inappropriately treated the trial design as a parallel study and no conclusions can be reached in favour of either drug. AUTHORS' CONCLUSIONS:
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Authors | L Vignatelli, R D'Alessandro, L Candelise |
Journal | The Cochrane database of systematic reviews
(Cochrane Database Syst Rev)
Issue 3
Pg. CD003724
(Jul 20 2005)
ISSN: 1469-493X [Electronic] England |
PMID | 16034909
(Publication Type: Journal Article, Review, Systematic Review)
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Chemical References |
- Antidepressive Agents
- Piperidines
- femoxetine
- Clomipramine
- Fluvoxamine
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Topics |
- Antidepressive Agents
(therapeutic use)
- Cataplexy
(drug therapy)
- Clomipramine
(therapeutic use)
- Fluvoxamine
(therapeutic use)
- Humans
- Narcolepsy
(drug therapy)
- Piperidines
(therapeutic use)
- Randomized Controlled Trials as Topic
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