Narcolepsy is a neurological condition that affects typical sleep-wake cycles and can severely affect daily activities. Many medications are available to treat the condition and its symptoms, such as modafinil and antidepressants.

Narcolepsy is a long-term condition that affects sleep patterns. The condition may cause excessive sleepiness during the day and disrupted sleep at night. This can result in difficulties performing daily activities.

The National Institute of Neurological Disorders and Stroke (NINDS) states that narcolepsy affects around 135,000—200,000 people in the United States. It typically starts during childhood, adolescence, or young adulthood.

The symptoms of narcolepsy include:

The disruptions to sleep patterns can cause additional problems, such as depression, fatigue, and overeating.

There are two primary types of narcolepsy. Type 1 causes cataplexy with the other symptoms. A low level of hypocretin is a possible cause of this condition, which is a brain chemical for regulating sleep. Type 2 occurs without cataplexy. People with this form of the condition have a typical level of hypocretin, and the cause of the condition is unclear.

People with narcolepsy typically require medication to manage their condition and maintain a regular lifestyle. The goal of treatment is to increase daytime alertness and reduce sleep disruptions at night. This reduces symptoms of the condition and improves people’s quality of life.

In this article, we discuss the types of medication someone with narcolepsy might take, as well as other available treatments.

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Excessive daytime sleepiness is a major symptom of narcolepsy that can be highly disruptive to daily life. Doctors may prescribe medications to address this symptom, such as:

  • Modafinil: Available as the brand-name drug Provigil, modafinil is a first-line prescription medication that stimulates the central nervous system (CNS). Doctors typically prescribe this medication first because it is less addictive and has fewer side effects than other stimulants. Modafinil can increase alertness and reduce daytime tiredness.
  • Armodafinil: This is a similar medication to modafinil that can also improve wakefulness.
  • Amphetamine-like stimulants: Doctors may prescribe amphetamine-like stimulants where modafinil is not effective. These powerful stimulants can alleviate daytime sleepiness. However, they can be addictive and cause several side effects, such as nervousness and heart rhythm disruptions. Examples include methylphenidate and dexamfetamine.
  • Solriamfetol: Available as the brand-name drug Sunosi, solriamfetol is a dopamine-norepinephrine reuptake inhibitor that can help reduce daytime sleepiness. Research suggests that solriamfetol is similarly effective to modafinil in treating daytime sleepiness.

Medications for treating cataplexy include:

  • Antidepressants: Tricyclic antidepressants and selective serotonin and noradrenergic reuptake inhibitors are both effective at reducing cataplexy. They have fewer side effects than amphetamines. However, they can still cause problems in some people, such as impotence or high blood pressure.
  • Sodium oxybate: Available as the brand-name drug Xyrem, sodium oxybate treats narcolepsy by reducing daytime sleepiness and cataplexy. It works by depressing the CNS and increasing deep sleep during rest. Additionally, lower sodium oxybate alternatives are available for individuals with cardiovascular disease, hypertension, or kidney disease.
  • Pitolisant: Available as the brand-name drug Wakix, pitolisant is another drug that affects the CNS to treat excessive daytime sleepiness and cataplexy.

Medications are an important way of treating excessive daytime sleepiness and cataplexy in people with narcolepsy. Doctors may also prescribe other treatments alongside or sometimes instead of medications. These treatments will depend on several factors, including the person’s age, tolerance to medications, and the severity of the disease.

NINDS suggests several lifestyle changes that can help people with narcolepsy to maintain alertness during the day and sleep better at night. These include:

  • taking short naps during the day and scheduled intervals
  • maintaining a regular bedtime and waking time
  • avoiding caffeine and alcohol, if applicable
  • exercising regularly
  • avoiding large meals before bed
  • relaxing before bed
  • avoiding smoking

They also highlight the importance of taking safety precautions, particularly when driving.

Researchers are investigating several experimental medications to help with narcolepsy. For example, hypocretin may influence the development of narcolepsy, so researchers are investigating whether manipulating these cells can treat narcolepsy.

Genetic factors may play a role in the development of narcolepsy. As such, gene therapy may be another avenue for future treatments. For example, gene therapy could help people with narcolepsy to produce sleep-regulating proteins.

Learn about good sleep hygiene here.

Narcolepsy is a long-term condition that causes disruptions to the sleep-wake cycle. The two primary symptoms of narcolepsy are excessive daytime sleepiness and cataplexy. These symptoms can make it difficult for people to perform typical daily activities without treatment.

Doctors typically prescribe medications to treat daytime sleepiness, such as modafinil. There are also medications available for treating cataplexy, including antidepressants. Some medications can treat both symptoms, such as pitolisant.

Lifestyle changes that help someone maintain good sleep hygiene can also support treatment for narcolepsy, such as aiming for a consistent bedtime and taking scheduled naps.