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Medications for Narcolepsy

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, talk to your doctor.

Prescription Medications

Stimulants

  • Mazindol
  • Modafinil
  • Armodafinil
  • Methylphenidate
  • Dextroamphetamine

Anticataplexy Medication

  • Sodium oxybate

Tricyclic antidepressants

  • Imipramine
  • Desipramine
  • Clomipramine
  • Protriptyline

Selective serotonin reuptake inhibitors (SSRIs)

  • Fluoxetine
  • Paroxetine
  • Sertraline
Stimulants

Common names include:

  • Modafinil
  • Armodafinil
  • Mazindol
  • Methylphenidate
  • Dextroamphetamine

Stimulants can help you be more alert and awake. While using stimulant medications, you should take the following precautions:

  • To avoid difficulty sleeping at night, ask your doctor about taking your last dose before 6:00 pm.
  • Do not suddenly stop taking a stimulant drug.
  • Have your doctor approve any other medications you take while you are using stimulant medications. Stimulants can interact with a number of over-the-counter medications.
  • If you are taking sustained-release tablets, never crush or chew them.
  • If you have a history of seizures, tell your doctor. Your medications will have to be carefully chosen.

You may experience the following side effects:

  • Decreased appetite with potential weight loss
  • Insomnia
  • High blood pressure
  • Increased agitation, anxiety, jitteriness, or jumpiness
  • Vomiting, nausea, decreased appetite
  • Increased heart rate and arrhythmia
  • Lightheadedness, drowsiness, or blurred vision
  • Serious rash

Note: You may notice these things when you first begin taking a stimulant medication. Until you know how the medication will affect you, you should avoid driving, operating machinery, and doing hazardous activities.

Anticataplexy Medication
  • Sodium oxybate

Sodium oxybate is used to treat cataplexy. It is a drug that can be abused, so it is a controlled substance. Abuse can cause serious problems, such as trouble breathing, seizures, loss of consciousness, coma, and death. Abuse can also lead to dependence, craving, and withdrawal symptoms. If you are prescribed sodium oxybate, you will have to get the medicine from one central pharmacy. It is not available anywhere else.

Sodium oxybate can reduce the number of cataplexy attacks, but it must be taken exactly as prescribed. The medication works very fast, so you need to take it only when you are ready to fall asleep. Sodium oxybate must be taken in 2 doses each night. The first dose is taken right at bedtime and the second dose is taken 2½-4 hours later. You will probably need to wake yourself up to take the second dose. The most common side effects are nausea, lightheadedness, headache, sleep problems, confusion, vomiting, and bedwetting.

Do not engage in activities that require alertness, such as driving, for 6 hours after taking the medication. Do not use alcohol or other sedatives while taking this medication. Your doctor must instruct you in the safe and effective use of this medication.

Tricyclic Antidepressants

Common names include:

  • Imipramine
  • Desipramine
  • Clomipramine
  • Protriptyline

You may be given a tricyclic antidepressant if you have symptoms, such as attacks of weakness, hallucinations as sleep begins, or sleep paralysis. To avoid stomach upset, take your tricyclic antidepressants with food, unless your doctor has told you otherwise.

Possible side effects include:

  • Dry mouth
  • Lightheadedness, drowsiness, or blurred vision
  • Low or high blood pressure
  • Constipation
  • Increased effects from alcohol, sleeping pills, tranquilizers, or sedatives
  • Sensitivity to sun
  • Blood sugar changes in people with diabetes
  • Hyperthermia—elevated body temperature
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients. Young adults may be at a higher risk for this side effect.
Selective Serotonin Reuptake Inhibitors (SSRIs)

Common names include:

  • Fluoxetine
  • Paroxetine
  • Sertraline

You may be given an SSRI to treat weakness, hallucinations as sleep begins, or sleep paralysis. If this medication upsets your stomach, you can take it with food.

Do not take monoamine oxidase (MAO) inhibitors:

  • During SSRI therapy
  • For two weeks prior to starting SSRI therapy
  • For five weeks after stopping SSRI therapy

Serious side effects of SSRI antidepressants include:

  • Anxiety
  • Mania
  • Serious weight loss
  • Weight gain
  • Seizures
  • Low blood sugar in people with diabetes
  • Lightheadedness, drowsiness, or blurred vision
  • Arrhythmia
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients. Young adults may be at a higher risk for this side effect.

Note: You may notice these symptoms when you first begin taking a medication. Until you know how the medication will affect you, you should avoid driving, operating machinery, and doing hazardous activities.

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Plan ahead for refills if you need them.
  • Do not share your prescription medication with anyone.
  • Medications can be dangerous when mixed. Talk to your doctor if you are taking more than one medication, including over-the-counter products and supplements.

Revision Information

  • Antidepressant use in children, adolescents, and adults. Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Updated April 13, 2016. Accessed May 18, 2016.

  • Narcolepsy. American Sleep Association website. Available at: https://www.sleepassociation.org/patients-general-public/narcolepsy. Updated September 2007. Accessed May 18, 2016.

  • Narcolepsy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 4 2016. Accessed May 18, 2016.

  • Narcolepsy fact sheet. National Heart, Lung, and Blood Institute website. Available at: http://www.ninds.nih.gov/disorders/narcolepsy/detail%5Fnarcolepsy.htm. Updated April 6, 2016. Accessed May 18, 2016.

  • Xyrem (sodium oxybate) information. Center for Drug Evaluation and Research website. Available at: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm332408.htm. Updated July 24, 2015. Accessed May 18, 2016.

  • 2/18/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.