Narcolepsy. Signs, symptoms, differential diagnosis and treatment

ABSTRACT

Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness and cataplexy and, less commonly, by hypnagogic hallucinations and sleep paralysis. While patients report excessive daytime sleepiness and cataplexy as the most common symptoms of this condition, excessive daytime sleepiness is generally believed to be the most debilitating. Narcolepsy is often undiagnosed or misdiagnosed for a variety of reasons. Although confirmation of an initial diagnosis requires monitoring of physiological variables performed in a sleep center by specialists, the primary care physician has a fundamental role in the identification and treatment of this incurable condition. This article provides recommendations for the diagnosis and treatment of narcolepsy. Cataplexy associated with narcolepsy can be controlled with tricyclic antidepressants. Excessive sleepiness is controlled with stimulants, but newer agents, such as modafinil, which will be marketed as Provigil, and selegiline hydrochloride, with fewer adverse effects and less potential for abuse, may offer a means to promote daytime wakefulness. Groups such as the National Sleep Foundation, Washington, DC, and Narcolepsy Network, Cincinnati, Ohio, can provide patients with the necessary support and information.

• orexins
  
• Adrafinil
  
• selegiline
  
• Glutamate
  
• Narcolepsy
• Modafinil: review
• Modafinil: structure
• Modafinil and serotonin
  
• Narcolepsy: causes
  
• Modafinil as an antidepressant
• Orexins to treat narcolepsy
  
• Excessive daytime sleepiness
• Modafinil as an antidepressant
• Modafinil versus amphetamine
  
• Modafinil versus methylphenidate