How is narcolepsy treated?

Many doctors prescribe the drug modafinil (Provigil) first for narcolepsy because it is less addictive and has fewer side effects compared to other stimulants. Other medications prescribed for narcolepsy include methylphenidate (Ritalin) or amphetamines.

Selective serotonin reuptake inhibitors (SSRIs) and antidepressants are often prescribed to treat cataplexy and other narcolepsy symptoms, including hallucinations and sleep paralysis. The effects vary depending on the medication your doctor recommends. In severe cases of cataplexy, your doctor may prescribe sodium oxybate.
Although there is no cure for narcolepsy, individualized treatments can help reduce symptoms, although it may take weeks or months to find what works best for you. Lifestyle approaches, such as taking three or more short, scheduled naps throughout the day, may help control excessive daytime sleepiness (EDS) and help you stay alert. However, daytime naps can't replace nighttime sleep.

Prescription medications may also help. These include:
  • Modafinil (Provigil) and armodafinil (Nuvigil), which are considered first-line drug treatments for narcolepsy. These medications help you stay awake but don't interfere with nighttime sleep. They work on the sleep/wake centers of the brain so you are less likely to feel jittery or overly stimulated as you might with caffeine or other stimulant medications.
  • Central nervous system stimulants. These include dextroamphetamine sulfate (Dexedrine) and methylphenidate hydrochloride (Ritalin). Although these drugs are usually effective in people with narcolepsy, they also produce some undesirable side effects and so must be carefully monitored.
  • Antidepressants. Several categories are prescribed to treat symptoms of narcolepsy. One category includes tricyclic antidepressants, such as imipramine (Tofranil), clomipramine (Anafranil) and protriptyline (Vivactil). Other antidepressants commonly used are the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft). Venlafaxine (Effexor) has properties similar to the SSRIs and is also sometimes used to treat the symptoms of narcolepsy. These drugs can produce multiple side effects. There is some evidence that antidepressants may increase suicide risk in some people, especially in children and adolescents, according to the U.S. Food and Drug Administration (FDA). Discuss this risk with your doctor and always review medication packaging information.
  • Sodium oxybate (Xyrem). Sodium oxybate helps control cataplexy in people with narcolepsy. It works to improve sleep, and in higher doses, to control daytime sleepiness. However, because it has been associated with serious side effects, such as trouble breathing during sleep and bed wetting, it's strictly regulated by the FDA.
If you have narcolepsy and other health conditions, such as high blood pressure or heart disease, make sure you talk with your doctor about any possible medication interactions.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
There is no cure for narcolepsy—yet—but you can manage it. For example, you may learn by keeping a journal that you experience cataplexy (sudden muscle tone loss) more often after an emotional moment, or that eating a heavy meal always causes an unplanned nap. Medications may also help.

The treatment for narcolepsy usually involves taking medications to reduce sleepiness during the day and in those who have cataplexy, other medications to prevent cataplexy. The medications to prevent sleep during the day are a group of medicines called stimulants that includes Ritalin, Adderall, Dexedrine, Provigil and others. Cataplexy is usually treated with antidepressant medications that repress REM (dreaming) sleep such as Tofranil, Norpramin, Prozac, Paxil and Zoloft.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.