Pharmacological management of narcolepsy with and without cataplexy.

Kallweit, Ulf; Bassetti, Claudio (2017). Pharmacological management of narcolepsy with and without cataplexy. Expert opinion on pharmacotherapy, 18(8), pp. 809-817. Informa Healthcare 10.1080/14656566.2017.1323877

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INTRODUCTION

Narcolepsy is an orphan neurological disease and presents with sleep-wake, motoric, neuropsychiatric and metabolic symptoms. Narcolepsy with cataplexy is most commonly caused by an immune-mediated process including genetic and environmental factors, resulting in the selective loss of hypocretin-producing neurons. Narcolepsy has a major impact on workableness and quality of life. Areas covered: This review provides an overview of the temporal available treatment options for narcolepsy (type 1 and 2) in adults, including authorization status by regulatory agencies. First- and second-line options are discussed as well as combination therapies. In addition, treatment options for frequent coexisting co-morbidities and different phenotypes of narcolepsy are presented. Finally, this review considers potential future management strategies. Non-pharmacological approaches are important in the management of narcolepsy but will not be covered in this review. Expert opinion: Concise evaluation of symptoms and type of narcolepsy, coexisting co-morbidities and patients´ distinct needs is mandatory in order to identify a suitable, individual pharmacological treatment. First-line options include Modafinil/Armodafinil (for excessive daytime sleepiness, EDS), Sodium Oxybate (for EDS and/with cataplexy), Pitolisant (for EDS and cataplexy) and Venlafaxine (for cataplexy (off-label) and co-morbid depression). New symptomatic and causal treatment most probably will be completed by hypocretin-replacement and immune-modifying strategies.

Item Type:	Journal Article (Review Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
UniBE Contributor:	Kallweit, Ulf, Bassetti, Claudio L.A.
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1465-6566
Publisher:	Informa Healthcare
Language:	English
Submitter:	Stefanie Hetzenecker
Date Deposited:	27 Feb 2018 12:48
Last Modified:	02 Mar 2023 23:29
Publisher DOI:	10.1080/14656566.2017.1323877
PubMed ID:	28443381
Uncontrolled Keywords:	Narcolepsy cataplexy co-morbidities excessive daytime sleepiness hypocretin management pharmacological treatment
URI:	https://boris.unibe.ch/id/eprint/107971