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 and Bassetti, Claudio

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:

27 Feb 2018 12:48

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

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