Emerging therapies in narcolepsy-cataplexy

Sleep. 2005 Jun;28(6):754-63. doi: 10.1093/sleep/28.6.754.

Abstract

In the past, narcolepsy was primarily treated using amphetamine-like stimulants and tricyclic antidepressants. Newer and novel agents, such as the wake-promoting compound modafinil and more selective reuptake inhibitors targeting the adrenergic, dopaminergic, and/or serotoninergic reuptake sites (ie, venlafaxine, atomoxetine) are better-tolerated available alternatives. The development of these agents, together with sodium oxybate (a slow-wave sleep-enhancing agent that consolidates nocturnal sleep, reduces cataplexy, and improves sleepiness), has led to improved functioning and quality of life for many patients with the disorder. However, these treatments are all symptomatically based and do not target hypocretin, a major neurotransmitter involved in the pathophysiology of narcolepsy. In this review, we discuss emerging therapies in the area of narcolepsy. These include novel antidepressant or anticataplectic, wake-promoting, and hypnotic compounds. We also report on novel strategies designed to compensate for hypocretin deficiency and on the use of immunosupression at the time of narcolepsy onset.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Genetic Therapy
  • Histamine Agonists / pharmacology
  • Histamine Agonists / therapeutic use*
  • Histamine Antagonists / pharmacology
  • Histamine Antagonists / therapeutic use*
  • Humans
  • Hypnotics and Sedatives / pharmacology
  • Hypnotics and Sedatives / therapeutic use*
  • Narcolepsy / drug therapy*
  • Narcolepsy / therapy
  • Sleep / drug effects

Substances

  • Histamine Agonists
  • Histamine Antagonists
  • Hypnotics and Sedatives