Treating Your Narcolepsy

You can’t cure your narcolepsy. But, you can manage your condition and regain control of your life by treating your narcolepsy symptoms. Your healthcare provider will discuss pharmaceutical or non-pharmaceutical treatment options with you. They will come up with a treatment plan to meet your specific needs. These are some of your options to treat some of your narcolepsy symptoms.

Pharmaceutical Options

Your healthcare provider prescribes medications to treat your narcolepsy symptoms. We call these pharmaceutical options. You may use one or more of these medicines to treat your narcolepsy.

Stimulants

Healthcare providers commonly prescribe stimulants to treat some of your narcolepsy symptoms, namely your excessive daytime sleepiness. Stimulants stimulate your nervous system and help you stay awake. These are some of the stimulants you make take to treat your narcolepsy symptoms.

Caffeine

Caffeine and caffeinated beverages are known to reverse sleepiness. That’s their job! But did you know that they also promote wakefulness? Caffeine supplements or caffeinated drinks like coffees, teas, and sodas help you stay awake and alert because of their stimulating nature.

Your healthcare provider may be reluctant to recommend caffeine. That’s because caffeine has known effects on your heart. This doesn’t mean that you have to avoid caffeine at all costs. Unless, of course, you are sensitive to caffeine. Or you consume too much of it. Caffeine in small doses can increase your energy.

Modafinil

Modafinil is another stimulant that treats some of your narcolepsy symptoms. Namely your excessive drowsiness, disturbed sleep habits, and your sudden muscle toss. Modafinil helps you stay alert and gets rid of your fatigue and daytime drowsiness.

How modafinil does this, we’re not sure. We suspect that it binds to certain chemicals in your brain. And when it binds to them, it helps create lots of them, one of them being the chemicals that affect your sleep.

It seems that stimulants cause stomach or neurological side effects in some people. Modafinil is no different. But it appears that side effects are mild and include nausea, diarrhea, headaches, insomnia, and even anxiety.

Pilostant

Pilostant is a relatively new drug that healthcare providers use to treat your excessive daytime drowsiness. Providers are more likely to prescribe this medication to you. This makes it a first-line medication to treat your narcolepsy. We consider it a stimulant, but it is different from other stimulants. 

Other stimulants focus on your brain’s ability to produce more chemicals that regulate your sleep-wake cycle. Pilostant is a bit different. It does stimulate those chemicals in your brain. But it does so by binding to and blocking your body’s histamine receptors. These receptors are important for regulating your body’s inflammation and your cognition, energy levels, and sleep-wake cycle.

Your provider may recommend that you use Pilostant alone or with other medications to treat your narcolepsy. Their decision is influenced by how well you tolerate the treatment and your unique health needs. Even though we consider Pilostant a different stimulant, it can cause similar side effects, like headaches, nausea, insomnia, and depression. For many of you, your side effects are mild and resolve when you stop treatment.

Sodium Oxybate

Healthcare providers prescribe sodium oxybate to treat the majority of your narcolepsy symptoms. Most medications treat one of your symptoms, like your excessive drowsiness or your sudden muscle loss. Sodium oxybate is different because it treats both. It’s also the only drug the FDA has approved to treat your sudden muscle loss.

We know that sodium oxybate depresses your central nervous system. But we aren’t sure how it does that. We think it stimulates a chemical in your brain whose job is to decrease activity in your nervous system.

Sodium oxybate can cause side effects like other stimulants, such as nausea, headaches, insomnia, and dizziness. But those aren’t the only side effects. It may cause involuntary urination, fecal incontinence, psychosis, suicidal ideation, swelling, worsening muscle loss, mood swings, loss of appetite, or GERD in some people. The good news is that these side effects often resolve once you stop treatment. However, you should contact your healthcare provider immediately if you have one of those side effects.

Solriamfetol

Solriamfetol is another stimulating drug that healthcare providers prescribe to treat your excessive daytime drowsiness. It’s similar to other stimulants that increase your brain’s production of a chemical that regulates your sleep-wake cycle. But it also affects your stress hormones.

Solriamfetol can cause many of the same side effects as other stimulants, such as headaches, nausea, insomnia, and mental health problems. It can also cause chest pain, respiratory infections, the flu, and weight problems. Your side effects resolve when you stop taking this medication.

Methylphenidate

Methylphenidate is another stimulant drug that treats narcolepsy symptoms. But it wouldn’t be your first option; it’s considered a second-line medicine for treating your narcolepsy. It has the same effects on your brain as other stimulants, where your brain produces chemicals that regulate your sleep-wake cycle. Much like other stimulant drugs, methylphenidate decreases your daytime sleepiness while also increasing your focus and attention.

Methylphenidate can cause side effects like other stimulants, such as stomach problems, weight problems, and it can even cause insomnia. More dangerous side effects occur when you misuse or abuse your medication. Consult with your healthcare provider immediately if you notice any new or worsening side effects while taking methylphenidate.

Dextroamphetamine

Dextroamphetamine is a stimulant that your healthcare provider may prescribe for treating your narcolepsy symptoms. It stimulates your central nervous system and increases your brain’s production of dopamine. Dopamine is a chemical that regulates your sleep-wake cycle. So, dextroamphetamine helps to regulate your sleep pattern.

But dextroamphetamine isn’t without side effects. First, it can affect your cognition. But that’s not the only side effect. It also causes gastrointestinal problems, like stomach pains, weight loss, and even anorexia. Your healthcare provider may consider other medications before prescribing this.

Amphetamines

Amphetamines are another class of stimulating drugs that treat your narcolepsy. They are the last option for treating your narcolepsy symptoms. These drugs stimulate your brain. Much like Dextroamphetamine, Amphetamines stimulate the production of different hormones in your brain that regulate your sleep-wake cycle and stress levels.

Amphetamines rid of your daytime drowsiness and make you feel awake and alert. They increase your energy and, for some, induce feelings of euphoria and pleasure. 

Your healthcare provider may recommend that you use amphetamines with dextroamphetamine. This is because you’re given amphetamines in small doses, and they may not be effective on their own. Despite this, you should use your medications as prescribed. Amphetamine misuse or abuse affects not just your physical health but also your emotional and mental health.

Antidepressants

Did you know that certain antidepressant medications may treat narcolepsy? We say may because the Food and Drug Administration (FDA) hasn’t approved them for treating all narcolepsy symptoms. These medications may not do much to treat your daytime sleepiness. But they seem promising for treating your cataplexy. So your healthcare provider may recommend that you use one of these antidepressants with a stimulant.

Venlafaxine

Venlafaxine is the most preferred antidepressant for treating narcolepsy. It doesn’t treat all of your narcolepsy symptoms. But it does help with your sudden muscle loss.

Venlafaxine is a selective serotonin reuptake inhibitor (SSRI) drug. These drugs increase chemicals in your brain that are responsible for your mood, feelings, and overall happiness. These same chemicals are also involved in your sleeping and eating habits.

Much like other medicines, Venlafaxine can cause side effects, such as nausea or an upset stomach. However, compared to other antidepressants, the side effects of Venlafaxine are few.

Fluoxetine

Fluoxetine is an SSRI drug that treats different mental health issues, such as anxiety and depression. But did you know that healthcare providers use this same medication to treat your narcolepsy symptoms? It’s true! It seems to offer a lot of benefits for treating your sudden loss of muscle movement.

SSRI drugs cause side effects that are similar and a bit different from stimulants. The similarities are that it can cause headaches, nausea, insomnia, and weight loss. But, it can cause other side effects. Movement disorders are a possible side effect. Also, fluoxetine can affect your sexual behaviors and performance. It can also cause violent or aggressive behaviors in some people.

Citalopram

Citalopram is another drug that your provider may give you to treat your loss of muscle tone. It’s a tricyclic drug. Tricyclic antidepressants are different from SSRIs because they balance the chemicals in your brain. They do this in two ways. First, they increase the amount of sleep and stress regulating chemicals in your brain. Next, they decrease those chemicals that cause movement. We don’t know how this drug works. But we think it affects the chemical responsible for motor movements.

Citalopram isn’t used as often as other medicines, like Fluoxetine. But it isn’t because it’s ineffective. Citalopram is just as effective, if not more effective. Citalopram also has fewer side effects than other SSRI drugs. And the side effects are mild and seem to happen as your body adjusts to the new medicine. 

Non-Pharmaceutical Options

Healthcare providers don’t recommend that you use these treatment options alone because they’re not the most effective at treating your narcolepsy symptoms. But, you can use them along with your medications.

Naps

Regular napping can help normalize your sleep habits. Taking short, scheduled naps each day can relieve you of your sleepiness after waking and help with excessive daytime sleepiness. Your naps don’t have to be too long. Short naps of just 30-minutes are enough to manage your drowsiness.

Naps sound like the solution to your sleep disturbances, but they may not be your best option. Scheduled naps can have negative effects on your social and professional life. Consider your ability to nap frequently throughout your work or school day. It seems practically impossible to do while working full-time or juggling other responsibilities.

Diet Changes

Would you believe that diets, like low-carb, high-protein diets, can help treat your narcolepsy symptoms? There isn’t a lot of research on why they help. But, we believe that it has something to do with the fact that narcolepsy puts you at risk for being overweight or obese. We think that people with higher BMIs have lower energy levels, contributing to sleep disturbances. The solution is to eat a diet that would increase your energy.

Carbs are the source of our body’s fuel. But only some carbs give our bodies the energy we need. The same is also true for protein. Our bodies break down carbs easier than protein. But all carbs aren’t good. 

Adjusting your diet may not do much for treating your narcolepsy symptoms. But, it would help those of you carrying excess weight. Changing your diet will help you lose weight, lower your BMI, and lower your risk of other health issues.

Manage Your Stress

Stress is normal. But too much of it is not good. It’s not good for our mental or emotional health. And it’s also not good for your sleep. Have you noticed that you have trouble falling asleep when you’re stressed? It’s no coincidence; stress affects our sleep. 

Manage your stress levels with

• Regular exercise
• Deep breathing
• Therapy
• Yoga and meditation

Managing your stress levels doesn’t make your narcolepsy go away. And it may not do much for the physical effects of narcolepsy. But, it may help to regulate your sleep habits when with other treatments.