Michael Thorpy, MD, director, Sleep-Wake Disorders Center, Montefiore, and professor of neurology, Albert Einstein College of Medicine, addresses the treatment of narcolepsy in recent years.
There are several features of narcolepsy that are considered when prescribing treatment, with sodium oxybate currently serving as a first-line treatment in these patient populations, said Michael Thorpy, MD, director, Sleep-Wake Disorders Center, Montefiore, and professor of neurology, Albert Einstein College of Medicine.
Can you speak on current methods of treatment for narcolepsy-related excessive daytime sleepiness and factors considered when prescribing treatment?
For the treatment of narcolepsy, we have quite a large number of medications. There have been a number of new medications that have been approved recently. Traditionally, we had the stimulants, such as amphetamines and methylphenidate, and these are largely sort of going away, as we have drugs and medications that are more specific for the treatment of narcolepsy.
There are many features to narcolepsy, such as excessive daytime sleepiness, abnormal REM [rapid-eye movement] phenomena, and disturbed nocturnal sleep. And the medications that are being used in narcolepsy have targeted either 1 or more of these particular symptoms. Most of the medications that have been used in the past have targeted the excessive daytime sleepiness component of narcolepsy, so they would be more alerting or wake-promoting medications.
With the development of sodium oxybate back in 2000, we really saw medication that could treat all symptoms of narcolepsy. So we could treat the nocturnal sleep disturbance that we typically see in narcolepsy, the excessive daytime sleepiness, and the abnormal REM phenomena, particularly cataplexy. So, oxybate has become really a first-line treatment for patients with narcolepsy.