adderall and prozac for narcolepsy with cataplexy

Table Table1 1 shows the five main pharmacological treatments for narcolepsy, dosage, indications, and mechanism of action. We conducted a systematic review to pull the data of clinical trials to analyze the Epworth Sleepiness Scale (ESS) and the efficiency of the drug in narcolepsy.

Pitolisant is the last drug to be approved by the Food and Drug Administration (FDA) in 2019 to treat narcolepsy it showed improvement in previous clinical trials . Treatments include counseling, psychosocial guidance, and regular medical follow-up tailored to age, profession, specific lifestyles, and comorbidities . Symptomatic treatment for narcolepsy involves both non-pharmacological and pharmacological approaches. Patients also report sleep paralysis, described as the inability to speak or move any voluntary muscles, usually during awakening. Hypnagogic hallucinations occur during sleep onset, while hypnopompic hallucinations occur during awakening. Patients may also experience hallucinations during periods of sleep. The loss of muscle tone seen in cataplexy can manifest as face drooping, eyelid closure, jaw drop, dysarthria, passive tongue protrusion, and bilateral loss of motor control of the extremities. A specific symptom of narcolepsy is cataplexy, defined as brief episodes of bilateral loss of muscle tone triggered by sudden emotions in the presence of a normal state of consciousness. Patients experience involuntary, irresistible sleepiness with rapid transitions into sleep, called “sleep attacks” that last from 15 - 20 minutes. Excessive daytime sleepiness (EDS) is a cardinal feature typically causing an inability to stay awake but is also accompanied by difficulties in concentration. The sleep-wake disturbances in narcolepsy cause several symptoms to a patient’s motor, psychiatric, emotional, cognitive, metabolic, and autonomic functions.

Genetic, environmental, and possible autoimmune processes are involved in the pathogenesis of narcolepsy. Hypocretin is a neuropeptide produced by neurons in the lateral hypothalamus which promotes wakefulness. Narcolepsy with cataplexy (narcolepsy type I), which is caused by the loss of hypocretin or orexin neurons, and narcolepsy without cataplexy (narcolepsy type II) has normal hypocretin and an unknown etiology. Multiple studies suggest narcolepsy occurs in North America and Europe, with a prevalence of 0.03% - 0.05%. The incidence of narcolepsy is 1 in 2,000 individuals. It is characterized by excessive daytime sleepiness and rapid eye movement (REM) sleep dysregulation, causing cataplexy, sleep paralysis, hypnagogic, and hypnopompic hallucinations. Narcolepsy is the most common neurological cause of chronic sleepiness.

Adderall and prozac for narcolepsy with cataplexy