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Sodium oxybate, sold under the brand name Xyrem among others, is a medication used to treat symptoms of narcolepsy: sudden muscle weakness and excessive daytime sleepiness. [3] [7] [8] It is used sometimes in France and Italy as an anesthetic given intravenously.
Pitolisant, sold under the brand name Wakix among others, is a medication used for the treatment of excessive daytime sleepiness in adults with narcolepsy. [3] It is an inverse agonist of the histamine H 3 receptor. [3]
Narcolepsy is a chronic neurological disorder that impairs the ability to regulate sleep–wake cycles, and specifically impacts REM (rapid eye movement) sleep. [1] The pentad symptoms of narcolepsy include excessive daytime sleepiness (EDS), sleep-related hallucinations, sleep paralysis, disturbed nocturnal sleep (DNS), and cataplexy. [1]
While modafinil is primarily used to treat excessive sleepiness, it may also help reduce the frequency and severity of cataplexy attacks in some people. Modafinil is approved for management of narcolepsy with or without cataplexy. However, it is not specifically approved for the treatment of cataplexy. [28] [29]
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Pitolisant has been shown to be effective and well-tolerated for the treatment of narcolepsy with or without cataplexy. [181] [180] [179] Pitolisant is the only non-controlled anti-narcoleptic drug in the US. [179] It has shown minimal abuse risk in studies. [179] [182]
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Treatment for narcolepsy and cataplexy can be divided to those that act on the excessive daytime sleepiness (EDS) and those that improve cataplexy. Most patients require lifelong use of medications. [15] Most treatments in humans will act only symptomatically and do not target the loss of the orexin-producing neurons. [16]