Narcolepsy cataplexy co-morbidities excessive daytime sleepiness hypocretin management pharmacological treatment. New symptomatic and causal treatment most probably will be completed by hypocretin-replacement and immune-modifying strategies. First-line options include Modafinil/Armodafinil (for excessive daytime sleepiness, EDS), Sodium Oxybate (for EDS and/with cataplexy), Pitolisant (for EDS and cataplexy) and Venlafaxine (for cataplexy (off-label) and co-morbid depression). Expert opinion: Concise evaluation of symptoms and type of narcolepsy, coexisting co-morbidities and patients´ distinct needs is mandatory in order to identify a suitable, individual pharmacological treatment. Non-pharmacological approaches are important in the management of narcolepsy but will not be covered in this review. Finally, this review considers potential future management strategies. You can also have sleep attacks where you fall asleep during the day without. Your sleep is affected so that you feel excessively tired and drowsy during the daytime but have disturbed night-time sleep. The name comes from the Greek seized by somnolence (somnolence is another word for drowsiness). In addition, treatment options for frequent coexisting co-morbidities and different phenotypes of narcolepsy are presented. Narcolepsy is a long-term (chronic) problem. First- and second-line options are discussed as well as combination therapies. Areas covered: This review provides an overview of the temporal available treatment options for narcolepsy (type 1 and 2) in adults, including authorization status by regulatory agencies. Narcolepsy has a major impact on workableness and quality of life. Narcolepsy with cataplexy is most commonly caused by an immune-mediated process including genetic and environmental factors, resulting in the selective loss of hypocretin-producing neurons. Narcolepsy is an orphan neurological disease and presents with sleep-wake, motoric, neuropsychiatric and metabolic symptoms.
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