Even Mild Narcolepsy Symptoms Should Be Treated

Mild narcolepsy symptoms, unlike severe symptoms of the chronic sleep disorder, can be effectively treated in a variety of ways. Lifestyle treatments of mild narcolepsy symptoms include a schedule of 3 or more napping/sleeping sessions each day. Narcoleptics must also avoid drinking alcohol and heavy meals since these can interfere with the sleeping schedule.

Most people experiencing mild narcolepsy symptoms may not require medication, and can maintain enough alertness to perform all their necessary daily tasks by just following the mentioned sleeping schedule. Doctors show conflicting opinions on whether these scheduled naps are necessary when a patient responds favourably to medications.

The approved medications for narcolepsy mild symptoms target cataplexy and sleepiness. Stimulants can be used to neutralize excessive daytime sleepiness; antidepressants and other similar compounds, on the other hand, target cataplexy. Cataplexy as a symptom of Narcolepsy indicates a severe case of Narcolepsy as the risk of injury is added to each activity. The FDA approved two specific drugs for treating narcolepsy and its mild symptoms and these two are now first-line treatments. They are Modafinil (Provigil) which is for uncontrollable and excessive daytime sleepiness, and sodium oxybate (Xyrem) to combat cataplexy.  Often doctors take no chances even with patients who only exhibit mild symptoms of Narcolepsy, and treat them for cataplexy, although it may not be chronically affecting them.  A sudden loss of muscle control due to a episode of cataplexy can leave people seriously injured depending on when the episode occurs.

Medications for Mild Symptoms of Narcolepsy

Provigil or Modafinil – is a drug that’s used to alleviate the mild narcolepsy symptom, excessive sleepiness, and other similar symptoms characteristic to other sleeping disorders. It has mainly replaced Ritalin (methylphenidate) and other similar stimulants as a treatment for narcoleptic sleepiness. However, patients who switch from methylphenidate to Modafinil tend to encounter a few problems once they start tapering off from the stimulant dose gradually.

Modafinil can help patients suffering from mild narcolepsy symptoms stay awake during daytime. While only a few actually experience the wakefulness of a normal person, those who take modafinil are likely to improve their capacity to stay awake and reduce the number of sleep attacks. Unfortunately, the medicine has not yet been verified to be safe for pregnant women; the benefits and risks should be wisely weighed for any patient. Figure 01-03a shows the benefits and risks of taking Modafinil for sufferers of narcolepsy symptoms.  Although extensive, the majority of the side effects are easily treated or uncommon.  Be sure to take a look at the benefits and side effects of any drug you take.  Narcoleptics, even those with mild narcolepsy symptoms, are often prescribed drugs. Those diagnosed narcoleptic should be prepared to deal with common moderate side effects and report on any major side effects they experience.

Figure 01-03a – Modafinil’s Benefits and Risks

Benefits

Possible Side Effects

  • It can be proven that Modafinil doesn’t affect the body’s hormones that play large roles in sleeping. Taking Modafinil will not affect daytime naps or nighttime sleep.  However it does ease mild Narcolepsy symptoms and act like a stimulant, making narcoleptics more alert during their waking hours.
  • Unlike stimulants it is not known to cause anxiety in consumers.
  • Unlike stimulants commonly prescribed for this illness, people with mild symptoms of narcolepsy experience near full relief from daytime sleepiness and do not crash like they would on a stimulant, when the drug wears off.
  • There is less potential to abuse Modafinil than commonly prescribed stimulants.

 

  • Headaches
  • Congestion of throat and nose
  • Dry mouth
  • Back pain
  • Nausea
  • Dizziness
  • Anxiety and nervousness
  • Difficulty falling asleep or insomnia
  • Decrease in the effectiveness of the pill. Women taking Modafinil may have to switch to another birth control method.
  • Mania, anxiety, suicidal ideation, hallucinations and other psychiatric effects can occur. Physicians should be cautious in prescribing the drug to patients experiencing mild narcolepsy symptoms and at the same time having histories of depression, mania or psychosis.
  • Serious, although rare, skin reactions like Steven-Johnson syndrome occur in patients experiencing mild narcolepsy symptoms.  Patients should discontinue taking modafinil immediately and contact their physicians right away if they develop a serious rash.
  • Modafinil may be habit forming so patients are usually taken of this drug slowly.
  • Modafinil is not yet approved for children; only for adults.

NuVigil (Armodafinil) - a relatively newer drug that’s almost identical to Modafinil, has also been prescribed as a treatment for narcolepsy and its mild symptoms. Clinical trials show that Armodafinil improves wakefulness, attention, memory and fatigue in persons with mild narcolepsy symptoms.

Stimulants –Because of the dangers of these drugs stimulants are not usually prescribed for mild narcolepsy symptoms any more. However many stimulants and even sedatives are used to treat sever daytime sleepiness and interrupted REM sleep at night if Narcolepsy affect a patient’s life dramatically.

Stimulants commonly prescribed include methylphenidate (Ritalin), Methamphetamine (Desoxyn), and Dextroamphetamine (Dexedrine). Dextroamphetamine and methylpheidate commonly last for two to five hours; both used to be standard drugs for treatment of excessive daytime sleepiness. These drugs are often very effective for people who are suffering more intense symptoms.  Mild Narcolepsy symptoms are often be treated with daytime naps that are regularly scheduled and by making room for more sleep to help ensure we get good night’s sleep. Stimulants can interfere with both of these treatment plans.

Whether dealing with severe or mild narcolepsy symptoms the medications themselves can become less effective with continuous use.  For this reason patients are often put on a schedule where they are on and off drugs.  On days when patients are not using their medication they may experience an increase in mild narcolepsy symptoms.  For this reason they should take special care in performing activities such as walking, running, etc.  As anyone can see the treatment plans are not perfect.  Those suffering from this illness are often forced to cope with at least mild symptoms of narcolepsy on top of the side effects of the drugs they take to treat it.

All of this information is sometimes discouraging to people who experience mild symptoms of Narcolepsy.  People often do not want to admit to a doctor that they suffer from it because of the affects it can have on their life. For example many narcoleptics are not permitted to drive a car and are not able to obtain a driver’s license.  It is however important to start treating even mild symptoms of narcolepsy as close to the onset as possible.

Remember just because the signs and symptoms are minor doesn’t mean they cannot suddenly get worse.  That is the danger of untreated narcolepsy.  An attack of cataplexy (which occurs in 60% of narcoleptics) can occur suddenly and without warning causing injury to the patient and others.  These unfortunate realities can be quite depressing for those who are faced with severe or mild narcolepsy symptoms.

  • http://tribily.com Walter Heck

    When you have mild Narcolpesy symptoms (like me), think twice before putting a bunch of drugs in your body everyday with little effect!
    I sleep once or twice a day on really good days, and 10+ times on really bad days. I find that listening to my body and eating healthy make a world of difference! I have been without drugs for 10+ years now (tried modafinil and ritalin) and wouldn’t want it any other way :)
    Feel free to contact me if you have narcolepsy and want to exchange experiences!

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