Modes of action of drugs related to narcolepsy: Pharmacology of wake-promoting compounds and anticataplectics

Abstract

The pharmacological treatments of excessive daytime sleepiness (EDS) of narcolepsy include amphetamine-like central nervous system (CNS) stimulants and modafinil (and its R-enantiomer). Other less often used stimulants are compounds with dopamine uptake inhibitions. Caffeine is the most commonly consumed CNS stimulant that may also be effective for mild EDS cases. These compounds do not improve cataplexy and other REM sleep abnormalities (hypnogogic hallucinations and sleep paralysis), and antidepressants (monoamine uptake inhibitors) are additionally used for the treatment of cataplexy and REM sleep abnormalities. Gamma-hydroxybutyrate (GHB, a short-acting sedative) given at night reduces both EDS and cataplexy. In this review, modes of actions proposed for the therapeutic compounds for narcolepsy are discussed. © 2010 Springer-Verlag New York.