Narcolepsy. Signs, symptoms,
 differential diagnosis, and management 
by
Green PM, Stillman MJ
Kalamazoo Neurology, Mich., USA. 
Arch Fam Med 1998 Sep-Oct; 7(5):472-8 
ABSTRACT
Narcolepsy is a chronic neurologic disorder characterized by excessive 
daytime sleepiness and cataplexy and less often by hypnagogic hallucinations and 
sleep paralysis. While patients report excessive daytime sleepiness and 
cataplexy as the more frequent symptoms of this condition, excessive daytime 
sleepiness is generally believed to be the most debilitating. Narcolepsy often 
is undiagnosed or misdiagnosed for a variety of reasons. Although confirmation 
of an initial diagnosis requires monitoring of physiologic variables conducted 
at a sleep center by specialists, the primary care physician has a critical role 
in the identification and management of this incurable affliction. This article 
provides recommendations for the diagnosis and management of narcolepsy. The 
cataplexy associated with narcolepsy can be managed with tricyclic 
antidepressants. The excessive sleepiness is managed with stimulants but newer 
agents, such as modafinil, which will be marketed as Provigil, and selegiline 
hydrochloride, with fewer adverse effects and less abuse potential, may offer 
means of promoting daytime wakefulness. Groups such as the National Sleep 
Foundation, Washington, DC, and the Narcolepsy Network, Cincinnati, Ohio, can 
provide patients with needed support and information. 
 
Orexins
Adrafinil
Selegiline
Glutamate
Narcolepsy
Modafinil: review
Modafinil: structure
Narcolepsy: causes
Modafinil and serotonin
Orexins to treat narcolepsy
Excessive daytime sleepiness
Modafinil as an antidepressant
Modafinil versus amphetamine
Modafinil versus methylphenidate
Narcolepsy and Sleep Disorders: some hotlinks
[an error occurred while processing this directive]