Thorpy Michael J
Sleep-Wake Disorders Center, Montefiore Medical Center, Bronx, NY, USA,
Curr Treat Options Neurol. 2015 May;17(5):347. doi: 10.1007/s11940-015-0347-4.
Narcolepsy is a severe, incurable, neurological disorder that is treated by pharmacological management of its symptoms. The main symptoms are excessive daytime sleepiness (EDS) and cataplexy, although addition symptoms that may require treatment include sleep paralysis, hypnagogic hallucinations, and disturbed nocturnal sleep. Sodium oxybate and modafinil/armodafinil are the first-line treatments for EDS, and sodium oxybate for cataplexy. Sodium oxybate treats all the symptoms of narcolepsy, whereas modafinil is effective for EDS only. Alternative medications for EDS include methylphenidate or amphetamines such as dextroamphetamine, lisdexamfetamine, methamphetamine, or combination amphetamine salts. Non-FDA approved medications for cataplexy include norepinephrine reuptake inhibitors such as venlafaxine or atomoxetine. Combination therapy can be more effective for sleepiness such as sodium oxybate and modafinil/armodafinil. Medication for narcolepsy is generally well tolerated and usually required life-long although does not eliminate all symptoms of narcolepsy.
发作性睡病是一种严重的、无法治愈的神经系统疾病，通过对其症状进行药物治疗。主要症状是日间过度嗜睡（EDS）和猝倒，不过可能需要治疗的其他症状还包括睡眠瘫痪、入睡前幻觉和夜间睡眠紊乱。羟丁酸钠和莫达非尼/阿莫达非尼是治疗EDS的一线药物，而羟丁酸钠用于治疗猝倒。羟丁酸钠可治疗发作性睡病的所有症状，而莫达非尼仅对EDS有效。治疗EDS的替代药物包括哌甲酯或苯丙胺类药物，如右旋苯丙胺、赖右苯丙胺、甲基苯丙胺或复方苯丙胺盐。美国食品药品监督管理局（FDA）未批准的用于治疗猝倒的药物包括去甲肾上腺素再摄取抑制剂，如文拉法辛或托莫西汀。联合治疗对嗜睡可能更有效，如羟丁酸钠和莫达非尼/阿莫达非尼联合使用。发作性睡病的药物通常耐受性良好，通常需要终身服用，尽管不能消除发作性睡病的所有症状。
