Xu Qinglin, Lou Guodong, Wang Tiantian, Zhang Lisan
Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
Center for Sleep Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 Aug 25;49(4):419-424. doi: 10.3785/j.issn.1008-9292.2020.08.17.
Narcolepsy is the most common cause of excessive daytime sleepiness (EDS) following obstructive sleep apnea. Its treatment aims to reduce EDS and cataplexy, improve nighttime sleep disturbance, sleep paralysis and sleep-related hallucinations. Pitolisant (a histamine H3 receptor antagonist) and solriamfetol (a norepinephrine reuptake inhibitor) have recently been approved effective for narcolepsy in the United States and the European Union. Pitolisant has proved to be effective for both EDS and cataplexy. Besides being effective on EDS, solriamfetol seems to have advantages in abuse potential and withdrawal syndrome. As potential treatments for EDS and cataplexy associated with narcolepsy, several new drugs are being developed and tested. These new drugs include new hydroxybutyrate preparations (controlled release sodium hydroxybutyrate FT218, low sodium hydroxybutyrate JZP-258), selective norepinephrine reuptake inhibitor (AXS-12), and modafinil combined with astroglial junction protein inhibitor (THN102). This paper reviews the recently approved drugs and potential treatments for narcolepsy.
发作性睡病是阻塞性睡眠呼吸暂停后导致日间过度嗜睡(EDS)的最常见原因。其治疗目标是减轻EDS和猝倒,改善夜间睡眠障碍、睡眠麻痹和与睡眠相关的幻觉。匹托利生(一种组胺H3受体拮抗剂)和索利那新(一种去甲肾上腺素再摄取抑制剂)最近在美国和欧盟被批准用于治疗发作性睡病。匹托利生已被证明对EDS和猝倒均有效。除了对EDS有效外,索利那新在滥用可能性和戒断综合征方面似乎具有优势。作为治疗发作性睡病相关EDS和猝倒的潜在药物,几种新药正在研发和测试中。这些新药包括新型羟丁酸钠制剂(控释羟丁酸钠FT218、低钠羟丁酸钠JZP - 258)、选择性去甲肾上腺素再摄取抑制剂(AXS - 12)以及莫达非尼与星形胶质细胞连接蛋白抑制剂联合制剂(THN102)。本文综述了最近批准用于发作性睡病的药物和潜在治疗方法。