Pellitteri Gaia, Dolso Pierluigi, Valente Mariarosaria, Gigli Gian Luigi
Clinical Neurology Unit, Department of Neurosciences, Udine University Hospital, Udine, Italy.
Department of Medicine (DAME), University of Udine, Udine, Italy.
Nat Sci Sleep. 2020 Dec 31;12:1237-1240. doi: 10.2147/NSS.S286358. eCollection 2020.
We describe a case of a young male patient with narcolepsy type 1 (NT1), who developed generalized cataplexy attacks during sexual intercourses, on which we have obtained a satisfactory control with pitolisant. Orgasmolepsy is an uncommon feature of NT1 that has been poorly described in the literature. The prevalence of this condition is unclear, as it is reasonably underreported by patients for embarrassment and not well investigated by physicians. Pitolisant is a novel treatment for narcolepsy, effective on excessive daytime sleepiness and cataplexy by modulating the histaminergic system. Real-world data collection on pitolisant efficacy and safety is still ongoing. However, pitolisant effectiveness on orgasmolepsy in NT1 has no precedent in the literature. Orgasmolepsy and other sexual disturbances should be actively searched in narcoleptic patients and, if present, may guide clinicians to prefer pitolisant or sodium oxybate, avoiding antidepressants for their possible sexual side effects.
我们描述了一例1型发作性睡病（NT1）的年轻男性患者，其在性交过程中出现全身性猝倒发作，使用匹莫林后病情得到了满意控制。性高潮发作性睡病是NT1的一种不常见特征，在文献中描述较少。这种情况的患病率尚不清楚，因为患者因尴尬而未充分报告，医生也未进行充分调查。匹莫林是一种用于发作性睡病的新型治疗药物，通过调节组胺能系统对日间过度嗜睡和猝倒有效。关于匹莫林疗效和安全性的真实世界数据收集仍在进行中。然而，匹莫林对NT1中性高潮发作性睡病的有效性在文献中尚无先例。应积极在发作性睡病患者中寻找性高潮发作性睡病和其他性障碍，如果存在，可能会指导临床医生优先选择匹莫林或羟丁酸钠，避免使用可能有性副作用的抗抑郁药。
