Modafinil and armodafinil improve excessive daytime sleepiness symptoms and have little abuse potential, but have no effect on cataplexy, so other drugs, such as antidepressants, are required to control cataplexy attacks.(4) Sodium oxybate improves both excessive daytime sleepiness and cataplexy. Many of these medicines are not licensed for the treatment of narcolepsy and they vary in the evidence available for their effectiveness in. reuptake inhibitors (SNRIs) or tricyclic antidepressants. Currently there is no cure for narcolepsy, so treatment focuses on control of symptoms.(2) Although the sympathomimetic stimulants, such as amphetamines or methylphenidate, are effective in improving excessive daytime sleepiness in patients with narcolepsy, they have the potential for dependence, have sometimes disabling sympathomimetic side-effects and are associated with tolerance.(3) To date, there is clear evidence of the efficacy of modafinil, armodafinil and sodium oxybate in patients with narcolepsy. Summary on the evidence on pitolisant for treating narcolepsy with or without cataplexy to inform local NHS planning and decision-making. In addition, behavioral measures can be of notable value. It is extremely incapacitating, and frequently results in impaired psychosocial functioning and reduced work performance. Abstract Management of narcolepsy with or without cataplexy relies on several classes of drugs, namely stimulants for excessive daytime sleepiness and irresistible episodes of sleep, antidepressants for cataplexy and hypnosedative drugs for disturbed nocturnal sleep. (1) Narcolepsy is a rare disorder of unknown aetiology characterized by excessive daytime sleepiness and typically associated with cataplexy.
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