Modafinil |
Excessive daytime sleepiness |
Strong |
Moderate |
100–400mg |
Headache, nausea, dry mouth, nervousness, dyspepsia, pain, vomiting, increased blood pressure, psychosis, and mania. # Risk of cardiovascular disorders.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
|
Armodafinil |
Excessive daytime sleepiness |
Strong |
Moderate |
150–250mg |
Headache, nausea, dry mouth, nervousness, dyspepsia, pain, vomiting, increased blood pressure, psychosis, and mania. # Risk of cardiovascular disorders.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
57 Aguilar AC, Frange C, Pimentel Filho LH, Reis MJ, Tufik S, Coelho FMS. Lisdexamfetamine to improve excessive daytime sleepiness and weight management in narcolepsy: a case series. Br J Psychiatry 2020;42(03):314–316. Doi: 10.1590/1516-4446-2019-0544 https://doi.org/10.1590/1516-4446-2019-0...
-5858 Lin JS, Gervasoni D, Hou Y, et al. Effects of amphetamine and modafinil on the sleep/wake cycle during experimental hypersomnia induced by sleep deprivation in the cat. J Sleep Res 2000;9 (01):89–96. https://www.ncbi.nlm.nih.gov/pubmed/10733694 https://www.ncbi.nlm.nih.gov/pubmed/1073...
|
Methylphenidate |
Excessive daytime sleepiness |
Weak |
Low |
5–60mg |
Headache, nausea, dry mouth, nervousness, dyspepsia, pain, vomiting, increased blood pressure, psychosis, and mania. # Risk of cardiovascular disorders.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
|
Amphetamines |
Excessive daytime sleepiness |
Weak |
Low |
Lisdexanfetamina 10–70mg |
Headache, nausea, dry mouth, nervousness, dyspepsia, pain, vomiting, increased blood pressure, psychosis, and mania. # Risk of cardiovascular disorders.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
,6262 Dauvilliers Y, Mignot E, Del Río Villegas R, et al. Oral Orexin Receptor 2 Agonist in Narcolepsy Type 1. N Engl J Med 2023;389 (04):309–321. Doi: 10.1056/NEJMoa2301940 https://doi.org/10.1056/NEJMoa2301940...
|
Solriamfetol |
Excessive daytime sleepiness |
Strong |
Moderate |
37.5mg-150mg |
Insomnia, headache, nausea, decreased appetite, anxiety.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
Solriamfetol is not available in Brazil. |
L-Carnitine |
Excessive daytime sleepiness |
Weak |
Low |
510mg |
It is safe during pregnancy.6565 Calvo-Ferrandiz E, Peraita-Adrados R. Narcolepsy with cataplexy and pregnancy: a case-control study. J Sleep Res 2018;27(02): 268–272. Doi: 10.1111/jsr.12567 https://doi.org/10.1111/jsr.12567...
,6666 Barros F, Aguilar ACR, Tufik S, Coelho FM. Oral L–Carnitine used to treat narcoleptic type 1 patient during pregnancy - A case report. Sleep Sci 2018;11(04):215–216. Doi: 10.5935/1984-0063.20180035 https://doi.org/10.5935/1984-0063.201800...
,6969 Dauvilliers Y, Carlander B, Rivier F, Touchon J, Tafti M. Successful management of cataplexy with intravenous immunoglobulins at narcolepsy onset. Ann Neurol 2004;56(06):905–908. Doi: 10.1002/ana.20339 https://doi.org/10.1002/ana.20339...
|
Selegiline |
Excessive daytime sleepiness |
Strong |
Low |
5–10mg |
Dry mouth, headache, insomnia, sweating.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
|
Caffeine |
Excessive daytime sleepiness |
Weak |
Low |
200mg |
Complementary therapy.7070 Aldosari MS, Olaish AH, Nashwan SZ, Abulmeaty MMA, BaHammam AS. The effects of caffeine on drowsiness in patients with narcolepsy: a double-blind randomized controlled pilot study. Sleep Breath 2020;24(04):1675–1684. Doi: 10.1007/s11325-020-02065-6. https://doi.org/10.1007/s11325-020-02065...
|
Hypocretin receptor agonists |
Excessive daytime sleepiness and cataplexy |
No evidence |
No evidence |
– |
A recent study was published with promissory results and liver toxicity.6161 Dauvilliers Y, Shapiro C, Mayer G, et al. Solriamfetol for the Treatment of Excessive Daytime Sleepiness in Participants with Narcolepsy with and without Cataplexy: Subgroup Analysis of Efficacy and Safety Data by Cataplexy Status in a Randomized Controlled Trial. CNS Drugs 2020;34(07):773–784. Doi: 10.1007/ s40263-020-00744-2 https://doi.org/10.1007/s40263-020-00744...
|
Pitolisant |
Excessive daytime sleepiness and cataplexy |
Strong |
Moderate |
8.9–35.6mg |
Headache, insomnia, and abdominal discomfort.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
Pitolisant is not available in Brazil. |
Sodium Oxybate |
Excessive daytime sleepiness and Cataplexy |
Strong |
Moderate |
1.5–9 g |
Nocturnal confusion, enuresis, dizziness, nausea, weight loss, psychosis, depression, and worsening of OSA.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
Oxybate is not available in Brazil. |
Tricyclic antidepressants |
Cataplexy |
Strong |
Low |
Clomipramine 10–150mg |
Weight gain, sexual dysfunction, constipation, and dry mouth.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
|
Other antidepressants |
Cataplexy |
Strong |
Low |
Venlafaxine 37.5–225mg |
Nausea, dizziness, decreased appetite, irritability, insomnia, weight gain, sexual dysfunction, hyperhidrosis, diarrhea, constipation.5656 Bassetti CLA, Kallweit U, Vignatelli L, et al. European guideline and expert statements on the management of narcolepsy in adults and children. J Sleep Res 2021;30(06):e13387. Doi: 10.1111/jsr.13387 https://doi.org/10.1111/jsr.13387...
|
Baclofen |
Cataplexy |
Weak |
Low |
10–40mg |
Sleepiness, nausea, vomiting, diarrhea, headaches, dry mouth, blurred vision or difficulty focusing, excessive sweating, and rash.6464 Huang YS, Guilleminault C. Narcolepsy: action of two gammaaminobutyric acid type B agonists, baclofen and sodium oxybate. Pediatr Neurol 2009;41(01):9–16. Doi: 10.1016/j.pediatrneurol.2009.02.008 https://doi.org/10.1016/j.pediatrneurol....
|