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Treatment of narcolepsy in adults

Thomas E Scammell, MD
Section Editor
Ruth Benca, MD, PhD
Deputy Editor
April F Eichler, MD, MPH


Nearly half of patients with narcolepsy report that their sleepiness and cataplexy substantially interfere with their daily lives, including school, jobs, marriages, or social life [1,2]. The mainstays of therapy are brief daytime naps and pharmacologic therapy [3].

It is important to realize that patients with narcolepsy often have concomitant obstructive sleep apnea, periodic limb movements of sleep, fragmented sleep, and/or rapid eye movement (REM) sleep behavior disorder that contribute to their daytime sleepiness. It is often helpful to treat these disorders first and then to focus on improving the sleepiness that is caused by the narcolepsy. This topic assumes that coexisting sleep disorders have been treated and reviews the treatment of narcolepsy and its symptoms.

The diagnosis and neurobiology of narcolepsy and the treatment of narcolepsy in children are discussed separately. (See "Clinical features and diagnosis of narcolepsy in adults" and "Narcolepsy in children".)


There are several nonpharmacologic interventions that may benefit the patient with narcolepsy. Many patients will benefit from these nonpharmacologic approaches, but most also require medications that reduce sleepiness and cataplexy.

Avoidance of certain drugs — Some drugs should be avoided by patients with narcolepsy. Drugs that can worsen daytime sleepiness include benzodiazepines, opiates, antipsychotics, and alcohol. (See "Excessive daytime sleepiness due to medical disorders and medications".)

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Literature review current through: Nov 2017. | This topic last updated: Jun 21, 2017.
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