Narcolepsy can be treated with medications, including stimulants like modafinil (Provigil) and methylphenidate (Ritalin), to reduce daytime sleepiness and enhance alertness. Consider speaking with a doctor about what treatment option may be right for you.

Narcolepsy is a chronic sleep disorder that impairs the brain’s ability to control sleep-wake cycles, leading to symptoms like excessive daytime sleepiness, which can disrupt daily life.

While there is no cure for the disorder, narcolepsy medication can help manage its symptoms by improving wakefulness and enhancing quality of life.

Learn more about the most common narcolepsy medication, discussing how these medications work and their potential side effects.

Stimulants treat narcolepsy by increasing the release of neurotransmitters like dopamine and norepinephrine in the central nervous system. These neurotransmitters control aspects like your mood and sleep.

Stimulants are usually taken as oral tablets or capsules to promote wakefulness and improve daytime functioning in the management of narcolepsy.

Commonly prescribed stimulants for narcolepsy include:

Modafinil

Modafinil, sold under the brand name Provigil, is a stimulant that promotes wakefulness by altering neurotransmitters in the brain.

It is commonly prescribed as a first-line treatment for narcolepsy to reduce excessive daytime sleepiness with a lower risk of dependence compared to other stimulants.

The standard starting dose is 200 milligrams (mg) taken once daily in the morning, though this can be adjusted depending on individual needs.

Commonly reported side effects include:

Methylphenidate

Methylphenidate (Ritalin) is an oral stimulant that increases dopamine and norepinephrine levels in the brain, improving attention and alertness.

It’s available in several forms, including:

  • oral tablets
  • chewable tablets
  • extended-release tablets
  • extended-release capsules
  • orally disintegrating tablets

It’s often prescribed to reduce daytime sleepiness and enhance focus when modafinil is not effective. Typical doses range from 5 to 20 mg, taken two to three times daily.

Potential side effects include:

  • nervousness
  • difficulty sleeping
  • headache
  • decreased appetite

Solriamfetol

Solriamfetol (Sunosi) is a prescription medication used to treat excessive daytime sleepiness caused by narcolepsy or obstructive sleep apnea.

It works by increasing the levels of dopamine and norepinephrine in the brain, helping to improve wakefulness and alertness during the day.

Solriamfetol is taken as a tablet once daily in the morning. The typical starting dose is 75 mg, but it may be adjusted based on a person’s response to treatment.

Side effects of solriamfetol can include:

Gamma-hydroxybutyrate (GHB) derivatives are primarily used to treat cataplexy, a symptom of narcolepsy that leads to sudden muscle weakness.

These medications help reduce daytime symptoms like excessive drowsiness and cataplexy.

Sodium oxybate

Sodium oxybate (Xyrem) is a liquid medication that enhances restorative sleep, helping reduce daytime drowsiness and preventing sudden muscle weakness.

It’s approved by the Food and Drug Administration (FDA) for treating narcolepsy or cataplexy in people ages 7 and older.

The typical starting dose is 4.5 grams (g) per night, divided into two doses, one before bed and another a few hours later. The dosage may increase gradually, with a maximum of 9 g per night.

Common side effects include:

Histamine H3-receptor inhibitors are non-stimulant medications that promote wakefulness by increasing histamine levels in the brain.

They are a suitable alternative for people who experience side effects from stimulant medications or are at risk of developing dependence.

Pitolisant

Pitolisant (Wakix) is a non-stimulant oral medication used to increase histamine activity in the brain, helping to regulate wakefulness without the risk of addiction linked to stimulants.

It is particularly beneficial for people with narcolepsy or other sleep disorders.

The typical starting dose of pitolisant is 8.9 mg taken once daily, with the dosage gradually increased up to a maximum of 35.6 mg based on the person’s response and tolerance.

Possible side effects may include:

  • headache
  • insomnia
  • nausea
  • anxiety

However, pitolisant may take more than 8 weeksto show its full effect, and dosage adjustments may be necessary for optimal results.

Although there’s no cure for narcolepsy, certain lifestyle measures, in addition to medications, can help manage symptoms, improve daily functioning, and enhance quality of life.

Other treatment options for narcolepsy can include:

  • Scheduled naps: Taking short, scheduled naps during the day may reduce excessive daytime sleepiness and improve alertness.
  • Good sleep hygiene: Establishing a regular sleep schedule, making the sleep environment comfortable, and minimizing nighttime disruptions may improve sleep quality.
  • Diet modifications: Eating small, balanced meals throughout the day and avoiding heavy meals before bed may help stabilize energy levels and reduce nighttime disruptions.
  • Exercise: Engaging in regular physical activity, particularly in the morning or early afternoon, may help regulate sleep patterns and promote alertness during the day.
  • Cognitive behavioral therapy (CBT): CBT may help manage the emotional challenges of living with narcolepsy, such as managing anxiety and stress, while also improving coping strategies for symptoms like sleep paralysis and hallucinations.

If you experience persistent daytime sleepiness or other symptoms of narcolepsy, it’s important to speak with a doctor. A thorough medical evaluation, including specific tests, can confirm the diagnosis and guide a personalized treatment plan.

If you’re already on medication for narcolepsy and notice significant side effects or changes in your symptoms, reach out to a doctor. They can adjust your dosage or explore alternative treatments to ensure better symptom management and minimize side effects.

What is the best medication for excessive daytime sleepiness?

The best medication for excessive daytime sleepiness can depend on your individual symptoms and lifestyle. However, modafinil is a stimulant medication that is considered to be one of the most effective drugs for treating excessive daytime sleepiness.

What worsens narcolepsy?

If you have narcolepsy, it is strongly advised to avoid alcohol and caffeine before bedtime, as this can worsen symptoms.

Narcolepsy is a chronic condition that requires ongoing management, but various medications can help manage its symptoms.

Stimulants like modafinil and methylphenidate are effective for managing excessive daytime sleepiness, while sodium oxybate can address cataplexy and improve nighttime sleep quality.

In addition to medication, lifestyle measures and behavioral therapy can provide additional support. Consider talking with a healthcare professional to find the most suitable treatment plan for your individual needs.