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Emerging treatment options for excessive sleepiness associated with narcolepsy

Jonathan RL Schwartz

Narcolepsy is a chronic neurological sleep disorder characterized by symptoms of excessive sleepiness, cataplexy and abnormal manifestations of rapid eye movement sleep. Several therapeutic options are available for the management of narcolepsy, for which the primary treatment goal is improvement of excessive sleepiness symptoms through the waking period. First-line treatment options include modafinil and the CNS stimulants. Sodium oxybate may also be used for the treatment of cataplexy or as augmentation for refractory sleepiness. The new agent armodafinil may also have a role in the management of this disorder. Evidence supporting the use of these agents and discussion of their place in therapy will be reviewed.