Z hypnotics in the management of narcolepsy: a case series

Document Type

Article

Publication Date

12-30-2024

Publication Title

J Clin Sleep Med

Abstract

STUDY OBJECTIVES: Here we report our experience treating patients with narcolepsy using benzodiazepine receptor agonists (BzRA), zolpidem (Zol) or eszopiclone (Esz) taken at bedtime for both excessive daytime sleepiness (EDS) and cataplexy.

METHODS: We reviewed the medical records of 53 patients diagnosed with narcolepsy, between 2002 and 2023. Twenty-three patients, 8 with type1 (NT1), 13 with type 2 (NT2) and 2 with secondary narcolepsy, were treated with BzRA's (20 Zol and 3 Esz).

RESULTS: Seven out of 8 (88%) with NT1, 9 out of 13 (69%) with NT2 and 2 out of 2 (100%) with secondary narcolepsy, treated with BzRA, had good to excellent subjective response in their symptoms of EDS and/or cataplexy; 5 patients, 1 of whom with NT1, had marginal or no response. Three of the responding patients remained on zolpidem in monotherapy (ie. no stimulants).

CONCLUSIONS: The BzRa drugs may be effective to manage several of the cardinal symptoms of narcolepsy, regardless of the narcolepsy type. Placebo controlled trials are needed to confirm our observations.

Medical Subject Headings

Humans; Narcolepsy/drug therapy; Male; Female; Zolpidem/therapeutic use; Hypnotics and Sedatives/therapeutic use; Adult; Middle Aged; Eszopiclone/therapeutic use; Treatment Outcome; Retrospective Studies; GABA-A Receptor Agonists/therapeutic use; Young Adult; benzodiazepine receptor agonists; eszopiclone; narcolepsy; sodium oxybate; zolpidem

PubMed ID

39745471

ePublication

ePub ahead of print

Volume

21

Issue

5

First Page

753

Last Page

756

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