INTEGRATED TREATMENT OF THE SYMPTOMS OF NARCOLEPSY-CATAPLEXY SYNDROME WITH SODIUM OXYBATE

Introduction. Treatment of narcolepsy-cataplexy is based on the use of different drugs that either stimulate or modify REM sleep, which makes it possible to improve the symptoms that characterise the disease. Aim. To present the characteristics of sodium oxybate, a new drug that has been approved in the United States and in the European Union for use in treating narcolepsy-cataplexy; the main contribution made by this new agent is the possibility of acting on all the symptoms of the disease at the same time. Development. In four randomised, double-blind, placebo-controlled studies and with a class A level of evidence, sodium oxybate has proved to be effective in improving the cardinal symptoms of narcolepsy-cataplexy, that is to say, hypersomnia, cataplexy and fragmentation of nocturnal sleep. Treatment was well tolerated and the side effects, consisting mainly of nausea or symptoms related with the nervous system, such as anxiety, depression, confusion or drowsiness, were mild or moderate in most cases and rarely led to the patient's giving up the treatment. The drug has a favourable pharmacokinetic profile, with little potential to interact with other pharmaceuticals. It seems to have a synergic effect with modafinil, boosting its effects in the treatment of excessive sleepiness. Although it is a substance that has been used as a recreational drug, no cases of addiction or drug abuse have been observed in narcoleptic patients treated in a controlled manner Conclusions. Sodium oxybate can be considered to be a first-choice drug in the treatment of narcolepsy-cataplexy. [REV NEUROL 2009: 48: 27-31]