Abstract
Oral sodium oxybate solution (Xyrem®) is a valuable first-line option for the treatment of narcolepsy. It reduces both the major narcolepsy symptoms of cataplexy and excessive daytime sleepiness, as well as having beneficial effects on sleep-related parameters and other symptoms of narcolepsy. Risk-management strategies, warnings and precautions should be followed to minimize the risk of abuse/misuse and adverse effects potentially associated with the use of sodium oxybate.
Similar content being viewed by others
References
Mignot EJM. A practical guide to the therapy of narcolepsy and hypersomnia syndromes. Neurotherapeutics. 2012;9(4):739–52.
De la Herrán-Arita AK, García-García F. Current and emerging options for the drug treatment of narcolepsy. Drugs. 2013;73(16):1771–81.
Morgenthaler TI, Kapur VK, Brown T, et al. Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. Sleep. 2007;30(12):1705–11.
International Classification of Sleep Disorders: third edition (ISCD-3). Darien (IL): American Academy of Sleep Medicine; Epub 2014. Available from: http://www.aasmnet.org/library/default.aspx?id=9.
Jennum P, Ibsen R, Knudsen S, et al. Comorbidity and mortality of narcolepsy: a controlled retro- and prospective national study. Sleep. 2013;36(6):835–40.
Ohayon MM, Black J, Lai C, et al. Increased mortality in narcolepsy. Sleep. 2014;37(3):439–44.
Black J, Reaven NL, Funk SE, et al. The Burden of Narcolepsy Disease (BOND) study: health-care utilization and cost findings. Sleep Med. 2014;15(5):522–9.
Morrish E, King MA, Smith IE, et al. Factors associated with a delay in the diagnosis of narcolepsy. Sleep Med. 2004;5(1):37–41.
Xyrem® (sodium oxybate) oral solution CIII: US prescribing information. Palo Alto (CA): Jazz Pharmaceuticals, 2014.
Xyrem 500 mg/mL oral solution (sodium oxybate): summary of product characteristics. London: European Medicines Agency, 2011.
Robinson DM, Keating GM. Sodium oxybate: a review of its use in the management of nacrolepsy. CNS Drugs. 2007;21(4):337–54.
US Xyrem® Multicenter Study Group. A randomized, double-blind, placebo-controlled multicenter trial comparing the effects of three doses of orally administered sodium oxybate with placebo for the treatment of narcolepsy. Sleep. 2002;25(1):42–9.
US Xyrem® Multicenter Study Group. Sodium oxybate demonstrates long-term efficacy for the treatment of cataplexy in patients with narcolepsy. Sleep Med. 2004;5(2):119–23.
Xyrem® International Study Group. A double-blind, placebo-controlled study demonstrates sodium oxybate is effective for the treatment of excessive daytime sleepiness in narcolepsy. J Clin Sleep Med. 2005;1(4):391–7.
Black J, Houghton WC. Sodium oxybate improves excessive day-time sleepiness in narcolepsy. Sleep. 2006;29(7):939–46.
Xyrem® International Study Group. Further evidence supporting the use of sodium oxybate for the treatment of cataplexy: a double-blind, placebo-controlled study in 228 patients. Sleep Med. 2005;6(5):415–21.
Weaver TE, Cuellar N. A randomized trial evaluating the effectiveness of sodium oxybate therapy on quality of life in narcolepsy. Sleep. 2006;29(9):1189–94.
Black J, Pardi D, Hornfeldt CS, et al. The nightly use of sodium oxybate is associated with a reduction in nocturnal sleep disruption: a double-blind, placebo-controlled study in patients with narcolepsy. J Clin Sleep Med. 2010;6(6):596–602.
Black J, Pardi D, Hornfeldt CS, et al. The nightly administration of sodium oxybate results in significant reduction in the nocturnal sleep disruption of patients with narcolepsy. Sleep Med. 2009;10(8):829–35.
US Xyrem® Multicenter Study Group. A 12-month, open-label, multicenter extension trial of orally administered sodium oxybate for the treatment of narcolepsy. Sleep. 2003;26(1):31–5.
US Xyrem® Multicenter Study Group. The abrupt cessation of therapeutically administered sodium oxybate (GHB) does not cause withdrawal symptoms. J Toxicol Clin Toxicol. 2003;41(2):131–5.
Mamelak M, Swick T, Emsellem H, et al. A 12-week open-label, multicenter study evaluating the safety of sodium oxybate (SXB) in patients with narcolepsy [abstract no. 0666]. Sleep. 2014;37(Abstract Suppl):A233.
Billiard M, Bassetti C, Dauvilliers Y, et al. EFNS guidelines on management of narcolepsy. Eur J Neurol. 2006;13(10):1035–48.
Bogan RK, Roth T, Schwartz J, et al. Time to response with sodium oxybate for the treatment of excessive daytime sleepiness (EDS) and cataplexy in patients with narcolepsy [abstract no. 0667]. Sleep. 2014;37(Abstract Suppl):A233.
Steffen AD, Lai C, Weaver TE. Development of definition of responder to narcolepsy treatment [abstract no. 1029]. Sleep. 2014;37(Abstract Suppl):A361.
Poryazova R, Tartarotti S, Khatami R, et al. Sodium oxybate in narcolepsy with cataplexy: Zurich sleep center experience. Eur Neurol. 2011;65(3):175–82.
Alshaikh MK, Gacuan D, George S, et al. Long-term follow-up of patients with narcolepsy-cataplexy treated with sodium oxybate (Xyrem). Clin Neuropharmacol. 2011;34(1):1–4.
Lecendreux M, Poli F, Oudiette D, et al. Tolerance and efficacy of sodium oxybate in childhood narcolepsy with cataplexy: a retrospective study. Sleep. 2012;35(5):709–11.
Aran A, Einen M, Lin L, et al. Clinical and therapeutic aspects of childhood narcolepsy-cataplexy: a retrospective study of 51 children. Sleep. 2010;33(11):1457–64.
Murali H, Kotagal S. Off-label treatment of severe childhood narcolepsy-cataplexy with sodium oxybate. Sleep. 2006;29(8):1025–9.
Carter LP, Pardi D, Gorsline J, et al. Illicit gamma-hydroxybutyrate (GHB) and pharmaceutical sodium oxybate (Xyrem): differences in characteristics and misuse. Drug Alcohol Depend. 2009;104(1–2):1–10.
Wang YG, Swick TJ, Carter LP, et al. Safety overview of postmarketing and clinical experience of sodium oxybate (Xyrem): abuse, misuse, dependence, and diversion. J Clin Sleep Med. 2009;5(4):365–71.
Acknowledgments
The manuscript was reviewed by: M.D. Lemon, Veterans Affairs Black Hills Health Care System and College of Pharmacy, South Dakota State University, Fort Meade, South Dakota, USA; M.B. Scharf, TriState Sleep Disorders Center, Cincinnati, Ohio, USA.
Disclosure
The preparation of this review was not supported by any external funding. K.A. Lyseng-Williamson is a salaried employee of Adis/Springer. During the peer review process, the manufacturers of the agent under review were offered an opportunity to comment on the article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lyseng-Williamson, K.A. Sodium oxybate: a guide to its use in narcolepsy. Drugs Ther Perspect 30, 282–289 (2014). https://doi.org/10.1007/s40267-014-0140-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40267-014-0140-6