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An Update on the Misuse and Abuse Potential of Pharmacological Treatments for Central Disorders of Hypersomnolence

  • Hypersomnia Disorders (DT Plante, Section Editor)
  • Published:
Current Sleep Medicine Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

All medications currently approved for the treatment of central disorders of hypersomnolence, with the exception of pitolisant, are scheduled substances. There is a perceived and real potential for misuse and abuse of traditional stimulants and sodium oxybate, with generally less concern for modafinil. Pitolisant and solriamfetol are newer approved agents with unique pharmacological profiles. In our paper, we aim to review the misuse and abuse potential of new and existing treatments for narcolepsy and idiopathic hypersomnia.

Recent Findings

Available preclinical, clinical, and post-marketing surveillance data on pitolisant, solriamfetol, and modafinil suggest that these agents have a very low potential for misuse and abuse. Agents that have high potential for misuse, specifically stimulants and sodium oxybate, most likely carry lower risks when used to treat narcolepsy or idiopathic hypersomnia compared to risks of misuse in the general population or among other neuropsychiatric conditions.

Summary

Approved therapies for central disorders of hypersomnolence carry low yet varying risks for misuse and abuse. Further studies in patients diagnosed with central disorders of hypersomnolence are required to comprehensively assess the misuse and abuse potential of these therapeutic agents.

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Authors and Affiliations

  1. University of WI School of Medicine and Public Health, Madison, WI, USA

    Quang Ngo & David T. Plante

  2. Department of Psychiatry, Wisconsin Psychiatric Institute and Clinics, University of WI – Madison, 6001 Research Park Blvd, Madison, WI, 53719, USA

    David T. Plante

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  1. Quang Ngo
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Correspondence to David T. Plante.

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Conflict of Interest

Dr. Plante has served as a consultant for Teva Pharmaceuticals Australia, a consultant for Harmony Biosciences, and consultant/medical advisory board member for Jazz Pharmaceuticals. Dr. Plante has also received research support from the AASM Foundation, NIA, NINR, the Great Lakes Center for Occupational Health and Safety, and the Madison Educational Partnership. Dr. Plante also has a patent application pending not related to this work. Mr. Ngo has no conflicts of interest to declare.

Human and Animal Rights and Informed Consent

This review did not directly involve human participants or animals and is thus exempt from Institutional Review Board or Institutional Animal Care and Use Committee oversight.

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This article has been edited by Dr. Alon Avidan, as Dr. David Plante is Section Editor for the topical collection Hypersomnia Disorders.

This article is part of the Topical Collection on Hypersomnia Disorders

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Ngo, Q., Plante, D.T. An Update on the Misuse and Abuse Potential of Pharmacological Treatments for Central Disorders of Hypersomnolence. Curr Sleep Medicine Rep 8, 147–159 (2022). https://doi.org/10.1007/s40675-022-00227-4

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