Skip to main content
SpringerLink
Log in
Book cover

Narcolepsy pp 295–299Cite as

Sodium Oxybate in the Treatment of Narcolepsy

  • Chapter
  • First Online:

  • 1232 Accesses

Abstract

Narcolepsy is a lifelong neurodegenerative disorder which causes considerable impairment of quality of life. So far the treatment for one of the main symptoms excessive daytime sleepiness was restricted to stimulants, whereas the other main symptom cataplexy was treated with antidepressants, and fragmented night-time sleep with hypnotics. Sodium oxybate is an efficacious drug for all three symptoms which improves the quality of life of narcoleptic patients. Due to its pharmacokinetics there is very little interaction with other drugs. In combination with modafinil some of its therapeutic benefits are enhanced. Adverse events and side effects are moderate, although some precautions have to be considered before starting the treatment.

This chapter gives an overview of the substance that has been FDA and EMEA approved for the treatment of narcolepsy with cataplexy.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   199.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Billiard, M., Bassetti, C., Dauvilliers, Y., et al. (2006) EFNS guidelines on management of narcolepsy. Eur J Neurol 13, 1035–48

    Article  CAS  PubMed  Google Scholar 

  2. Black, J., et al. (2002) Effect of increasing doses of sodium oxybate on nocturnal oxygen saturation: preliminary findings. Sleep 25(suppl), A474–5 [Abstract]

    Google Scholar 

  3. Black, J., and Houghton, W. (2006) Sodium oxybate improver excessive day time sleepiness in narcolepsy. Sleep 9, 939–946

    Google Scholar 

  4. Borgen, L., Lane, E., Lai, A. (2000) Xyrem (sodium oxybate). A study of dose proportionality in healthy human subjects. J Clin Pharmacol 40, 1053 [Abstract]

    Google Scholar 

  5. Borgen, L. A., Okerholm, R., Morrison, D., Lai, A. (2003) The influence of gender and food on the pharmacokinetics of sodium oxybate oral solution in healthy subjects. J Clin Pharmacol 43, 59–65

    Article  CAS  PubMed  Google Scholar 

  6. Borgen, L. A., Okerholm, R. A., Scharf, M. B. (2004) The pharmacokinetics of sodium oxybate following acute and chronic administration to narcoleptic patients. J Clin Pharmacol 44, 253–257

    Article  CAS  PubMed  Google Scholar 

  7. Broughton, R., and Mamelak, M. (1980) Effects of nocturnal gamma-hydoxybutyrate on sleep/waking patterns in narcolepsy-cataplexy. Can J Neurol Sci 7, 23–31

    CAS  PubMed  Google Scholar 

  8. Engber, T. M., Koury, E. J., Dennis, S. A., Miller, M. S., Contreras, P. C., Bhat, R.V. (1998) Differential patterns of regional c-Fos induction in the rat brain by amphetamine and the novel wakefulness-promoting agent modafinil. Neurosci Letter 241, 95–98

    CAS  Google Scholar 

  9. Ferraro, L., Tanganelli, S., O’Connor, W. T., et al. (1996) The vigilance promoting drug modafinil decreases GABA release in the medial preoptic area and in the posterior hypothalamus of the awake rat: possible involvement of the serotonergic 5-HT3 receptor. Neurosci Lett 220, 5–8

    Article  CAS  PubMed  Google Scholar 

  10. Hayduk, R., and Mitler, M. (2001) Sodium oxybate therapy improves the quality of life in narcoleptic patients. Sleep 24 (abstract), 571.K

    Google Scholar 

  11. Lammers, G. J., Arends, J., Declerck, A. C., Ferrari, M. D., Schouwink, G., Troost, J. (1993) Gammahydroxybutyrate and narcolepsy: a double-blind placebo-controlled study. Sleep 16, 216–220

    CAS  PubMed  Google Scholar 

  12. Mamelak, M., Black, J., Montplaisir, J., Ristanovic, R. (2004) A pilot study on the effects of sodium oxybate on sleep architecture and daytime alertness in narcolepsy. Sleep 27, 1327–34

    Google Scholar 

  13. Morgenthaler, T. I., Kapur, V. K., Brown, T., et al. (2007) Standards of Practice Committee of the AASM. Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. Sleep 30, 1705–1711

    Google Scholar 

  14. Nelson, T., Kaufman, E., Kline, J., Sokoloff, L. (1981) The extramural distribution of γ-hydroxybutyrate. J Neurochem 37, 1345–1348

    Article  CAS  PubMed  Google Scholar 

  15. Pardi, D., and Black, J. E. (2006) Sodium oxybate: neurobiology and clinical efficacy. Future Neurol 1(6), 721–35

    Article  CAS  Google Scholar 

  16. Ristanovic, R., et al. (2002) Analysis of dose-effects of sodium oxybate on nocturnal respiratory disturbances. Sleep 24(suppl), A473–474 [Abstract]

    Google Scholar 

  17. Scharf, M. B., Lai, A. A., Branigan, B., Stover, R., Berkowitz, D. B. (1998) Pharmacokinetics of gamma-hydroxybutyrate (GHB) in narcoleptic patients. Sleep 21, 507–514

    CAS  PubMed  Google Scholar 

  18. Scrima, L., Hartman, P. G., Johnson, F. H. Jr., Hiller, F. C. (1989) Efficacy of gamma-hydroxybutyrate versus placebo in treating narcolepsy-cataplexy: double-blind subjective measures. Biol Psychiatry 26, 331–343

    Article  CAS  PubMed  Google Scholar 

  19. Scrima, L., Hartman, P. G., Johnson, F. H. Jr., Thomas, E. E., Hiller, F. C. (1990) The effects of gamma-hydroxybutyrate on the sleep of narcolepsy patients: a double-blind study. Sleep 13, 479–490

    CAS  PubMed  Google Scholar 

  20. Snead, O. C., and Gibson, K. M. (2005) γ-hydroxybutyric acid. N Engl J Med 352, 2721–2732

    Article  CAS  PubMed  Google Scholar 

  21. Black, J., and Houghton, W. (2006) Sodium oxybate improver excessive day time sleepiness in narcolepsy. Sleep 9, 939–946

    Google Scholar 

  22. The Xyrem International Multicenter Study Group (2005) A double-blind, placebo-controlled study demonstrates the nightly administration of sodium oxybate is effective for the treatment of excessive daytime sleepiness in narcolepsy. Journal of Clinical Sleep Medicine 1, 391–397

    Google Scholar 

  23. Thorpy, M.J., G. Mayer, J. Shneerson. (2008) Treatment of narcolepsy with cataplexy – an overview of the disease and a report on sodium oxybate dosage and prescribing information. European Neurological Review 3, 84–88

    Google Scholar 

  24. U.S. Modafinil in Narcolepsy Multicenter Study Group (2000) Randomized trial of modafinil as a treatment for the excessive daytime somnolence of narcolepsy. Neurology 54, 1166–1175

    Google Scholar 

  25. U.S. Xyrem Multicenter Study Group (2004) Sodium oxybate demonstrates long-term efficacy for the treatment of cataplexy in patients with narcolepsy. Sleep Med 5, 119–123

    Article  Google Scholar 

  26. U.S. Xyrem Multicenter Study Group (2003) A 12-month, open-label, multicenter extension trial of orally administered sodium oxybate for the treatment of narcolepsy. Sleep 26, 31–35

    Google Scholar 

  27. U.S. Xyrem Multicenter Study Group (2002) 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 25, 42–49

    Google Scholar 

  28. Weaver, T. E., and Cuellar, N. (2006) A randomized trial evaluating the effectiveness of sodium oxybate therapy on quality of life in narcolepsy. Sleep 29, 1189–1194

    PubMed  Google Scholar 

  29. Xyrem International Study Group (2005) Further evidence supporting the use of sodium oxybate for the treatment of cataplexy: a double-blind, placebo-controlled study in 228 patients. Sleep Medicine 6, 415–421

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hephata Klinik, Schimmelpfengstr. 2, 34613, Schwalmstadt-Treysa, Germany

    Geert Mayer

Authors
  1. Geert Mayer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Geert Mayer .

Editor information

Editors and Affiliations

  1. Narcolepsy Institute, Montefiore Medical Center, East 210 Street 111, Bronx, 10467, U.S.A.

    Meeta Goswami

  2. Dept. Pharmacology, Columbia University, West 168th St. 630, New York, 10032, U.S.A.

    S. R. Pandi-Perumal

  3. Sleep-Wake Disorders Center, Montefiore Hospital, East 210th Street 111, Bronx, 10467, U.S.A.

    Michael J. Thorpy

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Mayer, G. (2010). Sodium Oxybate in the Treatment of Narcolepsy. In: Goswami, M., Pandi-Perumal, S., Thorpy, M. (eds) Narcolepsy. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0854-4_26

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-0854-4_26

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-0853-7

  • Online ISBN: 978-1-4419-0854-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation