Skip to main content

Advertisement

SpringerLink
Log in

Management of Narcolepsy

  • Sleep Disorders (A Iranzo, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Opinion statement

Narcolepsy type 1 (NT1) and type 2 (NT2) are two rare neurological diseases, classified as central disorders of hypersomnolence. The pathophysiology of NT1 is well known; it is caused by the selective destruction of hypocretin (Hcrt) neurons, by a highly suspected autoimmune process. On the contrary, little is known about NT2 etiology, sharing with NT1 somnolence and signs of dysregulation of rapid eye movement (REM) sleep, but not cataplexy. Management strategies are rather codified, at least in adults, with a lifelong treatment required in NT1, whereas no pharmacological study focused only on NT2 patients, with sometimes spontaneous improvement or disappearance of their symptoms. We recommend that medications and guidelines in NT2 should be the same as for NT1 (except for cataplexy), but the benefit risk ratio should be reassessed regularly. The main symptom in both diseases is a disabling excessive daytime sleepiness (EDS). First-line medications should be stimulants such as modafinil, armodafinil, or sodium oxybate, second-line methylphenidate and pitolisant, where available, and amphetamines as third-line therapy. Sodium oxybate has the advantage to be also effective to manage the fragmented nocturnal sleep, another common symptom in NT1. We advise to wait a few weeks with a stimulant drug before starting an anticataplectic treatment in NT1, except for severe cataplexy. Furthermore, cataplexy treatment should not be systematic. First-line strategy is the use of sodium oxybate, the only drug approved for cataplexy and EDS in adults. However, antidepressant agents such as venlafaxine are also commonly used, with few adverse effects and a good efficacy, although based on expert consensus only. A clinically relevant tool is required to quantify the severity of narcolepsy, subjective symptoms, and their consequences, to monitor the treatment efficacy, and to finally optimize narcolepsy management. In the future, Hcrt replacement or Hcrt agonists will certainly be options to treat NT1, but for now the different peptides do not cross easily the blood brain barrier. Immune-based therapies are other possibilities in NT1, at disease onset, with already some successful attempts to slow down or stop the autoimmune process.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as • Of importance

  1. AASM: American Academy of Sleep Medicine. ICSD-3: International Classification of Sleep Disorders, 3rd ed. American Academy of Sleep Medicine. 2014. This recent classification is the reference for the diagnosis of sleep disorders worldwide.

  2. Partinen M, Kornum BR, Plazzi G, Jennum P, Julkunen I, Vaarala O. Narcolepsy as an autoimmune disease: the role of H1N1 infection and vaccination. Lancet Neurol. 2014;13:600–13.

    Article  CAS  PubMed  Google Scholar 

  3. Ohayon MM, Priest RG, Zulley J, Smirne S, Paiva T. Prevalence of narcolepsy symptomatology and diagnosis in the European general population. Neurology. 2002;58:1826–33.

    Article  CAS  PubMed  Google Scholar 

  4. Dauvilliers Y, Arnulf I, Mignot E. Narcolepsy with cataplexy. Lancet. 2007;369:499–511.

    Article  PubMed  Google Scholar 

  5. Scammell TE. Narcolepsy. N Engl J Med. 2015;373:2654–62. A recent review article about symptoms and diagnosis of narcolepsy.

    Article  CAS  PubMed  Google Scholar 

  6. AASM. ICSD-2: International Classification of Sleep Disorders, 2d ed. American Academy of Sleep Medicine. 2005.

  7. Trotti LM, Staab BA, Rye DB. Test-retest reliability of the multiple sleep latency test in narcolepsy without cataplexy and idiopathic hypersomnia. J Clin Sleep Med. 2013;9:789–95.

    PubMed  PubMed Central  Google Scholar 

  8. Andlauer O, Moore H, Hong S-C, Dauvilliers Y, Kanbayashi T, Nishino S, et al. Predictors of hypocretin (orexin) deficiency in narcolepsy without cataplexy. Sleep. 2012;35:1247–55F.

    PubMed  PubMed Central  Google Scholar 

  9. Barateau L, Lopez R, Dauvilliers Y. Treatment options for narcolepsy. CNS Drugs. 2016;30:369–79. A recent review about management strategies in narcolepsy.

    Article  CAS  PubMed  Google Scholar 

  10. Billiard M, Besset A, Montplaisir J, Laffont F, Goldenberg F, Weill JS, et al. Modafinil: a double-blind multicentric study. Sleep. 1994;17:S107–12.

    CAS  PubMed  Google Scholar 

  11. Broughton RJ, Fleming JA, George CF, Hill JD, Kryger MH, Moldofsky H, et al. Randomized, double-blind, placebo-controlled crossover trial of modafinil in the treatment of excessive daytime sleepiness in narcolepsy. Neurology. 1997;49:444–51.

    Article  CAS  PubMed  Google Scholar 

  12. Randomized trial of modafinil as a treatment for the excessive daytime somnolence of narcolepsy: US Modafinil in Narcolepsy Multicenter Study Group. Neurology. 2000;54:1166–75.

  13. Randomized trial of modafinil for the treatment of pathological somnolence in narcolepsy. US Modafinil in Narcolepsy Multicenter Study Group. Ann. Neurol. 1998;43:88–97.

  14. Wisor JP, Eriksson KS. Dopaminergic-adrenergic interactions in the wake promoting mechanism of modafinil. Neuroscience. 2005;132:1027–34.

    Article  CAS  PubMed  Google Scholar 

  15. Schwartz JRL, Feldman NT, Bogan RK, Nelson MT, Hughes RJ. Dosing regimen effects of modafinil for improving daytime wakefulness in patients with narcolepsy. Clin Neuropharmacol. 2003;26:252–7.

    Article  CAS  PubMed  Google Scholar 

  16. Leonard BE, McCartan D, White J, King DJ. Methylphenidate: a review of its neuropharmacological, neuropsychological and adverse clinical effects. Hum Psychopharmacol. 2004;19:151–80.

    Article  CAS  PubMed  Google Scholar 

  17. U.S. Xyrem Multicenter Study Group. Sodium oxybate demonstrates long-term efficacy for the treatment of cataplexy in patients with narcolepsy. Sleep Med. 2004;5:119–23.

    Article  Google Scholar 

  18. Black J, Houghton WC. Sodium oxybate improves excessive daytime sleepiness in narcolepsy. Sleep. 2006;29:939–46.

    PubMed  Google Scholar 

  19. Wang YG, Swick TJ, Carter LP, Thorpy MJ, Benowitz NL. Safety overview of postmarketing and clinical experience of sodium oxybate (Xyrem): abuse, misuse, dependence, and diversion. J Clin Sleep Med. 2009;5:365–71.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Lin J-S, Dauvilliers Y, Arnulf I, Bastuji H, Anaclet C, Parmentier R, et al. An inverse agonist of the histamine H(3) receptor improves wakefulness in narcolepsy: studies in orexin-/- mice and patients. Neurobiol Dis. 2008;30:74–83.

    Article  PubMed  Google Scholar 

  21. Dauvilliers Y, Bassetti C, Lammers GJ, Arnulf I, Mayer G, Rodenbeck A, et al. Pitolisant versus placebo or modafinil in patients with narcolepsy: a double-blind, randomised trial. Lancet Neurol. 2013;12:1068–75. A randomized trial that showed the efficacy and safety of a new drug in narcolepsy, that activates histamine neurons.

    Article  CAS  PubMed  Google Scholar 

  22. Mitler MM, Hajdukovic R, Erman MK. Treatment of narcolepsy with methamphetamine. Sleep. 1993;16:306–17.

    CAS  PubMed  Google Scholar 

  23. Auger RR, Goodman SH, Silber MH, Krahn LE, Pankratz VS, Slocumb NL. Risks of high-dose stimulants in the treatment of disorders of excessive somnolence: a case-control study. Sleep. 2005;28:667–72.

    PubMed  Google Scholar 

  24. Alvarez B, Dahlitz M, Grimshaw J, Parkes JD. Mazindol in long-term treatment of narcolepsy. Lancet Lond Engl. 1991;337:1293–4.

    Article  CAS  Google Scholar 

  25. Nittur N, Konofal E, Dauvilliers Y, Franco P, Leu-Semenescu S, Cock VCD, et al. Mazindol in narcolepsy and idiopathic and symptomatic hypersomnia refractory to stimulants: a long-term chart review. Sleep Med. 2013;14:30–6.

    Article  PubMed  Google Scholar 

  26. Billiard M, Bassetti C, Dauvilliers Y, Dolenc-Groselj L, Lammers GJ, Mayer G, et al. EFNS guidelines on management of narcolepsy. Eur J Neurol. 2006;13:1035–48.

    Article  CAS  PubMed  Google Scholar 

  27. Thorpy MJ, Dauvilliers Y. Clinical and practical considerations in the pharmacologic management of narcolepsy. Sleep Med. 2015;16:9–18. A recent article with recommendations to manage narcolepsy symptoms.

    Article  PubMed  Google Scholar 

  28. Lecendreux M, Bruni O, Franco P, Gringras P, Konofal E, Nevsimalova S, et al. Clinical experience suggests that modafinil is an effective and safe treatment for paediatric narcolepsy. J Sleep Res. 2012;21:481–3.

    Article  PubMed  Google Scholar 

  29. Darwish M, Kirby M, Hellriegel ET, Robertson P. Armodafinil and modafinil have substantially different pharmacokinetic profiles despite having the same terminal half-lives: analysis of data from three randomized, single-dose, pharmacokinetic studies. Clin Drug Investig. 2009;29:613–23.

    Article  CAS  PubMed  Google Scholar 

  30. Borgen LA, Cook HN, Hornfeldt CS, Fuller DE. Sodium oxybate (GHB) for treatment of cataplexy. Pharmacotherapy. 2002;22:798–9. discussion 799.

    Article  PubMed  Google Scholar 

  31. Boscolo-Berto R, Viel G, Montagnese S, Raduazzo DI, Ferrara SD, Dauvilliers Y. Narcolepsy and effectiveness of gamma-hydroxybutyrate (GHB): a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2012;16:431–43.

    Article  PubMed  Google Scholar 

  32. Mitler MM, Shafor R, Hajdukovich R, Timms RM, Browman CP. Treatment of narcolepsy: objective studies on methylphenidate, pemoline, and protriptyline. Sleep. 1986;9:260–4.

    CAS  PubMed  Google Scholar 

  33. Mitler MM, Hajdukovic R, Erman M, Koziol JA. Narcolepsy. J Clin Neurophysiol. 1990;7:93–118.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Shindler J, Schachter M, Brincat S, Parkes JD. Amphetamine, mazindol, and fencamfamin in narcolepsy. Br Med J (Clin Res Ed). 1985;290:1167–70.

    Article  CAS  Google Scholar 

  35. Barateau L, Jaussent I, Lopez R, Boutrel B, Leu-Semenescu S, Arnulf I, et al. Smoking, alcohol, drug use, abuse and dependence in narcolepsy and idiopathic hypersomnia: a case-control study. Sleep. 2016;39:573–80.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Lopez R, Dauvilliers Y. Pharmacotherapy options for cataplexy. Expert Opin Pharmacother. 2013;14:895–903.

    Article  CAS  PubMed  Google Scholar 

  37. Rogers AE, Aldrich MS, Lin X. A comparison of three different sleep schedules for reducing daytime sleepiness in narcolepsy. Sleep. 2001;24:385–91.

    CAS  PubMed  Google Scholar 

  38. Van Dongen HP, Price NJ, Mullington JM, Szuba MP, Kapoor SC, Dinges DF. Caffeine eliminates psychomotor vigilance deficits from sleep inertia. Sleep. 2001;24:813–9.

    PubMed  Google Scholar 

  39. Dauvilliers Y, Siegel JM, Lopez R, Torontali ZA, Peever JH. Cataplexy—clinical aspects, pathophysiology and management strategy. Nat Rev Neurol. 2014;10:386–95. A recent review of pathophysiology of cataplexy, and treatment options of this pathognomonic symptom of narcolepsy type 1.

    Article  CAS  PubMed  Google Scholar 

  40. Husain AM, Ristanovic RK, Bogan RK. Weight loss in narcolepsy patients treated with sodium oxybate. Sleep Med. 2009;10:661–3.

    Article  PubMed  Google Scholar 

  41. Smith M, Parkes J, Dahlitz M. Venlafaxine in the treatment of the narcoleptic syndrome. J Sleep Res. 1996;5 Suppl 1:217.

    Google Scholar 

  42. Poryazova R, Siccoli M, Werth E, Bassetti CL. Unusually prolonged rebound cataplexy after withdrawal of fluoxetine. Neurology. 2005;65:967–8.

    Article  PubMed  Google Scholar 

  43. Frey J, Darbonne C. Fluoxetine suppresses human cataplexy: a pilot study. Neurology. 1994;44:707–9.

    Article  CAS  PubMed  Google Scholar 

  44. Langdon N, Shindler J, Parkes JD, Bandak S. Fluoxetine in the treatment of cataplexy. Sleep. 1986;9:371–3.

    CAS  PubMed  Google Scholar 

  45. Walker DJ, Mason O, Clemow DB, Day KA. Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder. Postgrad Med. 2015;127:686–701.

    Article  PubMed  Google Scholar 

  46. Schachter M, Parkes JD. Fluvoxamine and clomipramine in the treatment of cataplexy. J Neurol Neurosurg Psychiatry. 1980;43:171–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Roth T, Dauvilliers Y, Mignot E, Montplaisir J, Paul J, Swick T, et al. Disrupted nighttime sleep in narcolepsy. J Clin Sleep Med. 2013;9:955–65.

    PubMed  PubMed Central  Google Scholar 

  48. Thorpy MJ, Snyder M, Aloe FS, Ledereich PS, Starz KE. Short-term triazolam use improves nocturnal sleep of narcoleptics. Sleep. 1992;15:212–6.

    CAS  PubMed  Google Scholar 

  49. Dauvilliers Y, Jennum P, Plazzi G. Rapid eye movement sleep behavior disorder and rapid eye movement sleep without atonia in narcolepsy. Sleep Med. 2013;14:775–81.

    Article  PubMed  Google Scholar 

  50. McGrane IR, Leung JG, St Louis EK, Boeve BF. Melatonin therapy for REM sleep behavior disorder: a critical review of evidence. Sleep Med. 2015;16:19–26.

    Article  PubMed  Google Scholar 

  51. Schenck C, Hurwitz T, Mahowald M. Symposium: normal and abnormal REM sleep regulation: REM sleep behaviour disorder: an update on a series of 96 patients and a review of the world literature. J Sleep Res. 1993;2:224–31.

    Article  PubMed  Google Scholar 

  52. Liebenthal J, Valerio J, Ruoff C, Mahowald M. A case of rapid eye movement sleep behavior disorder in Parkinson disease treated with sodium oxybate. JAMA Neurol. 2016;73:126–7.

    Article  PubMed  Google Scholar 

  53. Shneerson JM. Successful treatment of REM sleep behavior disorder with sodium oxybate. Clin Neuropharmacol. 2009;32:158–9.

    Article  CAS  PubMed  Google Scholar 

  54. Ohayon MM. Narcolepsy is complicated by high medical and psychiatric comorbidities: a comparison with the general population. Sleep Med. 2013;14:488–92.

    Article  PubMed  Google Scholar 

  55. Kok SW, Overeem S, Visscher TLS, Lammers GJ, Seidell JC, Pijl H, et al. Hypocretin deficiency in narcoleptic humans is associated with abdominal obesity. Obes Res. 2003;11:1147–54.

    Article  CAS  PubMed  Google Scholar 

  56. Dauvilliers Y, Jaussent I, Krams B, Scholz S, Lado S, Levy P, et al. Non-dipping blood pressure profile in narcolepsy with cataplexy. PLoS One. 2012;7:e38977.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Donadio V, Liguori R, Vandi S, Pizza F, Dauvilliers Y, Leta V, et al. Lower wake resting sympathetic and cardiovascular activities in narcolepsy with cataplexy. Neurology. 2014;83:1080–6.

    Article  PubMed  Google Scholar 

  58. Feldman NT. Clinical perspective: monitoring sodium oxybate-treated narcolepsy patients for the development of sleep-disordered breathing. Sleep Breath Schlaf Atm. 2010;14:77–9.

    Article  Google Scholar 

  59. Dauvilliers Y, Paquereau J, Bastuji H, Drouot X, Weil J-S, Viot-Blanc V. Psychological health in central hypersomnias: the French Harmony study. J Neurol Neurosurg Psychiatry. 2009;80:636–41.

    Article  CAS  PubMed  Google Scholar 

  60. Fortuyn HAD, Lappenschaar MA, Furer JW, Hodiamont PP, Rijnders CAT, Renier WO, et al. Anxiety and mood disorders in narcolepsy: a case-control study. Gen Hosp Psychiatry. 2010;32:49–56.

    Article  PubMed  Google Scholar 

  61. Lecendreux M, Lavault S, Lopez R, Inocente CO, Konofal E, Cortese S, et al. Attention-deficit/hyperactivity disorder (ADHD) symptoms in pediatric narcolepsy: a cross-sectional study. Sleep. 2015;38:1285–95.

    PubMed  PubMed Central  Google Scholar 

  62. Plazzi G, Ferri R, Antelmi E, Bayard S, Franceschini C, Cosentino FII, et al. Restless legs syndrome is frequent in narcolepsy with cataplexy patients. Sleep. 2010;33:689–94.

    PubMed  PubMed Central  Google Scholar 

  63. Dauvilliers Y, Pennestri M-H, Petit D, Dang-Vu T, Lavigne G, Montplaisir J. Periodic leg movements during sleep and wakefulness in narcolepsy. J Sleep Res. 2007;16:333–9.

    Article  PubMed  Google Scholar 

  64. Abril B, Carlander B, Touchon J, Dauvilliers Y. Restless legs syndrome in narcolepsy: a side effect of sodium oxybate? Sleep Med. 2007;8:181–3.

    Article  PubMed  Google Scholar 

  65. Hoque R, Chesson AL. Pharmacologically induced/exacerbated restless legs syndrome, periodic limb movements of sleep, and REM behavior disorder/REM sleep without atonia: literature review, qualitative scoring, and comparative analysis. J Clin Sleep Med. 2010;6:79–83.

    PubMed  PubMed Central  Google Scholar 

  66. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540–5.

    CAS  PubMed  Google Scholar 

  67. Bastien CH, Vallières A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med. 2001;2:297–307.

    Article  PubMed  Google Scholar 

  68. Shaw JW, Johnson JA, Coons SJ. US valuation of the EQ-5D health states: development and testing of the D1 valuation model. Med Care. 2005;43:203–20.

    Article  PubMed  Google Scholar 

  69. Mieda M, Willie JT, Hara J, Sinton CM, Sakurai T, Yanagisawa M. Orexin peptides prevent cataplexy and improve wakefulness in an orexin neuron-ablated model of narcolepsy in mice. Proc Natl Acad Sci U S A. 2004;101:4649–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Deadwyler SA, Porrino L, Siegel JM, Hampson RE. Systemic and nasal delivery of orexin-A (hypocretin-1) reduces the effects of sleep deprivation on cognitive performance in nonhuman primates. J Neurosci Off J Soc Neurosci. 2007;27:14239–47.

    Article  CAS  Google Scholar 

  71. Weinhold SL, Seeck-Hirschner M, Nowak A, Hallschmid M, Göder R, Baier PC. The effect of intranasal orexin-A (hypocretin-1) on sleep, wakefulness and attention in narcolepsy with cataplexy. Behav Brain Res. 2014;262:8–13.

    Article  CAS  PubMed  Google Scholar 

  72. Nagahara T, Saitoh T, Kutsumura N, Irukayama-Tomobe Y, Ogawa Y, Kuroda D, et al. Design and synthesis of non-peptide, selective orexin receptor 2 agonists. J Med Chem. 2015;58:7931–7.

    Article  CAS  PubMed  Google Scholar 

  73. Arias-Carrión O, Murillo-Rodríguez E. Effects of hypocretin/orexin cell transplantation on narcoleptic-like sleep behavior in rats. PLoS One. 2014;9:e95342.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Liblau RS, Vassalli A, Seifinejad A, Tafti M. Hypocretin (orexin) biology and the pathophysiology of narcolepsy with cataplexy. Lancet Neurol. 2015;14:318–28. A recent analysis of current knowledge about neurobiology of narcolepsy.

    Article  CAS  PubMed  Google Scholar 

  75. Kantor S, Mochizuki T, Lops SN, Ko B, Clain E, Clark E, et al. Orexin gene therapy restores the timing and maintenance of wakefulness in narcoleptic mice. Sleep. 2013;36:1129–38.

    PubMed  PubMed Central  Google Scholar 

  76. Dauvilliers Y, Carlander B, Rivier F, Touchon J, Tafti M. Successful management of cataplexy with intravenous immunoglobulins at narcolepsy onset. Ann Neurol. 2004;56:905–8.

    Article  CAS  PubMed  Google Scholar 

  77. Plazzi G, Poli F, Franceschini C, Parmeggiani A, Pirazzoli P, Bernardi F, et al. Intravenous high-dose immunoglobulin treatment in recent onset childhood narcolepsy with cataplexy. J Neurol. 2008;255:1549–54.

    Article  PubMed  Google Scholar 

  78. Hasan S, Pradervand S, Ahnaou A, Drinkenburg W, Tafti M, Franken P. How to keep the brain awake? The complex molecular pharmacogenetics of wake promotion. Neuropsychopharmacology. 2009;34:1625–40.

    Article  CAS  PubMed  Google Scholar 

  79. Bogan RK, Feldman N, Emsellem HA, Rosenberg R, Lu Y, Bream G, et al. Effect of oral JZP-110 (ADX-N05) treatment on wakefulness and sleepiness in adults with narcolepsy. Sleep Med. 2015;16:1102–8. A phase II study that showed the efficacy of a new wake promoting agent (with dopaminergic and noradrenergic activity) on both objective and subjective daytime sleepiness in narcolepsy.

    Article  PubMed  Google Scholar 

  80. Duchêne A, Perier M, Zhao Y, Liu X, Thomasson J, Chauveau F, et al. Impact of astroglial connexins on modafinil pharmacological properties. Sleep. 2016;39:1283–92.

    Article  PubMed  Google Scholar 

  81. Liu X, Petit J-M, Ezan P, Gyger J, Magistretti P, Giaume C. The psychostimulant modafinil enhances gap junctional communication in cortical astrocytes. Neuropharmacology. 2013;75:533–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Sleep-Wake Disorders Center, Department of Neurology, Hôpital Gui-de-Chauliac, CHU Montpellier, Montpellier, France

    Lucie Barateau MD, Régis Lopez MD & Yves Dauvilliers MD, PhD

  2. National Reference Network for Narcolepsy, Montpellier, France

    Lucie Barateau MD, Régis Lopez MD & Yves Dauvilliers MD, PhD

  3. Inserm U1061, Montpellier, France

    Lucie Barateau MD, Régis Lopez MD & Yves Dauvilliers MD, PhD

Authors
  1. Lucie Barateau MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Régis Lopez MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yves Dauvilliers MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yves Dauvilliers MD, PhD.

Ethics declarations

Conflict of Interest

Lucie Barateau and Régis Lopez declare no potential conflicts of interest.

Yves Dauvilliers has received funds for speaking, board engagements, and travel to conferences with UCB pharma, Jazz, Theranexus, Flamel, GSK, and Bioprojet.

Human and Animal Rights and Informed Consent

We confirmed that the procedures for the studies cited in this article follow the compliance with Ethical Standards.

Additional information

This article is part of the Topical Collection on Sleep Disorders

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Barateau, L., Lopez, R. & Dauvilliers, Y. Management of Narcolepsy. Curr Treat Options Neurol 18, 43 (2016). https://doi.org/10.1007/s11940-016-0429-y

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11940-016-0429-y

Keywords

Search

Navigation