Table 6.
Pharmacologic treatment of narcolepsy based on onset of symptoms related to puberty: use, side effects, and reasons for discontinuation
| Prepubertal onset of narcolepsy (n = 19) | Modafinil (Provigil) | Sodium oxybate (Xyrem) | Venlafaxine (Effexor) |
|---|---|---|---|
| Number of medications tried prior to this medication | 0.9 ± 0.25 (16) | 3.8 ± 0.6 (17) | 1.1 ± 0.5 (12) |
| Months started after diagnosis | 9.8 ± 3.1 (16) | 26 ± 4.8 (17) | 21 ± 6.6 (12) |
| Maximum dose, mg/d | 333 ± 32 (16) | 7200 ± 400 (17) | 79 ± 16 (12) |
| Duration of treatment, mos. | 46 ± 6 (16) | 36 ± 4.1 (17) | 20 ± 7 (12) |
| Side effects, % | 38 (16) | 69 (16) | 55 (11) |
| Irritability | 25 (16) | 19 (16) | 36 (11) |
| Dry mouth | 6 (16) | 12 (16) | 9 (11) |
| Nausea | 0 (16) | 19 (16) | 0 (11) |
| Weight loss | 6 (16) | 25 (16) | 0 (11) |
| Weight gain | 0 (16) | 0 (16) | 18 (11) |
| Headaches | 19 (16) | 6 (16) | 0 (11) |
| Constipation | 0 (16) | 0 (16) | 9 (11) |
| Others | 6 (16)a | 13 (16)b | 0 (11) |
| Withdrawal due to, % | |||
| Side effects | 6 (16) | 18 (17) | 8 (12) |
| Lack of efficacy | 19 (16) | 0 (17) | 25 (12) |
| Cost | 0 (16) | 6 (17) | 0 (12) |
| Peripubertal or postpubertal onset of narcolepsy (n = 21) | |||
| Number of medications tried prior to this medication | 2.1 ± 0.6 (21) | 3.4 ± 0.6 (17) | 3.0 ± 0.4 (15) |
| Months started after diagnosis | 7.5 ± 2.5 (21) | 17 ± 4.8 (17) | 13.3 ± 3.8 (15) |
| Maximum dose, mg/d | 353 ± 22 (20) | 8100 ± 360 (17) | 103 ± 13 (15) |
| Duration of treatment, mos. | 62 ± 6.2 (20) | 52 ± 6.1 (17) | 59 ± 7.4 (15) |
| Side effects, % | 40 (20) | 40 (15) | 43 (14) |
| Irritability | 10 (20) | 0 (15) | 14 (14) |
| Dry mouth | 10 (20) | 0 (15) | 7 (14) |
| Nausea | 10 (20) | 13 (15) | 7 (14) |
| Weight loss | 0 (20) | 20 (15) | 0 (14) |
| Weight gain | 0 (20) | 0 (20) | 29 (14) |
| Headaches | 5 (20) | 5 (20) | 0 (14) |
| Constipation | 0 (20) | 0 (20) | 7 (14) |
| Others | 10 (20)c | 5 (20)d | 0 (14) |
| Withdrawal due to, % | |||
| Side effects | 0 (20) | 0 (20) | 12 (17) |
| Lack of efficacy | 15 (20) | 15 (20) | 12 (17) |
| Cost | 0 (20) | 5 (20) | 0 (17) |
Data are presented as mean ± SEM or percentage (number of subjects if different from total in the group).
a
Early waking (1);
b
Chest pain, tachycardia, fainting (1), bed wetting (1);
c
Insomnia (1), tremor and hypertension (1);
d
Somnambulism (1)