![]() Considered a histamine-3 (H3) receptor antagonist/inverse agonist, Wakix is believed to work by raising levels of histamine, a substance that promotes wakefulness. Wakix is the only drug currently approved to treat narcolepsy that is not scheduled as a controlled substance in the United States. Wakix (pitolisant) is also approved to treat excessive daytime sleepiness (EDS) and cataplexy associated with narcolepsy. There is also a newer version of Xyrem called Xywav, which is specifically designed to have a lower sodium content - which is helpful for people with salt-sensitive high blood pressure. It is not well understood how Xyrem works to treat cataplexy. Xyrem is available only through a restricted-access enrollment program. Another form of sodium oxybate, gamma hydroxybutyrate (GHB), is abused recreationally by some people. Common side effects of Xyrem can include confusion, dizziness, and headaches. Sodium oxybate, the active ingredient in Xyrem, is a substance that occurs naturally in the brain and is involved with sleep regulation. It is also approved to treat excessive daytime sleepiness associated with narcolepsy. Xyrem (sodium oxybate) is currently the only drug approved to treat type 1 narcolepsy (specifically indicated as cataplexy associated with narcolepsy). Most drugs approved for treating narcolepsy are scheduled by the government as controlled substances due to their potential for abuse. All of the drugs described below are taken orally. Food and Drug Administration treat narcolepsy based on the type or major symptoms. FDA-Approved Medicationsĭrugs approved by the U.S. Off-label means that the drugs have not been approved for treating narcolepsy. Food and Drug Administration (FDA) specifically to treat narcolepsy, while others may be prescribed to treat narcolepsy off-label. Many medications may be prescribed to treat narcolepsy. This kind of interprofessional team approach would maximize efficacy and minimize adverse drug reactions of sodium oxybate, translating to enhanced patient outcomes.Treatment for narcolepsy is most often a combination of medication and lifestyle changes that promote good sleep hygiene. If the poisoning was deliberate, referral to a psychiatrist is required. As depicted above, it is the responsibility of the entire healthcare team, such as clinicians (MDs, DOs, NPs, PAs), nurses, specialists, and pharmacists, to work in close collaboration. The medical toxicologist can assist if multiple drug ingestions are suspected. Critical care physicians ensure proper care of intubated patients. In overdose, emergency department physicians and triage nurses should stabilize the vitals. The program focuses on limiting drug distribution and educating patients on the proper use of the drug. An extensive risk management program from the drug manufacturer can help to prevent the misuse of sodium oxybate. ![]() Concomitant use of CNS depressant and the patient’s health history resulted in an unintentional overdose. Specially trained nurses can monitor for the signs of improvement and should inform the prescriber of any discrepancies. Furthermore, nurses can reinforce the importance of strict adherence to the treatment regimen.Ī 2009 forensic multi-drug intoxication fatality involving sodium oxybate presented a sleep apnea patient who had mistakenly received prescriptions for various CNS depressants, including sodium oxybate. Pharmacists should also counsel in detail regarding the potential adverse drug reactions. Pharmacists should ensure proper dosing and step-by-step instruction on taking sodium oxybate to minimize adverse events. Sodium oxybate is usually prescribed for narcolepsy by a board-certified sleep medicine physician or neurologist. Prescribers need to be cautious when prescribing a Schedule III controlled substance such as sodium oxybate due to the high potential for abuse.
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