Treatment and Medication Options for Cataplexy
There is no cure for cataplexy or narcolepsy.Symptoms of narcolepsy (including cataplexy) typically develop over several months and last a lifetime.Depending on the severity, some people with cataplexy may only have one or two attacks in a lifetime, whereas others may experience multiple attacks a day.Without proper diagnosis and treatment of narcolepsy, symptoms such as cataplexy can be dangerous and “life-restricting,” notes Dr. Olson. “Someone may stop competing to avoid winning something, or avoid laughing, or even engaging in intercourse,” says Olson.
In short, people affected by cataplexy may learn to modify their behavior and activities to minimize their risk of bringing on an episode, and many end up avoiding situations that may cause cataplexy.These adjustments can be consequential and vastly affect quality of life, such as if someone skips social situations with friends or avoids driving.
However, while narcolepsy with cataplexy is a lifelong condition, there are medications that can help you manage the symptoms.
Medication Options for Cataplexy
There are drugs that have been shown to be effective in treating cataplexy. Medications may reduce cataplectic attacks by 90 percent or eliminate them entirely in some people.
The primary treatment options are medications that allow people to stay awake during the day and push them to sleep at night, says Lois E. Krahn, MD, a professor of psychiatry in the Mayo Clinic College of Medicine who is based in Phoenix, Arizona.
There is some evidence that tricyclic antidepressants, such asclomipramine (Anafranil),imipramine (Tofranil), anddesipramine (Norpramin), andselective serotonin reuptake inhibitors (SSRIs)may be helpful for cataplexy, as well as other narcolepsy symptoms.Sodium oxybate, taken at night for its sedative effect, has also been shown to be effective in treating severe daytime sleepiness as well as cataplexy attacks.
If an individual has very rare episodes of cataplexy, intervention may be unnecessary.But people who experience frequent attacks (or ones that greatly disturb their lives) should discuss medication options with their doctor and consider the potential benefits, as well as possible side effects. For people with severe cataplexy, being able to take medication that can help control attacks may significantly improve social interaction, safety, and overall quality of life.
Alternative and Complementary Therapies for Cataplexy
In addition to medications, cognitive behavioral therapy (CBT), or learning techniques to improve behavior, may help people manage several symptoms of narcolepsy, including cataplexy.
CBT techniques for narcolepsy vary but can involve helping patients recognize conditions and emotions that trigger their cataplectic attacks and teaching them how to respond in ways that prevent an attack from occurring. Another potential CBT technique is known as stimulus satiation, a procedure in which the patient is repeatedly exposed to the trigger that prompts cataplectic episodes until its effect is lost. However, most studies have looked at CBT for other sleep disorders, and more research on the application of CBT for narcolepsy is needed.
Counseling and support groups can also help people with narcolepsy learn coping strategies to help manage symptoms like cataplexy.Find a support group through Narcolepsy Network. Or ask your doctor to help you locate a support group or qualified counselor.
Prevention of Cataplexy
Medications are typically the most effective way to prevent cataplexy, though other strategies may also help:
- Get enough sleep or plan strategic naps.You may be more likely to experience a cataplectic attack when you’re sleep-deprived. “If someone is exhausted, they are more vulnerable to an emotional trigger, so being well-rested is important,” Dr. Krahn says. If you’re unable to get a good night’s sleep or you’re bothered by excessive daytime sleepiness, try to take short, scheduled naps at times when you tend to feel sleepiest. “Naps don’t have to be terribly long — a person with narcolepsy can benefit from a 20-minute nap,” Krahn says.
- Get up and move.Regular physical activity may indirectly help with cataplexy by keeping daytime sleepiness at bay, according to Krahn. So if you start feeling sleepy and can’t take a quick nap, go for a walk.
- Get help from friends, family, and coworkers.Let people know if your cataplexy is triggered by strong emotions or specific situations. If you sense an attack is coming, encourage people to avoid these triggers if possible. Though you may not want to avoid strong emotions or specific situations, it may be preferable to an attack — especially if an attack is about to occur at an awkward time (like during a meal or work meeting).
