Original Paper

Sodium Oxybate in Narcolepsy with Cataplexy: Zurich Sleep Center Experience
R. Poryazova^a, S. Tartarotti^a, R. Khatami^b, C.R. Baumann^a, P. Valko^a, U. Kallweit^a, E. Werth^a, C.L. Bassetti<sup>a, c

a</sup>Department of Neurology, University Hospital Zurich, Zurich,
^bSleep Clinic, Barmelweid, and
^cDepartment of Neurology, Neurocenter (EOC) of Southern Switzerland, Ospedale Civico, Lugano, Switzerland

Address of Corresponding Author

Eur Neurol 2011;65:175-182 (DOI: 10.1159/000324549)

  Key Words

• Narcolepsy
• Cataplexy
• Excessive daytime sleepiness
• Sleep paralysis
• Hallucinations
• Sodium oxybate

  Abstract

Sodium oxybate (SO; Xyrem®) has been approved in most countries for treatment of narcolepsy and cataplexy. In this study, we present a single-center experience of a series of 18 patients with narcolepsy with cataplexy (18/18 DQB1*0602 positive, 17/17 with low/absent cerebrospinal fluid hypocretin) in whom SO was prescribed. After 26 ± 13 months, 13/18 patients were still on SO at a mean dosage of 6.1 ± 1.2 g (in 8 of them in combination with stimulants). The following significant effects were observed: improved subjective sleepiness (12/13), cataplexy (13/13; median number of attacks from 20 to 1/month), hallucinations (8/10) and sleep paralysis (8/8); increase in mean sleep latency on the Maintenance of Wakefulness Test (from 5.5 to 17.4 min) and sleep/rest efficiency on actigraphy (from 61 to 76%); decrease in Epworth Sleepiness Scale score (from 18 to 14), sleep onset REM periods on the Multiple Sleep Latency Test (from 3.6 to 2.4) and errors in the Steer-Clear Test (from 11 to 2%). Five patients discontinued SO because of insufficient compliance (n = 2), lack of efficiency (n = 1) and side effects (n = 1). These data confirm and expand previous reports on the good effects and tolerability of SO as a treatment for narcolepsy with cataplexy.

Copyright © 2011 S. Karger AG, Basel

  Author Contacts

Claudio L. Bassetti, MD
Department of Neurology
Neurocenter (EOC) of Southern Switzerland, Ospedale Civico
Via Tesserete 46, CH–6903 Lugano (Switzerland)
Tel. +41 91 811 6658, E-Mail claudio.bassetti@eoc.ch

  Article Information

Received: August 27, 2010
Accepted: January 23, 2011
Published online: March 8, 2011
Number of Print Pages : 8
Number of Figures : 2, Number of Tables : 3, Number of References : 36