European guideline and expert statements on the management of narcolepsy in adults and children.
Eur J Neurol
; 28(9): 2815-2830, 2021 09.
Article
em En
| MEDLINE
| ID: mdl-34173695
ABSTRACT
BACKGROUND AND AIM:
Narcolepsy is an uncommon hypothalamic disorder of presumed autoimmune origin that usually requires lifelong treatment. This paper aims to provide evidence-based guidelines for the management of narcolepsy in both adults and children.METHODS:
The European Academy of Neurology (EAN), European Sleep Research Society (ESRS) and European Narcolepsy Network (EU-NN) nominated a task force of 18 narcolepsy specialists. According to the EAN recommendations, 10 relevant clinical questions were formulated in PICO format. Following a systematic review of the literature (performed in Fall 2018 and updated in July 2020) recommendations were developed according to the GRADE approach.RESULTS:
A total of 10,247 references were evaluated, 308 studies were assessed and 155 finally included. The main recommendations can be summarized as follows (i) excessive daytime sleepiness in adults-scheduled naps, modafinil, pitolisant, sodium oxybate (SXB), solriamfetol (all strong), methylphenidate, amphetamine derivates (both weak); (ii) cataplexy in adults-SXB, venlafaxine, clomipramine (all strong) and pitolisant (weak); (iii) excessive daytime sleepiness in children-scheduled naps, SXB (both strong), modafinil, methylphenidate, pitolisant, amphetamine derivates (all weak); (iv) cataplexy in children-SXB (strong), antidepressants (weak). Treatment choices should be tailored to each patient's symptoms, comorbidities, tolerance and risk of potential drug interactions.CONCLUSION:
The management of narcolepsy involves non-pharmacological and pharmacological approaches with an increasing number of symptomatic treatment options for adults and children that have been studied in some detail.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Oxibato de Sódio
/
Cataplexia
/
Narcolepsia
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Systematic_reviews
Limite:
Adult
/
Child
/
Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article