Treatment choices should be tailored to each patient’s symptoms, comorbidities, tolerance and risk of potential drug interactions. 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). ResultsĪ total of 10,247 references were evaluated, 308 studies were assessed and 155 finally included. Following a systematic review of the literature (performed in Fall 2018 and updated in July 2020) recommendations were developed according to the GRADE approach.
According to the EAN recommendations, 10 relevant clinical questions were formulated in PICO format. 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. This paper aims to provide evidence-based guidelines for the management of narcolepsy in both adults and children. Narcolepsy is an uncommon hypothalamic disorder of presumed autoimmune origin that usually requires lifelong treatment.
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