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The Treatment of Narcolepsy-Cataplexy with Nocturnal Gamma-Hydroxybutyrate

Published online by Cambridge University Press:  18 September 2015

Roger Broughton*
Affiliation:
Division of Neurology, Ottawa General Hospital and University of Ottawa and the Department of Psychiatry, Sunnybrook Medical Centre and University of Toronto, Canada
Mortimer Mamelak
Affiliation:
Division of Neurology, Ottawa General Hospital and University of Ottawa and the Department of Psychiatry, Sunnybrook Medical Centre and University of Toronto, Canada
*
Department ot Medicine (Neurology), Ottawa General Hospital, Ottawa, Canada, ?1N 5C8.
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Summary

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Sixteen patients with narcolepsy and cataplexy were treated with gamma-hydroxybutyrate (GHB) given at night and tailored to achieve as continuous a night's sleep as possible. The dosage usually consisted of 1.5-2.25 gm orally at bedtime and then one or two further 1.0-1.5 gm doses with awakenings during the night, and totaled about 50 mg /kg. Apart from one patient who took only the bedtime dose, the subjective quality of night sleep improved in all patients and the number of irresistable daytime attacks of sleep and cataplexy substantially diminished. Some residual daytime drowsiness remained and this usually responded well to low doses of methylphenidate. Improvement has been maintained for up to 20 months without the development of tolerance. Two patients experienced adverse side effects necessitating withdrawal of GHB treatment, but no serious toxic effects have occurred.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1979

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