Narcolepsy is believed to result from a genetic predisposition and abnormal neurotransmitter (hypocretin, also known as orexin) functioning and sensitivity.
Genetic predisposition
Understanding of narcolepsy stems primarily from research involving narcoleptic dogs (for example, special laboratory-bred Dobermans and Labradors). In these animal models, the disorder is transmitted in an autosomal recessive fashion and is characterized mainly by cataplexy. Only 1% of human cases are inherited and, unlike the canine form, are transmitted in an autosomal dominant manner.
Neurotransmitter
The neurotransmitter hypocretin was identified in the last few years and is strongly associated with narcolepsy in dogs with a genetic predisposition. Hypocretin levels in human subjects with narcolepsy have been found to be undetectable or low in several recent studies of patients with narcolepsy. Hypocretin appears to modulate activity in the hypothalamus (the part of the brain associated with sleep). The deficiency of hypocretin might produce sleep attacks. The drug modafinil (Provigil) is useful in the treatment of narcolepsy is believed to activate hypocretin-containing nerve cells.| Printer-Friendly Format | | | Email to a Friend |
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Cymbalta is approved for the treatment of depression.
Important Safety Information
Cymbalta® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia.
Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.
You should not take Cymbalta if:
Before starting Cymbalta, tell your healthcare provider:
While taking Cymbalta, tell your healthcare provider:
If you have any questions, talk to your healthcare provider before taking Cymbalta.
The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.
Narcolepsy is characterized by the classic tetrad of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis.
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