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. 2021 Sep;28(9):2815-2830.
doi: 10.1111/ene.14888. Epub 2021 Jun 25.

European guideline and expert statements on the management of narcolepsy in adults and children

Claudio L A Bassetti  1 , Ulf Kallweit  2 , Luca Vignatelli  3 , Giuseppe Plazzi  3   4 , Michel Lecendreux  5   6 , Elisa Baldin  3 , Leja Dolenc-Groselj  7   8 , Poul Jennum  9 , Ramin Khatami  1   10 , Mauro Manconi  1   11 , Geert Mayer  12   13 , Markku Partinen  14 , Thomas Pollmächer  15 , Paul Reading  16 , Joan Santamaria  17 , Karel Sonka  18 , Yves Dauvilliers  19 , Gert J Lammers  20   21
Affiliations
Free article

European guideline and expert statements on the management of narcolepsy in adults and children

Claudio L A Bassetti et al. Eur J Neurol. 2021 Sep.
Free article

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.

Keywords: European; cataplexy; guideline; management; narcolepsy.

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References

REFERENCES

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