Diretrizes brasileiras para o tratamento da narcolepsia

• Autor(a) principal: Alóe, Flávio
• Data de Publicação: 2010
• Outros Autores: Alves, Rosana Cardoso, Araújo, John F., Azevedo, Alexandre, Bacelar, Andrea, Bezerra, Márcio, Bittencourt, Lia Rita Azeredo [UNIFESP], Bustamante, Guilherme, Cardoso, Tania Aparecida Marchiori de Oliveira, Eckeli, Alan L., Fernandes, Regina Maria França, Goulart, Leonardo, Pradella-Hallinan, Márcia Lurdes de Cássia [UNIFESP], Hasan, Rosa, Sander, Heidi Haueisen, Pinto Junior, Luciano Ribeiro [UNIFESP], Cecília Lopes, Maria, Minhoto, Gisele Richter, Moraes, Walter [UNIFESP], Moreira, Gustavo Antonio [UNIFESP], Pachito, Daniela, Pedrazzoli, Mario [UNIFESP], Poyares, Dalva [UNIFESP], Prado, Lucila Bizari Fernandes do [UNIFESP], Rizzo, Geraldo, Rodrigues, Raimundo Nonato, Roitman, Israel, Ademir Baptista, Silva [UNIFESP], Tavares, Stella Márcia Azevedo
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000bk51
• DOI: 10.1590/S1516-44462010000300016
• Texto Completo: http://dx.doi.org/10.1590/S1516-44462010000300016; http://repositorio.unifesp.br/handle/11600/5894
• topic: Antidepressants; Cataplexy; Stimulants; Narcolepsy; Excessive sleepness; Antidepressivos; Cataplexia; Estimulantes; Narcolepsia; Sonolência excessiva

This manuscript contains the conclusion of the consensus meeting of the Brazilian Sleep Association with Brazilian sleep specialists on the treatment of narcolepsy based on the review of medical literature from 1980 to 2010. The manuscript objectives were to reinforce the use of agents evaluated in randomized placebo-controlled trials and to issue consensus opinions on the use of other available medications as well as to inform about safety and adverse effects of these medications. Management of narcolepsy relies on several classes of drugs, namely, stimulants for excessive sleepiness, antidepressants for cataplexy and hypnotics for disturbed nocturnal sleep. Behavioral measures are likewise valuable and universally recommended. All therapeutic trials were analyzed according to their class of evidence. Recommendations concerning the treatment of each single symptom of narcolepsy as well as general recommendations were made. Modafinil is the first-line pharmacological treatment of excessive sleepiness. Second-line choices for the treatment of excessive sleepiness are slow-release metylphenidate followed by mazindol. The first-line treatments of cataplexy are the antidepressants, reboxetine, clomipramine, venlafaxine, desvenlafaxine or high doses of selective serotonin reuptake inibitors antidepressants. As for disturbed nocturnal sleep the best option is still hypnotics. Antidepressants and hypnotics are used to treat hypnagogic hallucinations and sleep paralysis.