Stimulants to Treat Narcolepsy

There are several different stimulants that may be prescribed to treat the daytime sleepiness or sleep attacks of narcolepsy. Stimulants help keep the person with narcolepsy awake during the day. These drugs also help the person remain alert during important times, such as during work, school, or driving.

Some of these drugs work within hours. Others may take several weeks to reach full effect. Even with stimulants and strategic daytime naps, most people with narcolepsy are able to stay awake only 70 to 80 percent of what is normal.1

Stimulants used for narcolepsy

Many stimulants may be prescribed to treat the daytime sleepiness of narcolepsy, including:1,2

  • Provigil and Nuvigil (modafinil and armodafinil)
  • Sunosi (solriamfetol)
  • Wakix (pitolisant)
  • Ritalin, Concerta, Metadate, Methylin (methylphenidate)
  • Dexedrine (dextroamphetamine)
  • Adderall (mixed amphetamine salts)

In the United States, Provigil and Nuvigil (modafinil and armodafinil) are usually prescribed first because it is less addictive and has fewer side effects than older stimulants. However, these drugs do not work for everyone, and the older drugs may still offer a good option for those people.3

What are the possible side effects of Provigil and Nuvigil?

Provigil (modafinil) is the first drug many doctors will prescribe for control of daytime sleepiness without disrupting nighttime sleep. Nuvigil (armodafinil) is a similar drug. Both are taken in the morning.

Side effects are uncommon and include:1,2

  • Headache
  • Nausea
  • Dry mouth
  • Rash
  • Anorexia
  • Diarrhea

A rash can be a sign of serious complications, so it is important to tell your doctor if you develop a rash. These drugs may be a good choice for older people but may not be the right option for those with high blood pressure or heart disease. Abuse of these drugs is rare.1,2

In Canada, modafinil is no longer recommended for women who are pregnant or plan to become pregnant. Both drugs make birth control pills less reliable, so you will need back-up contraception. People with liver or kidney disease should not take Provigil.1

Side effects of Sunosi

The most common side effects of Sunosi (solriamfetol) include:1

  • Headache
  • Nausea
  • Reduced appetite
  • Anxiety
  • Dry mouth
  • Diarrhea

Side effects of Wakix

The most common side effects of Wakix (pitolisant) include:1

  • Headache
  • Insomnia
  • Nausea

In addition to reducing daytime sleepiness, Wakix may also be prescribed to treat cataplexy in adults. This drug may make birth control pills less reliable. It should not be taken with certain antidepressants or by people with liver or kidney disease.1,4

Side effects of Ritalin, Concerta, Metadate, Methylin, Dexedrine, and Adderall

Each drug has its own set of possible side effects. However, there are some common side effects seen in Ritalin, Concerta, Metadate, Methylin, Dexedrine, and Adderall, including:1,2

  • Reduced appetite
  • Nausea
  • Headache
  • Insomnia

Serious potential side effects are more common at high doses and include:1,2

  • High blood pressure
  • Psychosis or mania
  • Seizures
  • Abnormal heart rhythm
  • Heart attack

In addition, all of these drugs are addictive or easy to abuse.1,2

People being treated for narcolepsy should see their doctor every 6 months. It is important to watch for drug side effects, changes in sleep or mood, and other health issues. None of these drugs should be stopped suddenly.2

Side effects can vary depending on the specific treatment/drug you are taking. These are not all the possible side effects of stimulants for narcolepsy. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with stimulants.

Other treatments for narcolepsy

In addition to stimulants, other drugs that are used to treat narcolepsy include antidepressants and central nervous system depressants. Your doctor will decide which treatments are best for you based on your individual symptoms and how you respond to different drugs.

Before beginning treatment for narcolepsy, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

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Written by: Jessica Johns Pool | Last reviewed: June 2020