STUDY OBJECTIVES: To investigate potential
stimulant and anticataplectic effects of 10 mg reboxetine in patients
diagnosed with narcolepsy.
DESIGN: 12 patients were treated for a 2-week
period with 10 mg reboxetine under open conditions. The dosage of reboxetine
was gradually increased between Day 1 and Day 9. Outcome parameters
consisted of nightime polysomnography (PSG), Multiple Sleep Latency Test (MSLT),
Epworth Sleepiness Scale (ESS), Visual Analog Scale for Sleepiness (VAS),
Ullanlinna Narcolepsy Scale (UNS), and the Beck Depression Inventory (BDI).
SETTING: Sleep Disorders Clinic at a University Hospital.
PATIENTS: 12
patients meeting ICSD-criteria for narcolepsy.
INTERVENTIONS:
Pharmacological treatment with reboxetine.
RESULTS: Following treatment for
two-weeks, a significant improvement in daytime sleepiness could be
observed, as reflected by a mean decrease of 48.6% on the Epworth Sleepiness
Scale and a mean increase of 54.7% in sleep latency on the MSLT.
Furthermore, a significant reduction in the cataplexy subscore of the
Ullanlinna Narcolepsy Scale and in REM-sleep was found.
CONCLUSIONS: Our
results suggest that reboxetine exerts stimulant and anticataplectic effects
in narcolepsy. Contrary to previous thinking, by which stimulant action
would require dopaminergic facilitation, noradrenergic mechanisms might be
relevant to the control of wakefulness.
