发作性睡病

实验治疗

实验治疗包括组胺受体激动剂/拮抗剂（例如 pitolisant）、[1]American Academy of Sleep Medicine. International classification of sleep disorders - third edition (ICSD-3). 2014 [Internet publication].http://www.aasmnet.org/library/default.aspx?id=9[101]Dauvilliers Y, Bassetti C, Lammers GJ, et al. Pitolisant versus placebo or modafinil in patients with narcolepsy: a double-blind, randomised trial. Lancet Neurol. 2013 Nov;12(11):1068-75.http://www.ncbi.nlm.nih.gov/pubmed/24107292?tool=bestpractice.com 下丘脑分泌素激动剂、[102]Weinhold SL, Seeck-Hirschner M, Nowak A, et al. The effect of intranasal orexin-A (hypocretin-1) on sleep, wakefulness and attention in narcolepsy with cataplexy. Behav Brain Res. 2014 Apr 1;262:8-13.http://www.ncbi.nlm.nih.gov/pubmed/24406723?tool=bestpractice.com 慢波睡眠增强剂（普瑞巴林、加巴喷丁）、静脉内γ-球蛋白、曲马多、左旋肉碱[100]Miyagawa T, Kawamura H, Obuchi M, et al. Effects of oral L-carnitine administration in narcolepsy patients: a randomized, double-blind, cross-over and placebo-controlled trial. PLoS One. 2013;8(1):e53707.http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0053707http://www.ncbi.nlm.nih.gov/pubmed/23349733?tool=bestpractice.com 和皮质类固醇。在未来，移植大脑的下丘脑分泌素分泌细胞或使用基因疗法治疗发作性睡病患者的下丘脑分泌素缺乏症可能会成为可能。一系统性综述[103]Lopez R, Dauvilliers Y. Pharmacotherapy options for cataplexy. Expert Opin Pharmacother. 2013 May;14(7):895-903.http://www.ncbi.nlm.nih.gov/pubmed/23521426?tool=bestpractice.com建议使用羟丁酸钠作为猝倒的一线药物治疗。尽管这只是基于专家的意见，基于它良好的收益-风险比，二线治疗应使用5-羟色胺-去甲肾上腺素-再摄取抑制剂文拉法辛。对于猝倒的未来治疗目标是在疾病早期阶段导向基于免疫的疗法和下丘脑分泌素替代治疗。