While there is no known cure for narcolepsy, physicians typically prescribe medication to reduce the symptoms accompanying the syndrome. Stimulants, such as Amphetamines, Methylphenidate, Mazindol, and Pemoline, have traditionally been used in controlling narcolepsy "by increasing the drive of the aminergic system, which inhibits REM sleep" (Hobson, 1989, p.177) and increasing the synaptic availability of norepinephrine (Aldrich, 1990). Many patients with narcolepsy take stimulants such as methylphenidate or dextroampetamine (5-50mg) daily or antidepressants, depending on the symptoms accompanying the narcolepsy. "Stimulants have been used to promote wakefulness and alertness, and the antidepressants have been used to suppress the auxiliary symptoms of the disease, cataplexy, sleep paralysis, and hypnagogic hallucinations" (Mamelak, 1991, p.208).
Dosage levels vary depending on the medication as indicated in Table 1. Daytime alertness has been improved with the use of modafinil, mazindol, and selegiline, and typically has fewer side effects than amphetamine (Parkes & Schachter, 1979). Also, tricyclic antidepressants, as indicated in the table, are primarily used for cataplexy, sleep paralysis, and hypnagogic hallucinations. These tricyclic antidepressants "act to inhibit the reuptake of norepinephrine and serotonin rather than by cholinergic blockade"(Aldrich, 1990, p.392).
Even though these treatments seem to be effective for those with narcolepsy, a gap in alertness between patients with narcolepsy and normal subjects has been demonstrated (Mitler, 1988; Mitler, Hajdukovic, Erman, and Kozio, 1990; Zarcone, 1973). These gaps should have been bridged with different types of treatments and thus have brought conventional treatment under scrutiny. Although there are problems, we must acknowledge that the current treatments do improve the symptoms accompanying narcolepsy. Nonetheless, a better treatment needs to emerge. However this may not occur until a cause is identified.
Other methods of treating the symptoms of narcolepsy also include naps and group therapy. Using these methods will not cure narcolepsy, but it will improve the quality of life for individuals suffering from the syndrome. Many people with narcolepsy find that 3 or more 15 to 20 minute naps daily, will significantly improve alertness without altering nightly sleep. Also, group therapy is useful in individuals with narcolepsy who may develope negative feelings towards themselves--often when others misunderstand and refer to them as lazy or social loafers. This group therapy typically acts as a support center for the individual and helps in coping with the syndrome.