The table below shows medicines that are approved by the U.S. Federal Drug Administration (FDA) specifically to treat narcolepsy (*) or idiopathic hypersomnia (IH) (†) and symptoms the medicines may improve. In the U.S., as long as a medicine is approved by the FDA to treat any condition, doctors may prescribe it “off-label” to treat other conditions.
| Medicines | Daytime sleepiness | Cataplexy | Sleep inertia | Sleep disruption |
|---|---|---|---|---|
| Modafinils* (such as Nuvigil) | ||||
| Oxybates*† (such as Xyrem) | ||||
| Pitolisant* (such as Wakix) | ||||
| Solriamfetol* (such as Sunosi) | ||||
| Amphetamines* (such as Adderall) | ||||
| Methylphenidates* (such as Jornay PM) |
The table below shows other medicines that may be used to treat idiopathic hypersomnia (IH) or narcolepsy, and the symptoms they may improve, based on currently available evidence. None of these are FDA-approved specifically to treat idiopathic hypersomnia (IH) or narcolepsy.
| Medicines | Daytime sleepiness | Cataplexy | Sleep inertia | Sleep disruption |
|---|---|---|---|---|
| Clarithromycin (such as Biaxin) | ||||
| Flumazenil | ||||
| Antidepressants (such as Prozac) | ||||
| Bupropion (such as Wellbutrin) | ||||
| Bupropion long-acting (such as Wellbutrin XL) | ||||
| Protriptyline (such as Vivactil) | ||||
| Selegiline (such as Emsam) | ||||
| Atomoxetine (such as Strattera) | ||||
| Reboxetine (such as Davedex) | ||||
| Levothyroxine (such as Synthroid) | ||||
| Baclofen (such as Lioresal) | ||||
| Caffeine (such as No Doz, drinks) | ||||
| Carnitine supplements (such as Carnitor) | ||||
| Melatonin long-acting |
For more in-depth information about these medicines, such as side effects, mechanisms of action, and evidence for use, visit our healthcare professional web page, “Treating people who have idiopathic hypersomnia or narcolepsy.”
What about brain fog and automatic behaviors?
Currently, there are no medicines that specifically treat brain fog or automatic behaviors. However, treating daytime sleepiness may also help these symptoms.
What about sleep paralysis and sleep-related hallucinations?
- These symptoms are similar to cataplexy because they also affect REM sleep. Therefore, they can sometimes get better with medicines that treat cataplexy.
- Some PWH report fewer problems with sleep paralysis and hallucinations if they avoid falling asleep flat on their backs.
- For sleep paralysis, specific forms of meditation may help.
Visit Project Sleep’s “Sleep Paralysis and Hallucinations” web page to get some other ideas and understanding that can help with these symptoms.
Example brand names of generic medicines used to treat hypersomnias
- Amphetamines and their derivatives: Adderall, Adzenys ER, Adzenys XR, Biphetamine, Dexedrine, Dyanavel XR, Evekeo, Mydayis, ProCentra, Vyvanse, and Zenzedi
- Atomoxetine: Attera, Attentin, Axepta, Axetra, Stramox, Strattera, and Tomoxetin
- Reboxetine: Davedex, Edronax, Irenor, Norebox, Prolift, Solvex, Yeluoshu, and Zuolexin
- Baclofen: Baclodol, Baklofen, Beklo, Clofen, Flexibac, Gablofen, Kemstro, Liofen, Lioresal, Lyflex, Lyvispah, Muslofen, Ozobax, and Sclerofen
- Bupropion: Aplenzin, Budeprion SR, Budeprion XL, Buproban, Forfivo, Forfivo XL, Wellbutrin, Wellbutrin SR, Wellbutrin XL, and Zyban
- Caffeine: No Doz
- Carnitine: Carnitor
- Clarithromycin: Biaxin, Biaxin XL
- Flumazenil: Romazicon
- Levothyroxine: Euthyrox, Levo-T, Levothroid, Levoxyl, Synthroid, Thyquidity, Tirosint, and Unithroid
- Mazindol: Quilience
- Methylphenidate formulations: Adhansia XR, Aptensio XR, Concerta, Cotempla XR-ODT, Daytrana, Focalin, Jornay PM, Metadate CD, Metadate ER, Methylin, Methylin ER, QuilliChew ER, Quillivant XR, Ritalin, Ritalin LA, and Ritalin SR
- Modafinil: Alertec, Modalert, Modavigil, and Provigil
- Armodafinil: Acronite, Armod, Armoda, Artivil, Modavital, Neoresotyl, Nuvigil, R-Modawake, and Waklert
- Pitolisant: Wakix
- Protriptyline: Vivactil
- Selegiline: Eldepryl, Emsam, and Zelapar
- Oxybates
- Sodium oxybate: Alcover, Gamma-OH, Natrii oxybutyras Kalceks, Somsanit, and Xyrem
- Lower-sodium oxybate: Xywav
- Extended-release sodium oxybate: Lumryz
- Solriamfetol: Sunosi
Example brand names of generic antidepressants used for cataplexy or depression
- SNRIs (serotonin norepinephrine reuptake inhibitors)
- Duloxetine: Cymbalta, Drizalma Sprinkle, and Irenka
- Milnacipran: Savella
Levomilnacipran: Fetzima - Venlafaxine: Effexor and Effexor XRDesvenlafaxine: Pristiq and Khedezla
- SSRIs (selective serotonin reuptake inhibitors)
- Citalopram: Celexa
Escitalopram: Lexapro - Fluoxetine: Prozac and Sarafem
- Paroxetine: Brisdelle, Paxil, and Pexeva
- Sertraline: Zoloft
- Citalopram: Celexa
- TCAs (tricyclic antidepressants)
- Clomipramine: Anafranil
- Protriptyline: Vivactil