Posted by Elizabeth on August 17, 2001, at 15:02:37
In reply to Sharing symptoms with narcolepsy! Noradrenaline!!, posted by Oscar on August 14, 2001, at 17:31:59
> Just now I've discovered that pathological REM sleep and daytime sleepiness are symptoms of narcolepsy.
That's true (really, they're the defining features of narcolepsy). And Provigil only improves alertness: it's just a stimulant with no specific efficacy for narcolepsy, but rather, general efficacy for daytime sleepiness (which of course is only one aspect of narcolepsy). Provigil doesn't help with cataplexy, in particular, as the older treatments for narcolepsy (stimulants, MAOIs, anticholinergic TCAs) do.
> It seems reasonable to think there may be a continuum between depression and narcolepsy given that stimulants and anti-depressants are used to treat both (ah yes, pharmocologic disection!).
I think that's an error. Stimulants (and some antidepressants) are REM sleep suppressors; that's why they're so effective in narcolepsy. Depressed people do often have abnormal sleep architecture with early onset of REM sleep, but not to the degree that narcoleptics do. And of course, there are effective antidepressants that don't suppress REM sleep. In narcolepsy, the problem is that the REM sleep generator is still turned on during waking states (perhaps due to a lack of communication between the cholinergic neurons in the pons, which generate REM sleep, and the hypothalamus, which controls the state of alertness. Narcoleptics aren't, as a rule, depressed, and depressives don't show most signs of narcolepsy: it's not a continuum, but two distinct conditions.
-elizabeth
poster:Elizabeth
thread:74869
URL: http://www.dr-bob.org/babble/20010814/msgs/75416.html