Tag Archives: Modafinil

Narcolepsy and Other Disorders of Excessive Daytime Sleepiness

Narcolepsy is a prime example of a disorder with dysfunction of a specific sleep state, in this case REM sleep. Isolated fragments of REM sleep intrude into wakefulness, and the result is the characteristic symptoms that invariably cause excessive daytime sleepiness. Narcolepsy in humans was first described in 1880 by the French neurologist Gelineau. Since… Read More »

What medications are used to treat ADHD in women and girls?

Research and clinical experience have shown that stimulant medications are the most effective first-line treatment for ADHD in both males and females. Currently, there are many medication formulations, including stimulants (methylphenidate and amphetamine preparations) and nonstimulants for the treatment of attention-deficit/hyperactivity disorder. Although a few skeptics continue to voice concerns over the prescription of medication… Read More »

Minor Depression

Etiology and Pathophysiology Minor depression is only a proposed diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and there are no International Classification of Diseases codes to categorize it. The proposed diagnostic category for minor depression in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition describes a depressive disorder that… Read More »

CNS Stimulants

Central Nervous System Stimulants Pharmacologic Profile General Use Used in the treatment of narcolepsy and as adjunctive treatment in the management of ADHD. General Action and Information Produce CNS stimulation by increasing levels of neurotransmitters in the CNS. Produce CNS and respiratory stimulation, dilated pupils, increased motor activity and mental alertness, and a diminished sense… Read More »

Sleep Disorders and Neurologic Disorders

Neurologic disorders can affect sleep on multiple levels, depending on the location of the lesion or dysfunction. Many classifications can be used, such as classifications related to the location of the lesion or classifications related to the clinical presentations. The latter have the advantage of enticing the practitioner to systematically evaluate specific sleep disorders. Such… Read More »

Autoimmune Disorders

Description of Autoimmune Disorders Sleep disorders and excessive daytime sleepiness are common in multiple sclerosis (MS), an autoimmune disorder that causes white matter plaques in affected areas of the brain. The most common sleep complaints include excessive daytime sleepiness and insomnia. Approximately 40% of patients with multiple sclerosis have insomnia. Other sleep complaints include restless… Read More »

Augmentation and combination therapies

Technically, ‘augmentation’ describes adding a medication that by itself is not an antidepressant to a recognized antidepressant. The addition of a second antidepressant at subtherapeutic doses is also considered to be an augmentation strategy, while ‘combination’ therapy involves the prescription of two antidepressants at therapeutic doses. However, these terms are often used interchangeably, as in… Read More »

Treatment of Hypersomnias

This post focuses on treatment of the hypersomnias of central origin as defined in the second edition of the International Classification of Sleep Disorders (ICSD-2). Rational therapy begins with an understanding of the normal anatomy, physiology, and neurochemistry of central wake / sleep mechanisms. Basic Wake Systems The ascending reticular activating system, defined in part… Read More »

Hypersomnia: Pharmacologic Therapy

Narcolepsy: Pharmacologic Therapy Recurrent Hypersomnias The recurrent hypersomnias described in the ICSD-2 are the Kleine-Levin syndrome and menstrual-related hypersomnia. Kleine-Levin Syndrome The Kleine-Levin syndrome was first described by Antimoff in 1898, detailed by Willi Kleine in 1925, clearly summarized by Max Levin in 1929, and formally named the Kleine-Levin syndrome by Critchley and Hoffmann in… Read More »