Management of narcolepsy during pregnancy

Oral l-carnitine as treatment for narcolepsy without cataplexy during pregnancy: A case report

“…The nocturnal sleep and daytime sleepiness symptoms in narcolepsy women have not been characterized during pregnancy but they appear to follow the pattern seen in healthy women with higher variability [1]. The management of narcolepsy during pregnancy is still debated [1,2]. We described a significant improvement of sleepiness in our pregnant narcoleptic patient after the L-carnitine intake.…”

“…restless legs, sleep-related breathing disorders) and/or leg cramps and fetal activity [6]. The nocturnal sleep and daytime sleepiness symptoms in narcolepsy women have not been characterized during pregnancy but they appear to follow the pattern seen in healthy women with higher variability [1]. The management of narcolepsy during pregnancy is still debated [1,2].…”

“…Our report suggests considering oral L-carnitine to treat daytime sleepiness in narcoleptic pregnant patients. It is difficult for a clinician to make an appropriate assessment of the benefit-risk ratio of narcolepsy medications during pregnancy [1,2]. It is ideally recommended that the narcolepsy treatment should be discontinued during the time of conception, pregnancy and lactation [2].…”

“…Several drugs for narcolepsy are designated Class C in pregnancy, and there are few data regarding their effects on the developing fetus or neonates [1]. Prematurity, low birth weight and withdrawal symptoms have been reported in infants born to women taking amphetamines for recreational purposes or addiction disorder, but lacking data in narcolepsy.…”

Central Disorders of Hypersomnolence

“…Th e majority of agents are in FDA pregnancy category C, meaning either an absence of both human and animal safety data or evidence for harm in animal studies but absent human studies. Although no published guidelines exist for the treatment of narcolepsy during pregnancy, Th orpy et al 121 summarized the animal and human data on these medications, which may be helpful to clinicians in guiding therapy decisions. Pregnancy registries, which compile data from women exposed to specifi c medications during pregnancy, are currently available for modafi nil and armodafi nil, and the FDA maintains an updated list of all medications for which such registries exist.…”