Mazindol in narcolepsy and idiopathic and symptomatic hypersomnia refractory to stimulants: A long-term chart review

Nittur, Nandini; Konofal, Éric; Dauvilliers, Yves; Franco, Patricia; Leu‐Semenescu, Smaranda; Cock, Valérie Cochen De; Inocente, Clara Odília; Bayard, Sophie; Scholtz, Sabine; Lecendreux, Michel; Arnulf, Isabelle

doi:10.1016/j.sleep.2012.07.008

Cited by 76 publications

(26 citation statements)

References 20 publications

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“…Stimulants, such as methylphenidate, are contraindicated in patients with hypertension, chest pain, cardiac arrhythmias, mitral valve prolapse, ventricular hypertrophy, angina and acute myocardial infarction. Patients with glaucoma, anxiety, epilepsy or Tourette's syndrome are prescribed methylphenidate with strong caution [35]. Modafinil, on the other hand, is well tolerated for the treatment of excessive sleepiness and has no cardiovascular or sleep-related side effects [36].…”

Section: Effect Of Melatonin On Hypersomnolencementioning

confidence: 99%

A review of sleep disorders and melatonin

Xie

Chen

et al. 2017

Neurological Research

316

181

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Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis and cause significant impairments in social and occupational functions. Although currently approved medications are efficacious, they are far from satisfactory. Benzodiazepines, antidepressants, antihistamines and anxiolytics have the potential for dependence and addiction. Moreover, some of these medications can gradually impair cognition. Melatonin (N-acetyl-5-methoxytryptamine) is an endogenous hormone produced by the pineal gland and released exclusively at night. Exogenous melatonin supplementation is well tolerated and has no obvious short-or long-term adverse effects. Melatonin has been shown to synchronize the circadian rhythms, and improve the onset, duration and quality of sleep. It is centrally involved in anti-oxidation, circadian rhythmicity maintenance, sleep regulation and neuronal survival. This narrative review aims to provide a comprehensive overview of various therapeutic functions of melatonin in insomnia, sleep-related breathing disorders, hypersomnolence, circadian rhythm sleep-wake disorders and parasomnias. Melatonin offers an alternative treatment to the currently available pharmaceutical therapies for sleep disorders with significantly less side effects.

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Section: Effect Of Melatonin On Hypersomnolencementioning

confidence: 99%

A review of sleep disorders and melatonin

Xie

Chen

et al. 2017

Neurological Research

316

181

View full text Add to dashboard Cite

show abstract

“…Recently, a case of partially reversible PAH associated with mazindol intake was reported [30]. However, in a larger series of 139 patients treated with mazindol, no cases of PAH were reported, but only 45 patients underwent cardiac echography [31]. Because of its mechanism, periodic cardiovascular examinations should be offered to patients treated with mazindol.…”

Section: Mazindolmentioning

confidence: 99%

Drug-induced pulmonary arterial hypertension: a recent outbreak

Montani¹,

Seferian²,

Savale³

et al. 2013

Eur Respir Rev

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Pulmonary arterial hypertension (PAH) is a rare disorder characterised by progressive obliteration of the pulmonary microvasculature resulting in elevated pulmonary vascular resistance and premature death. According to the current classification PAH can be associated with exposure to certain drugs or toxins, particularly to appetite suppressant intake drugs, such as aminorex, fenfluramine derivatives and benfluorex. These drugs have been confirmed to be risk factors for PAH and were withdrawn from the market. The supposed mechanism is an increase in serotonin levels, which was demonstrated to act as a growth factor for the pulmonary artery smooth muscle cells. Amphetamines, phentermine and mazindol were less frequently used, but are considered possible risk factors, for PAH. Dasatinib, dual Src/Abl kinase inhibitor, used in the treatment of chronic myelogenous leukaemia was associated with cases of severe PAH, potentially in part reversible after dasatinib withdrawal. Recently, several studies have raised the issue of potential endothelial dysfunction that could be induced by interferon, and a few cases of PAH have been reported with interferon therapy. PAH remains a rare complication of these drugs, suggesting possible individual susceptibility, and further studies are needed to identify patients at risk of drug-induced PAH. @ERSpublications Drug-associated PAH remains a clinical challenge: understanding the mechanisms and identifying drugs at-risk for PAH

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“…Published guidelines also mention selegiline, a monoamine oxidase inhibitor, as an option for EDS, as well as other drugs not currently available in the United States including mazindol, ritanserin, and reboxetine. Mazindol is an imidazolidine derivative that blocks dopamine and norepinephrine reuptake that may be effective for EDS and cataplexy [45], and is only available in France. Ritanserin is a serotonin-2 antagonist with potential efficacy for EDS, and reboxetine is a norepinephrine reuptake inhibitor that may be effective for cataplexy [43].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the purpose of this article is to discuss these factors and to provide clinically relevant recommendations for making treatment decisions that can enhance the effective management of patients with narcolepsy. There are several new approaches to therapy such as the histamine receptor inverse agonist/antagonist pitolisant [48] and the non-amphetamine stimulant mazindol [45], which are not available in the United States, as well as experimental therapies including JZP-110 [49,50] and hypocretin-based therapies such as hypocretin cell transplantation [51] or intranasal administration of hypocretin [52]. However, this article focuses on recommended and readily available therapies.…”

Section: Introductionmentioning

confidence: 99%

Clinical and practical considerations in the pharmacologic management of narcolepsy

Thorpy¹,

Dauvilliers²

2015

Sleep Medicine

Self Cite

114

110

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Despite published treatment recommendations and the availability of approved and off-label pharmacologic therapies for narcolepsy, the clinical management of this incurable, chronic neurologic disorder remains challenging. While treatment is generally symptomatically driven, decisions regarding which drug(s) to use need to take into account a variety of factors that may affect adherence, efficacy, and tolerability. Type 1 narcolepsy (predominantly excessive daytime sleepiness with cataplexy) or type 2 narcolepsy (excessive daytime sleepiness without cataplexy) may drive treatment decisions, with consideration given either to a single drug that targets multiple symptoms or to multiple drugs that each treat a specific symptom. Other drug-related characteristics that affect drug choice are dosing regimens, tolerability, and potential drug-drug interactions. Additionally, the patient should be an active participant in treatment decisions, and the main symptomatic complaints, treatment goals, psychosocial setting, and use of lifestyle substances (ie, alcohol, nicotine, caffeine, and cannabis) need to be discussed with respect to treatment decisions. Although there is a lack of narcolepsy-specific instruments for monitoring therapeutic effects, clinically relevant subjective and objective measures of daytime sleepiness (eg, Epworth Sleepiness Scale and Maintenance of Wakefulness Test) can be used to provide guidance on whether treatment goals are being met. These considerations are discussed with the objective of providing clinically relevant recommendations for making treatment decisions that can enhance the effective management of patients with narcolepsy.

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Mazindol in narcolepsy and idiopathic and symptomatic hypersomnia refractory to stimulants: A long-term chart review

Cited by 76 publications

References 20 publications

A review of sleep disorders and melatonin

A review of sleep disorders and melatonin

Drug-induced pulmonary arterial hypertension: a recent outbreak

Clinical and practical considerations in the pharmacologic management of narcolepsy

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