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

Romigi, Andrea; Liguori, Claudio; Izzi, Francesca; Albanese, Maria; Marchi, Angela; Mancini, C.; Tarquini, E.; Mercuri, Nicola Biagio; Placidi, Fabio

doi:10.1016/j.jns.2014.11.025

Cited by 9 publications

(8 citation statements)

References 11 publications

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“…Low serum level acylcarnitine were described in narcolepsy, and L-carnitine supplementation may reduce sleepiness 7 , 8 . The partial improvement of ESS reported by Barros et al 1 may be explained by a low dose of L-carnitine compared to our case (510 mg/d vs. 1000 mg/d) 2 . Since narcolepsy treatment during pregnancy is challenging 9 , L-carnitine may represent a safe and effective treatment, although randomized controlled-study should confirm its efficacy on sleepiness and cataplexy and effective and safe dosages in larger sample.…”

contrasting

confidence: 47%

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Oral L-carnitine and pregnancy: real opportunity for narcoleptic women?

Romigi¹,

Centonze²

2019

Sleep Sci

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contrasting

confidence: 47%

“…We previously described a case of narcolepsy type 2, who started oral L-carnitine therapy up to 500 mg b.i.d. 2 . The patient obtained sustained objective (MSLT) and subjective (ESS) improvement until 6-month follow up after the delivery.…”

mentioning

confidence: 99%

Oral L-carnitine and pregnancy: real opportunity for narcoleptic women?

Romigi¹,

Centonze²

2019

Sleep Sci

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“…In Williams et al’s research, intervention with L-carnitine started before pregnancy and was maintained during the gestational period 14 . In the research by Romigi et al and Barros et al, the intervention was performed during the gestational period 12 , 15 . These data are shown in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Near 37 weeks of pregnancy, this patient presented an increase of narcolepsy and cataplexy episodes, with the need to undergo an elective cesarean section, under spinal anesthesia, at 38 weeks. Before childbirth, the patient received 250 mg of intravenous carnitine every 6 hours until she could tolerate oral medication 15 . Barros et al reported that the patient had an uneventful pregnancy with a weight gain of 7 kg when using L-carnitine.…”

Section: Identification and Survey Selectionmentioning

confidence: 99%

Impact of L-carnitine in narcolepsy treatment: a systematic review on the effectiveness and safety

Salles¹,

Freitas²,

Cruz³

2022

Sleep Sci

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Introduction:Studies have shown that narcolepsy patients may present with low serum acylcarnitine levels, demonstrating a dysfunctional beta fatty acid oxidation pathway in these patients. Objective: Evaluate the therapeutic efficacy of L-carnitine as a treatment for narcolepsy patients. Methods: This study runned in form of systematic review. The terms used for the search: ("narcolepsy"[MeSH Terms] OR "narcolepsy"[All Fields]) AND ("carnitine"[MeSH Terms] OR "carnitine"[All Fields] OR "l carnitine"[All Fields]). Were included all surveys published until January 2021, with the diagnosis of narcolepsy, that performed drug treatment with I-carnitine. The clinical endpoints of interest were: excessive daytime sleepiness, dissociative REM sleep manifestations: cataplexy, sleep paralysis, hypnagogic hallucinations, and early REM sleep (REM sleep naps, SOREMP). Results: L-carnitine was found to be well-tolerated and without side effects in all surveys, at dosages ranging from 500 to 510 mg/day. Newborns did not present complications during delivery. Conclusion: This study corroborates the efficacy and good tolerability of L-carnitine therapy as a treatment for patients with narcolepsy, including during pregnancy.

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“…Although the sample size was small (30 subjects), the total time of dozing off during the daytime was decreased by l -carnitine administration compared with that of placebo treatment. In addition, a case report described a patient with NT2 who was successfully treated with oral l -carnitine 54 . Further studies with larger numbers of patients and long-term observations are required to confirm its efficacy.…”

Section: Genome-wide Association Studies (Gwass) Of Nt1mentioning

confidence: 99%

Genetics of narcolepsy

Miyagawa

Tokunaga

2019

Hum Genome Var

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Narcolepsy is a term that was initially coined by Gélineáu in 1880 and is a chronic neurological sleep disorder that manifests as a difficulty in maintaining wakefulness and sleep for long periods. Currently, narcolepsy is subdivided into two types according to the International Classification of Sleep Disorders, 3rd edition: narcolepsy type 1 (NT1) and narcolepsy type 2 (NT2). NT1 is characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis and is caused by a marked reduction in neurons in the hypothalamus that produce orexin (hypocretin), which is a wakefulness-associated neuropeptide. Except for cataplexy, NT2 exhibits most of the same symptoms as NT1. NT1 is a multifactorial disease, and genetic variations at multiple loci are associated with NT1. Almost all patients with NT1 carry the specific human leukocyte antigen (HLA) allele HLA-DQB1*06:02. Genome-wide association studies have uncovered >10 genomic variations associated with NT1. Rare variants associated with NT1 have also been identified by DNA genome sequencing. NT2 is also a complex disorder, but its underlying genetic architecture is poorly understood. However, several studies have revealed loci that increase susceptibility to NT2. The currently identified loci cannot explain the heritability of narcolepsy (NT1 and NT2). We expect that future genomic research will provide important contributions to our understanding of the genetic basis and pathogenesis of narcolepsy.

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

Cited by 9 publications

References 11 publications

Oral L-carnitine and pregnancy: real opportunity for narcoleptic women?

Oral L-carnitine and pregnancy: real opportunity for narcoleptic women?

Impact of L-carnitine in narcolepsy treatment: a systematic review on the effectiveness and safety

Genetics of narcolepsy

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