Orgasmolepsy in Narcolepsy Type 1 Responsive to Pitolisant: A Case Report

Pellitteri, Gaia; Dolso, Pierluigi; Valente, Mariarosaria; Gigli, Gian Luigi

doi:10.2147/nss.s286358

Cited by 1 publication

(5 citation statements)

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“…Other possible explanations of narcolepsy impact on sexual life are secondary impact of symptoms of the disease. One of these disorders is orgasmolepsy, which may be underreported due to the embarrassment, effectiveness of treatment, or it might be masked by other sexual disorders [39,40,50,55]. Studies suggest alterations in amygdala, as an explanation for the occurrence of orgasmolepsy [39] or involvement of dopaminergic and orexin systems [58][59][60][61]86].…”

Section: Discussionmentioning

confidence: 99%

“…Studies suggest alterations in amygdala, as an explanation for the occurrence of orgasmolepsy [39] or involvement of dopaminergic and orexin systems [58][59][60][61]86]. This aspect of narcolepsy's effect on sexual function can have a significant impact on the patient's relationships, emotional well-being and sexual life [41,55]. Honest conversation with a sexual partner may be helpful for easing the distress following this symptom [40].…”

Section: Discussionmentioning

confidence: 99%

“…Honest conversation with a sexual partner may be helpful for easing the distress following this symptom [40]. Pitolisant and sodium oxybate seem to be effective treatments for this symptom in some cases [39,55]. In some patients dreams delusions occur as nightmares and are very terrifying and vivid, with aggressive content like sexual assaults, which some patients interpret as real memories, what can affect psychosocial well-being [62].…”

Section: Discussionmentioning

confidence: 99%

“…Orgasmolepsy might be masked by other sexual disorders, which are commonly observed among NT1 patients as part of a dysautonomic syndrome [50]. However, the onset of an active sexual life may coincide with ongoing effective treatments for cataplexy in individuals with narcolepsy, thus preventing the occurrence of orgasmolepsy [50,55]. Patients experienced orgasmolepsy with their partners within stable relationships, implying that emotional disinhibition and reduced self-control may necessitate a state of intimacy as a precondition for orgasmolepsy.…”

Section: Orgasmolepsymentioning

confidence: 99%

“…Other theories suggest involvement of hypocretin and dopaminergic systems in pathophysiology of orgasmolepsy [17,[58][59][60][61]. It should be noted that orgasmolepsy effects on sexual function can have a significant impact on the patient's relationships and emotional well-being [55].…”

Section: Orgasmolepsymentioning

confidence: 99%

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The impact of narcolepsy symptoms and treatment on sex life - current evidence and reports

Kasprzak,

Dyzma-Kasprzak,

Wingralek

et al. 2024

Curr Probl Psychiatry

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Introduction: Narcolepsy (NT) can manifest as excessive daytime sleepiness (EDS), cataplexy, hypnagogic (HHG) and hypnopompic (HHP) hallucinations, sleep paralysis, orgasmolepsy – all of which may affect patients' functioning. The aim of the study was to determine the impact of NT, specific sexual dysfunctions and drugs used in NT on sex life. Materials and methods: A narrative review was conducted, using keywords: narcolepsy, sexual dysfunctions, medications in narcolepsy from repository inception to March 17, 2024 searching PubMed/MEDLINE, Google Scholar, Crossref, Cochrane databases. The quality of the reviewed articles was assessed using the Scale for the Assessment of Narrative Review Articles (SANRA). Results: Sexual activity and satisfaction are reduced in up to 81.1% of patients. There are often multiple co-occurring autonomic dysregulations in patients, including the genitourinary system, causing sexual dysfunction (erectile dysfunction in 48% of men; vaginal lubrication in 81% of women). Orgasmolepsy negatively affects sexual and social relationships in more than 1⁄3 of respondents. Sleep paralysis can be accompanied by HHG, which often present the impression of sexual assault and harassment. They may cause anxiety, post-traumatic stress disorder (PTSD) features, depressed mood, in extreme cases leading to suicide attempts. Of the drugs used in NT, only methylphenidate can increase libido and reduce erectile dysfunction in NT. Conclusions: Orgasmolepsy, sexual and autonomic dysfunction in NT significantly reduce patients' quality of sex life. Sleep paralysis with sexual HHG can reduce psychological well-being. A holistic intervention approach, using behavioural interventions, cognitive-behavioural therapy, education of the patient and their loved ones, is crucial in the treatment of sexual difficulties. Keywords: narcolepsy, sexual dysfunctions, medications in narcolepsy

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