Narcolepsy treatments are going to vary widely from patient-to-patient depending on what symptoms the patient experiences. Whether they have cataplexy or don't have cataplexy, or if they have other parts of the narcolepsy triad such as sleep paralysis, hypnagocic or hypnopompic hallucinations. Generally, the first line of treatment for narcolepsy is a sort of stimulant to keep them awake during the day. An amphetamine known as Adderall or Dexedrine, either of those, are common treatments. We can use forms of methylphenidate, which is commonly known as Ritalin. A newer treatment on the market is a medication called Provigil, which is a atypical stimulant that targets parts of the hypothalamus that regulates sleep and weight and in most patients don't have the sort of stimulating effect, or the feeling of a high that amphetamine or methylphenidate would. Just as you need to treat the sleepiness during the day for a narcoleptic, generally narcoleptics have poor quality nighttime sleep and require some sort of sedative treatment, something like Ambien or Restoril. Any number of sedatives could be used to aid a narcoleptic in nighttime sleep, if they have problems sleeping at night. Cataplexy and the other parts of the narcolepsy triad are caused by intrusions of REM into inappropriate parts of the sleep-wake cycle. Sleep paralysis is an example of this, where a person is completely and fully wide awake but they have no muscle tone. Therefore, they can't speak, can't move and have no control over themselves or their environment. Cataplexy, which I mentioned, where a strong emotion causes a person to lose muscle tone and appear to faint or have a seizure, that's an intrusion of REM. Hallucinations that come with narcolepsy, that come at either the beginning of sleep or at the end of sleep, again, are inappropriate intrusions of REM. It's found that antidepressant medications, such as, Prozac, Effexor or Zoloft, these medication's selective seratonin re-uptake inhibitors have a REM suppressant quality, as do tricyclic antidepressants, Elavil is the first one that comes to mind, there are a number that can be used. It depends on the patient. Sometimes it's a lengthy process to find the right combinations of medications for a narcoleptic. One of the newest medications on the market used to treat cataplexy is a medication called Xyrem. It's available, only from its manufacturer. It has been made under the Orphan Drug Act. It's so tightly controlled because it is the pharmaceutical version of the street drug GHB, which has been used successfully in date rapes and has been used as a recreational drug for a number of years. Xyrem, in a narcoleptic, is found to suppress cataplexy and to aid greatly in nighttime sleep and it has been quite a boom for a number of the patients with whom I have worked.