Drug Holidays in Narcolepsy

Opinion
Video

Drs Thorpy, Dogan, Doghramji, and Kushida talk about treatment holidays in narcolepsy.

This is a video synopsis/summary of a panel discussion involving Michael Thorpy, MD; Karl Doghramji, MD, FAASM, DFAPA; Clete Kushida, MD, PhD; and Richard K Bogan, MD.

The discussion delved into the topic of drug holidays for patients, particularly in the context of narcolepsy treatment. Traditional stimulants were once commonly used, and drug holidays were more prevalent. However, with newer medications, the usefulness of drug holidays is questioned. Studies, such as one concerning switching from modafinil to pitolisant, suggest benefits in managing excessive daytime sleepiness.

Considerations for implementing drug holidays include patient preference, medication effectiveness, and side effects. Some physicians advocate for drug holidays during weekends to mitigate tolerance with short-acting schedule 2 drugs while encouraging patients to stay active. However, newer wakefulness-promoting medications show less tolerance development, reducing the need for drug holidays.

The discussion also touched upon sodium oxybate, noting its unique properties. Unlike some medications, oxybate doesn't seem to induce tolerance, with patients sometimes exhibiting improved sleep patterns. Long-term studies suggest minimal tolerance development since its introduction in 2002. Thus, drug holidays are generally not recommended for oxybate.

Video synopsis is AI-generated and reviewed by NeurologyLive editorial staff.

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