Treatment of Intractable Narcolepsy with a Monoamine Oxidase Inhibitor

Abstract

Seven patients with intractable narcolepsy were treated with the monoamine oxidase inhibitor, phenelzine. Striking reductions in the amount of cataplectic attacks, sleep paralysis and hypnagogic hallucinations were noted. In addition, daytime sleeping and hypersomnia were diminished, but side effects (hypotension, edema, impaired sexual function) were bothersome. Phenelzine almost completely suppressed rapid-eye-movement sleep and remained effective for periods of more than a year. Although dreams were frequently reported before drug treatment no dreams were reported when rapid-eye-movement sleep was completely absent. No adverse psychologic effects were noted during the period of total rapid-eye-movement suppression.