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Uncontrollable ZZZZZs
Narcolepsy in Children
Part Two
By Carma Haley
If sleep evaluation and periodic, scheduled naps to not offer improvement, it may be necessary to introduce the use of medications as a treatment for narcolepsy. "In severe cases or cases that do not respond to previous treatment, the next step is the use of stimulants, most commonly, methylphenidate hydrochloride, also known as Ritalin," says Sheldon. "In addition, if cataplexy is present and one of the more troublesome symptoms but is not improved with the stimulants, then other medications like tricyclic antidepressants are used. This is one reason why children with narcolepsy evidence by cataplexy improve when diagnosed and treated for depression. The same holds true for those misdiagnosed with ADHD and treated with Ritalin. They may improve and get better but they have the wrong diagnosis."
Children with narcolepsy can lead an absolutely normal life once they have been diagnosed and are being treated for the disorder. "I typically explain to my patients that there is nothing that they can't do as long as they take their medication," says Sheldon. "However, discuss two big things with parents whose children are narcoleptic. First, the only time that narcolepsy becomes life threatening is when children get older, don't take their medication and drive a car. Then it becomes life threatening to them and to others because they will fall asleep while driving and hurt themselves, someone else or both. The second thing is that it is a genetic disorder. It can be passed on to their children. It will not keep them from having children at all and it shouldn't be a reason not to have children. But they should know that if they do have children they should have their children evaluated and treated early so that they can have the full benefit of a happy fulfilled life as well."