New Medication?

11 posts in this topic

Hey everyone,


I went to my doctor yesterday and she sent my insurance a referral for sleep specialist. While we were talking about narcolepsy she told me the reason she didn't want to give me any medication was because at her last office a pharm rep had come in to talk to the office about a new medication to treat narcolepsy. I was wondering if anyone else has heard anything. I tried googling it but the only thing I found was about Reset Therapeutics. But that sounded like that wouldn't be available for another 5 years. If anyone knows of anything else I'd love to hear about it!



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That's a long way off.  It is an orexin receptor agonist or a synthetic form of orexin.  A drug that does the opposite, Suvorexant (for insomnia), was recently killed by the FDA.  When given at certain doses, it's like speed.


The cause of narcolepsy is not the same in all patients, and there's more to it than just orexin.

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Yeah, I know about the orexin thing and all but the way my doctor was talking sounded like a new medication was coming out within the year, if not already out. At first I thought she might've been talking about Nuvigil but that didn't fit the time frame in which we were talking in. I was just wondering if I had missed something. As far as I know, Nuvigil is the newest medication on the market specifically for Narcolepsy and the Orexin won't be out for at least another 5 years, right? I've only been diagnosed for a little over a year, so I'm pretty new to a lot. I'm still learning.


On another note, I was wondering is Xyrem only for narcolepsy patients with cataplexy? I was reading about all different medications for narcolepsy and Xyrem was listed, but I've only read where people with cataplexy take it. Just trying to fill my narcolepsy book of knowledge!

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Ferret I was thinking the same thing!


I just had an appointment with my sleep doc on Monday.  I asked (even though I knew the answer) if any new drugs have come out for the day time.  He said no but mentioned the Orexin mist... we both laughed and he said "maybe in 30 years".


I hope it will come out in 5!

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There was a post about that stuff a year or so ago.  I feel like it was more expensive and someone tried it and it did jack!

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Sorry....I didn't realize you wouldn't be able to see the article.  Here it is: Surprising Narcolepsy Findings Have Therapeutic Potential

Megan Brooks

Jun 12, 2013


BALTIMORE, Maryland — Researchers have unexpectedly found an increase in histaminergic neurons in patients with narcolepsy, a finding that may have therapeutic implications.

Narcolepsy is caused by a loss of hypothalamic neurons that produce the orexin/hypocretin neuropeptides, which promote wakefulness. The new study shows narcolepsy is also associated with a "very large" increase in the number of neurons producing histamine, another wake-promoting neurotransmitter, principal investigator Thomas Scammell, MD, professor of neurology at Beth Israel Deaconess Medical Center in Boston, Massachusetts, said in a statement.

Philipp Valko, MD, also from Beth Israel Deaconess Medical Center and from University Hospital Zurich, Switzerland, presented the research at SLEEP 2013: Associated Professional Sleep Societies 27th Annual Meeting.

Compensatory Mechanism?

Using stereologic techniques, the study team counted the number of hypothalamic neurons producing orexin, melanin-concentrating hormone (MCH), and histamine in 7 patients with narcolepsy and 12 control patients.

They found that compared with controls, patients with narcolepsy had 94% more histaminergic neurons (233,572 vs 120,455; P < .001). This increase was more pronounced in 5 patients with narcolepsy who had severe orexin neuron loss than in 2 patients with less severe loss, the researchers say.

The results were similar in mouse models, where the number of histaminergic neurons was increased 53% in orexin ligand knockout mice compared with wild-type mice, while orexin/ataxin-3 transgenic mice showed an intermediate 28% increase.

The researchers say this "surprising" increase in wake-promoting histaminergic neurons in patients with narcolepsy may be a compensatory response to loss of excitatory drive from the orexin neurons.

Nathaniel Watson, MD, neurologist and sleep specialist with University of Washington, Seattle, who wasn't involved in the study, agrees.

"Histamine is a key component of the monoaminergic arousal system in the brain. Increases in histaminergic cells in the hypothalamus of narcolepsy patients suggest attempts at compensating for orexin cell loss to increase alertness to predisease levels in these patients," he told Medscape Medical News.

Increases in histaminergic neurons in narcolepsy may also contribute to some of the symptoms of narcolepsy, such as preserved consciousness during cataplexy and fragmented nighttime sleep, the investigators say.

Promising Drug Target

"Previous studies have assumed that loss of the orexin neurons was a sufficient explanation for the symptoms of narcolepsy, and this large increase in histamine-producing neurons was unexpected," Dr. Scammell noted.

"This new observation suggests that drugs that reduce histamine signaling at night may improve sleep in narcolepsy, whereas drugs that enhance histamine signals may be a good option for promoting alertness during the day," he added. Medications that enhance histamine are now under development.

The study was supported by the Swiss National Science Foundation. The authors and Dr. Watson have disclosed no relevant financial relationships.

SLEEP 2013: Associated Professional Sleep Societies 27th Annual Meeting. Abstract Presented June 3, 2013.

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