Drugs to treat excessive daytime sleepiness in narcolepsy
| Medication | Dosage | Side effects and federal schedule |
|---|---|---|
| Modafinil | 100–400 mg/day in 2 divided doses | Headache, anxiety, nausea, dry mouth, anorexia, diarrhea, reduction of efficacy of oral contraceptives, Stevens-Johnson syndrome (rare) Schedule IVa |
| Armodafinil | 150-250 mg once daily in the morning | Same as modafinil Schedule IV |
| Methylphenidate | Immediate-release: 5 mg twice daily titrated up by 5-10 mg per dose weekly up to to 10-20 mg twice daily; once on stable dose, transition to extended- or sustained-release formulation | Headache, anxiety, nausea, anorexia, tremor, psychosis, cardiovascular effects like hypertension and arrhythmias, abuse (rare) Schedule IIb |
| Dextroamphetamine | Short-acting: 5 mg twice daily titrated up by 5-10 mg per dose weekly up to 30 mg twice daily; once on stable dose, transition to long-acting formulation | Headache, anxiety, nausea, anorexia, tremor, psychosis, cardiovascular effects like hypertension and arrhythmias, abuse (rare) Schedule II |
| Amphetamine/dextroamphetamine | Short-acting: 5–10 mg daily titrated up by 10 mg weekly up to 60 mg/ day or satisfactory clinical response; may add additional doses 4–6 hours after first dose; once on stable dose, transition to long-acting formulation | Headache, anxiety, nausea, anorexia, tremor, psychosis, cardiovascular effects like hypertension and arrhythmias, abuse (rare) Schedule II |
↵a Schedule IV drugs have a low potential for abuse and low risk of dependence. See www.dea.gov/druginfo/ds.shtml.
↵b Schedule II drugs have a high potential for abuse, with use potentially leading to severe psychological or physical dependence.