![]() ![]() Differential pharmacology of newer antidepressants. Pharmacological aspects of human and canine narcolepsy. Neuropharmacology and neurochemistry of canine narcolepsy. Further characterization of the alpha-1 receptor subtype involved in the control of cataplexy in canine narcolepsy. Nishino S, Fruhstorfer B, Arrigoni J, Guilleminault C, Dement WC, Mignot E. ![]() Pharmacologic management of excessive daytime sleepiness. Desmethyl metabolites of serotonergic uptake inhibitors are more potent for suppressing canine cataplexy than their parent compounds. Nishino S, Arrigoni J, Shelton J, Dement WC, Mignot E. This compound had less side effect than those of tricyclic antidepressant, clomipramine. Our study contributes further to previously reported role of adrenergic uptake inhibition in cataplexy. Milnacipran reduced cataplexy in human patients and REM sleep in healthy human subjects. Milnacipran also significantly reduced cataplexy dose-dependently in the study on canine narcolepsy. The percentage of REM sleep significantly decreased ( p = 0.042) in the subjects with milnacipran (17.5 ± 1.7%) compared to subjects with placebo (21.5 ± 2.3%). Milnacipran significantly reduced cataplexy from 9.3 to 5.5 episodes per month in human patients without much side effects. The food-elicited cataplexy test was used to assess the anticataplectic effect of milnacipran. In the study on canine narcolepsy, four genetically narcoleptic Doberman pinschers were enrolled. To assess milnacipran’s depressant effect on REM sleep, we performed nocturnal polysomnography examinations twice on each eight healthy adult subjects who were administered with milnacipran or placebo. The change in the frequency of cataplexy and side effects before and after drug replacement was investigated. Ten human patients with narcolepsy–cataplexy who changed medication from clomipramine to milnacipran due to side effects were enrolled. We also assessed the effect of milnacipran on REM sleep suppression in nocturnal sleep. We assessed the anticataplectic effect of milnacipran, an SNRI, on human and canine narcolepsy. Even though tricyclic antidepressants are effective in reducing sleep paralysis and hypnagogic hallucinations, they even enhance daytime sleepiness, dizziness, and orthostatic hypotension. Cataplexy has been treated pharmacologically, most often with tricyclic antidepressants. Hypersomnia also occurs in patients with meningoencephalitis due to African trypanosomiasis (sleeping sickness), which is transmitted by the tsetse fly.Cataplexy is a sudden drop of antigravity-muscle tone triggered most often by positive emotional factors, which is one of the major symptoms of narcolepsy. Acute, relatively brief EDS and hypersomnia commonly accompany acute systemic disorders such as influenza. read more can also cause EDS with or without hypersomnia. read more, and seizure disorders Seizure Disorders A seizure is an abnormal, unregulated electrical discharge that occurs within the brain’s cortical gray matter and transiently interrupts normal brain function. Cardinal manifestations are jaundice, coagulopathy, and encephalopathy. read more, hepatic failure Acute Liver Failure Acute liver failure is caused most often by drugs and hepatitis viruses. Principal causes include hyperparathyroidism. ![]() read more, hypercalcemia Hypercalcemia Hypercalcemia is a total serum calcium concentration > 10.4 mg/dL (> 2.60 mmol/L) or ionized serum calcium > 5.2 mg/dL (> 1.30 mmol/L). read more, anemia, uremia, hypercapnia Ventilatory Failure Ventilatory failure is a rise in PaCO2 (hypercapnia) that occurs when the respiratory load can no longer be supported by the strength or activity of the system. In patients with diabetes who take insulin or antihyperglycemic. read more, hyperglycemia, hypoglycemia Hypoglycemia Hypoglycemia, or low plasma glucose level can result in sympathetic nervous system stimulation, and central nervous system dysfunction. Signs may include a typical facial appearance, hoarse slow speech, and dry skin. Symptoms include cold intolerance, fatigue, and weight gain. Hypothyroidism Hypothyroidism Hypothyroidism is thyroid hormone deficiency. These disorders include space-occupying lesions affecting the hypothalamus or upper brain stem, increased intracranial pressure, and certain forms of encephalitis. Other disorders that can cause chronic EDS are usually suggested by the history and physical examination brain imaging and blood and urine tests can confirm the diagnosis. ![]()
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