A questionnaire concerning eight situations of daily life where patients are likely to fall asleep: while reading, watching TV, driving, etc. Double the sleep resistanceįor three months, the 250 patients in the cohort were able to assess themselves using the Epworth scale. This innovative treatment no longer acts simply on the recapture of dopamine but also on noradrenaline and has therefore proved to be "very effective, well tolerated and without any escape over time, at least over a year of evaluation", says Yves Dauvilliers. After 4 years of work and tests at the Montpellier reference center, the new drug, developed with the laboratory JAZZ Pharmaceuticals, obtained its authorization to be marketed in the United States last March and should obtain European approval by the end of the year. Unfortunately, if you increase the doses too much, you risk side effects such as headaches, irritability, high blood pressure." Hence the need for a new treatment. If these last treatments are effective, their effects are not always sufficient and long-lasting, "there is sometimes a kind of escape, describes the researcher, with time, people become a little sleepy again.
They were gradually replaced by Ritalin, which is also prescribed for hyperactivity, and today by Modiodal or Wakix, which increases histamine levels. Avoiding the risk of side effectsĪmphetamines, which prevent the reuptake of dopamine, were used as the first treatment for narcolepsy. The drugs will prevent the recapture of these neurotransmitters to increase their number and thus promote wakefulness.
The neurons release their neurotransmitters in the pre-synaptic button but will then recapture part of them to avoid a new synthesis of proteins," explains Yves Dauvilliers. The objective of treatments against narcolepsy is therefore to increase the presence of these molecules in the synaptic gap connecting two neurons in order to stimulate the message of wakefulness. In fact, other neurotransmitters such as dopamine, noradrenaline, histamine, or acetylcholine can partially take over when the hypocretin neurons disappear.
Fortunately for narcoleptics, hypocretin is not the only one to play this role, otherwise they would be asleep 24 hours a day." Hypocretin is a neurotransmitter whose main role is to stimulate wakefulness, "it is because hypocretin neurons are activated that you can have wakeful behaviors, in other words eating, chatting, walking," says the researcher. The human brain contains more than 100 billion neurons," says Yves Dauvilliers, "and narcolepsy destroys 80,000 of them by targeting hypocretin neurons exclusively. 80,000 neurons destroyedĪn autoimmune disease of genetic and environmental origin, narcolepsy and its mechanisms have only been well known to researchers for about 20 years. Sleepiness can sometimes be accompanied by weight gain, hallucinations, sleep paralysis and frequently cataplexy, in other words a "loss of muscle strength related to favorable emotions such as laughter," explains Yves Dauvilliers of the Neuropsychiatry: Epidemiological and Clinical Research Laboratory, and coordinator of the four reference centers on narcolepsy recognized by the Ministry of Health and of which the Montpellier University Hospital is the leader. While difficulty staying awake is the main symptom of this neurological condition, it is not the only one. The most severe disease of sleepiness in men, narcolepsy generally occurs in people between the ages of 15 and 20. To better treat this disease, Yves Dauvilliers, a neurologist specializing in sleep, and his team at the Montpellier University Hospital have just developed an innovative treatment. When the inability to resist sleep becomes a nightmare! This is the daily life of nearly 20,000 people in France suffering from narcolepsy. Published on Decemin Health, Social & Disability, Science-Society
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