Medication Management of Patient with Narcolepsy During Pregnancy and Lactation

Narcolepsy is a rare neurological disorder characterized by excessive daytime sleepiness, sudden sleep attacks, sleep paralysis, hypnogogic/hypnopompic hallucinations, and loss of muscle tone triggered by emotions (in the case of narcolepsy type 1). This is a potentially debilitating disorder associated with significant loss of wages and inability to function normally if untreated. Treatment of narcolepsy is unique and challenging particularly during pregnancy and lactation. Large scale clinical trials are lacking due to the potential risk of maternal and/or fetal harm posed by the central nervous system stimulants, wake-promoting medications or the highly sedating night-time medications that improve cataplexy. Limited information is available from case reports and smaller scale mostly retrospective data analysis studies. This chapter represents the case of a young woman with Narcolepsy type 2 (without cataplexy), addressing the challenges faced during pregnancy, and after delivery of her child.