Narcolepsy: The Daily PANCE Blueprint
A 22-year-old female experiences sudden weakness in her legs when she laughs, along with excessive daytime sleepiness and occasional vivid hallucinations when falling asleep. Which of the following is the first-line pharmacologic treatment to reduce her daytime sleepiness?
A. Venlafaxine
B. Modafinil
C. Melatonin
D. Zolpidem
E. Diazepam
Answer and topic summary
The answer is B. Modafinil
Narcolepsy is a chronic, debilitating sleep disorder characterized by cataplexy, excessive daytime sleepiness (EDS), sleep paralysis, and hypnagogic or hypnopompic hallucinations. It usually begins in teens or twenties. Referral to a sleep clinic is indicated if narcolepsy is suspected. Typically patients will need to keep a sleep log for 2 weeks and then undergo polysomnography and a multiple sleep latency test. The multiple sleep latency test is the best diagnostic tool as it observes the quick transition to REM sleep to establish the diagnosis. The first line-treatment is typically a combination of behavioral strategies and pharmacological therapy. Modafinil is considered the preferred initial pharmacologic agent for excessive daytime sleepiness.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Psychiatry ⇒ ⇒
