Narcolepsy: The Daily PANCE Blueprint

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Narcolepsy: The Daily PANCE Blueprint

A 28-year-old woman presents to her primary care PA with a complaint of excessive daytime sleepiness. She describes falling asleep suddenly during the day, even while talking to friends. She also reports episodes of muscle weakness triggered by strong emotions. Sleep study confirms the diagnosis of narcolepsy. Which of the following is the most appropriate pharmacologic treatment for this patient?

A. Zolpidem
B. Modafinil
C. Alprazolam
D. Diphenhydramine
E. Methylphenidate

Answer and topic summary

The answer is B. modafinil (Provigil)

This patient has narcolepsy, a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. The symptoms described, including sudden sleep onset and cataplexy (muscle weakness triggered by strong emotions), are classic for narcolepsy. Modafinil is a first-line treatment for narcolepsy, promoting wakefulness, and is specifically indicated for excessive daytime sleepiness associated with this condition.

Incorrect Answers:

A. Zolpidem is used for insomnia, not narcolepsy.

C. Alprazolam is an anxiolytic and is not used to treat narcolepsy.

D. Diphenhydramine is an antihistamine that can cause drowsiness and is not used to treat narcolepsy.

E. Methylphenidate is a stimulant that can be used to treat narcolepsy but is generally considered second-line to modafinil.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Psychiatry ⇒ Sleep-wake disorders ⇒ Narcolepsy

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