What is the first-line treatment for narcolepsy?

The first-line treatment for narcolepsy is modafinil. This medication is a wakefulness-promoting agent that is particularly effective in managing excessive daytime sleepiness, one of the hallmark symptoms of narcolepsy. Modafinil has a favorable side effect profile and is less likely to be associated with dependence compared to traditional stimulants, making it a preferred choice in many cases.

In the context of narcolepsy, it works by affecting various neurotransmitters in the brain, promoting alertness without the euphoric highs associated with some other stimulants. This makes modafinil not only effective but also safer for long-term use as it mitigates the risk of abuse.

While other options, such as stimulants and antidepressants, can be used to treat narcolepsy, they are typically considered when modafinil is not effective or tolerated. Stimulants like methamphetamine or amphetamines can also be prescribed, but they may lead to side effects such as insomnia, anxiety, and appetite suppression. Antidepressants are most commonly used to address the cataplexy and other associated symptoms rather than the primary issue of excessive daytime sleepiness.