Treatment for narcolepsy has come a long way in the past decade. Not long ago, people with narcolepsy had only a few medication choices, and many caused tough side effects. Today, thanks to new research and drug development, there are more narcolepsy treatment options than ever to help manage symptoms.

This article discusses the newest narcolepsy medications, explains how they work in the brain, and highlights medical advances that may shape how the condition is treated in the future.

Current Treatments for Type 1 and Type 2 Narcolepsy

Narcolepsy is divided into two main types — type 1 and type 2.

Narcolepsy type 1 includes a symptom called cataplexy — a sudden loss of muscle control. Emotions like laughter, anger, fear, or excitement can trigger cataplexy. People with type 1 also live with excessive daytime sleepiness (EDS). This strong urge to sleep during the day occurs even after a full night’s sleep. People with EDS may also have trouble staying asleep at night.

Narcolepsy type 2 causes EDS but not cataplexy. People with type 2 may also have disrupted nighttime sleep.

Treatment of narcolepsy focuses on three main goals:

• Helping people stay awake during the day
• Reducing cataplexy
• Managing nighttime sleep problems and symptoms like broken sleep, sleep paralysis (being awake but unable to move), and hallucinations (seeing or hearing things that aren’t real)

Narcolepsy treatments work by changing the levels of neurotransmitters (brain chemicals) that help control sleep and alertness. For example, medications that boost dopamine and norepinephrine help people stay awake during the day. Drugs that affect serotonin or norepinephrine can help reduce cataplexy. Some treatments target gamma-aminobutyric acid B (a chemical that slows brain activity) or histamine, both of which play a role in sleep and muscle control.

Medications for Excessive Daytime Sleepiness

Drugs that help with EDS work by changing brain chemicals that control alertness. These include wakefulness drugs, stimulants, and medications that act on histamine, a neurotransmitter that helps keep you awake. Some options include:

• Armodafinil (Nuvigil) and modafinil (Provigil) — Increase dopamine, a brain chemical linked to focus and motivation
• Pitolisant (Wakix) — Blocks histamine H3 receptors to improve wakefulness and reduce cataplexy
• Solriamfetol (Sunosi) — Boosts dopamine and norepinephrine to improve alertness

If these don’t work well enough, doctors may suggest older stimulants like dextroamphetamine (Adderall) and methylphenidate hydrochloride (Ritalin, among others). These usually aren’t first-line treatments because they have stronger side effects.

Medications for Cataplexy

For people with narcolepsy type 1, cataplexy medications help reduce these episodes and may improve nighttime sleep. Some treatments also help manage other symptoms of narcolepsy, such as sleep paralysis and hallucinations. Cataplexy medications include:

• Antidepressants like fluoxetine (Prozac) and venlafaxine (Effexor) — These medications help prevent cataplexy by reducing rapid eye movement (REM) sleep, the stage of sleep in which cataplexy symptoms are more likely to happen. They also adjust levels of serotonin and norepinephrine.
• Sodium oxybate (Lumryz, Xyrem, Xywav) — These nighttime medicines increase deep sleep, which may reduce cataplexy, sleep paralysis, and hallucinations.

Healthy routines matter too. Doctors often recommend combining medications with good sleep habits and healthy daytime routines to help manage symptoms.

Newer Treatments for Narcolepsy

In recent years, the U.S. Food and Drug Administration (FDA) has approved several narcolepsy medications. These new options give doctors and people with narcolepsy more choices, especially when older medicines don’t work or cause side effects.

Pitolisant

Approved by the FDA in 2019 for adults and in 2024 for children ages 6 and up, pitolisant (Wakix) helps with both EDS and cataplexy by raising the brain’s histamine levels, helping you stay more alert during the day. Pitolisant is the first narcolepsy medicine in the U.S. that’s not a controlled substance, meaning it has a lower risk of misuse or dependence than many other treatments.

Solriamfetol

Also FDA-approved in 2019, solriamfetol (Sunosi) treats EDS in people with narcolepsy. It works by increasing dopamine and norepinephrine to help control alertness and energy levels. This drug doesn’t treat cataplexy, so it might be combined with other medications for people who have both symptoms.

Solriamfetol may have fewer side effects than traditional stimulants such as amphetamines. In clinical trials — studies that test therapies’ safety and effectiveness in humans — no serious complications were reported.

Sodium Oxybate

Lumyrz, a once-nightly version of sodium oxybate, treats both EDS and cataplexy. It was approved in 2023 for adults with narcolepsy and in 2024 for children 7 and older. Sodium oxybate is a central nervous system (CNS) depressant — it helps calm the brain and improve deep sleep.

Older forms of sodium oxybate require two doses a night, one at bedtime and another a few hours later. Lumryz is taken only at bedtime, which may help support uninterrupted sleep.

Recent Advances in Narcolepsy Research

Scientists are making exciting progress in understanding and treating narcolepsy. One key discovery is that type 1 is often caused by a loss of brain cells that make hypocretin (also known as orexin), a chemical that keeps you awake and alert. A lack of hypocretin can lead to daytime sleepiness and cataplexy symptoms, such as muscle weakness.

Researchers are working on new medications called hypocretin or orexin receptor agonists. The goal is to replace the missing hypocretin and help people stay awake during the day. Early clinical trials suggest that these drugs may help reduce both cataplexy and EDS.

Researchers are working on medications called hypocretin or orexin receptor agonists. The goal is to replace the missing hypocretin and help people stay awake during the day.

Another promising area of research focuses on the brain’s histamine system. New drugs are being tested to see if changing histamine levels can improve alertness in people with narcolepsy. Other studies are exploring autoimmune and hormone-based therapies. These are still in the early stages, but they aim to stop or slow the immune system from damaging the brain cells that produce hypocretin.

Although not FDA-approved yet, these emerging therapies offer hope for new ways to manage narcolepsy symptoms — especially for people who haven’t found relief with current treatments.

Get Involved With Clinical Trials for Narcolepsy

Clinical trials are a crucial part of finding new treatments for narcolepsy. Many of today’s medications exist because people volunteered to be part of research studies. Joining a clinical trial may give you access to therapies that aren’t available to the public yet. By participating, you may improve your own symptoms and also help others living with narcolepsy.

Clinical trials are a crucial part of finding new treatments for narcolepsy. Many of today’s medications exist because people volunteered to take part in these studies.

Talk to your healthcare team to find out more about what clinical trials you may be eligible for. They can help you understand which studies you might qualify for and answer questions about possible risks and benefits, as well as what to expect. You can also search for narcolepsy clinical trials online at ClinicalTrials.gov.

Talk With Others Who Understand

Navigating life with narcolepsy can be a challenge, but you don’t have to go it alone. On MyNarcolepsyTeam, the social network dedicated to people with narcolepsy and their loved ones, members from across the globe come together to ask questions, offer support and advice, and meet others who understand life with narcolepsy.

What new narcolepsy treatments have you tried? Which do you think you might consider in the future? Share your thoughts in the comments below or by posting on your Activities page.