The goal in using medications should be to approach normal alertness while minimizing side effects and disruptions to daily activities. Changes in behavior combined with drug treatment have helped most persons with narcolepsy improve their alertness and enjoy an active lifestyle. Some of the most common side effects of stimulants are headache, irritability, nervousness, insomnia, irregular heart beat, and mood changes. It does not act as a stimulant for other body systems and studies have shown that modafinil is effective in improving alertness with few side effects and low abuse potential. Several classes of antidepressants are prescribed to treat cataplexy, hypnagogic hallucinations and sleep paralysis.
Side effects vary from one class of antidepressants to another.
Those most often reported are drowsiness, sexual dysfunction and lowered blood pressure. In a small percentage of patients, SSRIs cause overexcitement, anxiety, insomnia, nausea and reduced sexual drive. It improves nighttime sleep, which may contribute to decreased daytime drowsiness and less cataplexy. Approval by the FDA is pending. Changes in behavior to encourage good nighttime sleep are important too.