Article

Management of narcolepsy during pregnancy

Sleep-Wake Disorders Center, Montefiore Medical Center, 111 East 210th St., Bronx, NY 10467, United States. Electronic address: .
Sleep Medicine (Impact Factor: 3.15). 02/2013; 14(4). DOI: 10.1016/j.sleep.2012.11.021
Source: PubMed

ABSTRACT

The management of pregnancy in patients with narcolepsy poses many questions regarding therapy, including the risk to the mother and fetus related to the disease, potential risks at the time of conception, the risk to both the mother and the fetus of the medications used to treat narcolepsy, and the risk to the infant from medications that might be secreted in breast milk. There are no detailed practice parameters on the treatment of narcolepsy patients during pregnancy. We surveyed narcolepsy specialists from around the world to determine their clinical approach to the management of patients with narcolepsy at the time of conception, during pregnancy and while breastfeeding.

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    • "Amphetamines have been associated with IUGR, and spontaneous miscarriages have been reported in women using sodium oxybate, although not at levels higher than in the general population. In a recent survey of 75 clinicians treating pregnant women with narcolepsy, most stopped narcolepsy medications at the time of conception or during pregnancy, and often reduced doses of medications during breast feeding [79]. In a large retrospective cohort study of 249 women with narcolepsy, among women who withdrew from all medications during the first trimester of pregnancy, 18.2% experienced an improvement in their symptoms, 40.1% had no change, and 40.1% had worsening of their symptoms [80]. "
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