GAMMAHYDROXYBUTYRATE AND NARCOLEPSY - A DOUBLE-BLIND PLACEBO-CONTROLLED STUDY

We treated 24 patients with narcolepsy for 4 weeks with gammahydroxybu tyrate (GHB), 60 mg/kg/night, in a randomized double-blind placebo-con trolled cross-over trial. Both clinical and polysomnographic criteria were used to assess the results. Compared to placebo, GHB reduced the daily number of hypnagogic hallucinations (from 0.87 to 0.28; p = 0.00 8). daytime sleep attacks (from 2.27 to 1.40; p = 0.001) and the sever ity of subjective daytime sleepiness (from 1.57 to 1.24 on a 0-4 scale ; p = 0.028). The number of daily cataplexy attacks was reduced from 1 .26 at baseline to 0. 56 after 4 weeks of GHB intake. This reduction, however, was not statistically significantly different from the differ ence between baseline and placebo. GHB stabilized nocturnal rapid eye movement (REM) sleep, i.e. it reduced the percentage of wakefulness du ring REM sleep (p = 0.007) and the number of awakenings out of REM sle ep (p = 0.016). and tended to increase slow wave sleep (p = 0.053). Ad verse events were few and mild. We conclude that GHB is an effective a nd well-tolerated treatment for narcolepsy.