Posted by zeugma on October 7, 2004, at 14:28:22
In reply to Could it be the Risperdal?, posted by Dinah on October 7, 2004, at 7:47:19
hi Dinah,
you know sleep paralysis is a symptom of narcolepsy. It is actually a manifestation of cataplexy- intrusion of REM atonia into a period not appropriate to it. Stimulants combat the fatigue and sleepiness narcoleptics constantly feel, but for the other synproms of the 'narcoleptic tetrad'- cataplexy, and hynogogic hallucinations- AD's such as imipramine or desipramine are called for. It appears to be NE reuptake inhibition that is the specific property associated with anti-cataleptic medications, others than Xyrem, whose method of action is not familiar to me. I found that Klonopin, because it blocks slow-wave sleep, induce cataleptic symptoms. I would think that Risperdal, because it blocks DA receptors, would aggravate cataplexy too because it would contribute to the loss of monoaminergic tome. Neurontin as a GABA enhancer would also cause the excitatory monoamines which hold REM in check (primarily norepinephrine, but also serotonin, although I do not understand the current practice, as canvassed by looking through narcolepsy forums, of prescribing SSRI's to narcoleptic patients. They control the cataplexy to some extent, but are less effective than noradrenergic meds in controlling the symptoms.).
The dilemma you face, as I understand it, is that TCA's increase your anxiety. I am no MD, but I would think that Klonopin is better from a side-effect standpoint than Risperdal, as it does not induce movement disorders (which I believe narcoleptics are particularly vulnerable to, due to the weakness of the aminergic systems). Other than that- sleep hygiene, getting adequate sleep every night. I had a hypnagogic hallucination last night, due to getting too little sleep this week, and it has upset my entire system, digestive included (left work early due to IBS flareup). I doubt any of this has been helpful but I'm feeling terrible thanks to narcolepsy complications as well and need to vent.
[end note: grammar and spelling mistakes left unedited because I'm feeling awful.]final question: do you notice that in the day following an attack of sleep paralysis, nothing feels 'right'? I am all jangled.
-z
poster:zeugma
thread:399908
URL: http://www.dr-bob.org/babble/20041007/msgs/400021.html