发作性睡病的药物治疗进展  

Advances in treatment of narcolepsy

作　　者：徐清霖 楼国东[3] 王甜甜 张力三[1,2] XU Qinglin;LOU Guodong;WANG Tiantian;ZHANG Lisan(Department of Neurology,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China;Center for Sleep Medicine,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China;Department of Pharmacy,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院神经内科,浙江杭州310016 [2]浙江大学医学院附属邵逸夫医院睡眠中心,浙江杭州310016 [3]浙江大学医学院附属邵逸夫医院药学部,浙江杭州310016

出　　处：《浙江大学学报（医学版）》2020年第4期419-424,共6页Journal of Zhejiang University(Medical Sciences)

基　　金：浙江省医药卫生科技计划(2020383055,2020KY164)。

摘　　要：发作性睡病是致残性白天睡眠增多的最常见原因之一,其治疗旨在减少白天睡眠增多和猝倒,改善夜间睡眠紊乱、睡眠瘫痪及与睡眠有关的幻觉。2019年,组胺H3受体拮抗剂替洛利生(Pitolisant)和多巴胺及去甲肾上腺素再摄取抑制剂索利氨酯(Solriamfetol)分别在欧盟和美国上市,前者具有促醒和抗猝倒作用,后者也有促醒作用,且戒断症状和滥用的发生率更低。目前,控释型羟丁酸钠(FT218)、低钠型羟丁酸盐(JZP-258)、选择性去甲肾上腺素再摄取抑制剂(瑞波西汀,又称AXS-12)以及莫达非尼联合氟卡尼制剂(THN102)等药物仍在开发和测试中,均可作为治疗发作性睡病相关白天睡眠增多和猝倒的潜在药物。本文重点介绍这些最近研发的发作性睡病治疗药物。Narcolepsy is the most common cause of excessive daytime sleepiness(EDS)following obstructive sleep apnea.Its treatment aims to reduce EDS and cataplexy,improve nighttime sleep disturbance,sleep paralysis and sleep-related hallucinations.Pitolisant(a histamine H3 receptor antagonist)and solriamfetol(a norepinephrine reuptake inhibitor)have recently been approved effective for narcolepsy in the United States and the European Union.Pitolisant has proved to be effective for both EDS and cataplexy.Besides being effective on EDS,solriamfetol seems to have advantages in abuse potential and withdrawal syndrome.As potential treatments for EDS and cataplexy associated with narcolepsy,several new drugs are being developed and tested.These new drugs include new hydroxybutyrate preparations(controlled release sodium hydroxybutyrate FT218,low sodium hydroxybutyrate JZP-258),selective norepinephrine reuptake inhibitor(AXS-12),and modafinil combined with astroglial junction protein inhibitor(THN102).This paper reviews the recently approved drugs and potential treatments for narcolepsy.

关 键 词：发作性睡病 替洛利生 索利氨酯 羟丁酸钠 制剂 副作用 综述 

分 类 号：R741[医药卫生—神经病学与精神病学] R969.4[医药卫生—临床医学]