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Treatment for Cataplexy
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Good morning - just wanted to share a clinical experience with cataplexy.
I have a 61 y/o male patient who has been on celexa for about 6 years for major depressive d/o. Recently he told me he had been diagnosed with narcolepsy about 20 years ago by a sleep specialist. He has cataplexy, where when he is startled or extremely anxious he becomes rigid and cannot get words out. It tends to happen at his job when he is put on the spot about something.
He asked me if I knew treatments - I remembered vaguely that tricyclics are used, and confirmed that with a little reasearch. He'd tried a couple when he was first diagnosed and felt they didn't work, also didn't like the side effects.
I figured since he is already on celexa we could make a tricyclic by adding wellbutrin. He agreed, we added it, and now he is on celexa 40mg daily and wellbutrin XL 300mg daily. His depressive symptoms are completely gone, and with the addition of the wellbutrin he has had not had a single new episode of cataplexy.
I thought this experience was interesting, so I thought I would share, and I would love to know if any of you have experience with this or other treatments to share.
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