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Effectiveness and side-effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice

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Effectiveness and side-effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice. / Thakrar, Chiraag; Patel, Kishankumar; D'ancona, Grainne; Kent, Brian D; Nesbitt, Alexander; Selsick, Hugh; Steier, Joerg; Rosenzweig, Ivana; Williams, Adrian J.; Leschziner, Guy D.; Drakatos, Panagis.

In: Journal of Sleep Research, Vol. 27, No. 4, e12627, 01.08.2018.

Research output: Contribution to journalArticle

Harvard

Thakrar, C, Patel, K, D'ancona, G, Kent, BD, Nesbitt, A, Selsick, H, Steier, J, Rosenzweig, I, Williams, AJ, Leschziner, GD & Drakatos, P 2018, 'Effectiveness and side-effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice', Journal of Sleep Research, vol. 27, no. 4, e12627. https://doi.org/10.1111/jsr.12627

APA

Thakrar, C., Patel, K., D'ancona, G., Kent, B. D., Nesbitt, A., Selsick, H., ... Drakatos, P. (2018). Effectiveness and side-effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice. Journal of Sleep Research, 27(4), [e12627]. https://doi.org/10.1111/jsr.12627

Vancouver

Thakrar C, Patel K, D'ancona G, Kent BD, Nesbitt A, Selsick H et al. Effectiveness and side-effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice. Journal of Sleep Research. 2018 Aug 1;27(4). e12627. https://doi.org/10.1111/jsr.12627

Author

Thakrar, Chiraag ; Patel, Kishankumar ; D'ancona, Grainne ; Kent, Brian D ; Nesbitt, Alexander ; Selsick, Hugh ; Steier, Joerg ; Rosenzweig, Ivana ; Williams, Adrian J. ; Leschziner, Guy D. ; Drakatos, Panagis. / Effectiveness and side-effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice. In: Journal of Sleep Research. 2018 ; Vol. 27, No. 4.

Bibtex Download

@article{d3468e9271394d349b946c5feda8fcb7,
title = "Effectiveness and side-effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice",
abstract = "Effectiveness and side-effect profile data on pharmacotherapy for daytime sleepiness in central hypersomnias are based largely upon randomized controlled trials. Evidence regarding the use of combination therapy is scant. The aim of this study was to examine the effectiveness and occurrence of drug-related side effects of these drugs in routine clinical practice. Adult patients diagnosed with a central hypersomnia during a 54-month period at a tertiary sleep disorders centre were identified retrospectively. Side effects were recorded at every follow-up visit. A total of 126 patients, with 3275 patient-months of drug exposure, were categorized into narcolepsy type 1 (n = 70), narcolepsy type 2 (n = 47) and idiopathic hypersomnia (n = 9). Modafinil was the most common drug used as a first-line treatment (93{\%}) and in combination therapy (70{\%}). Thirty-nine per cent of the patients demonstrated a complete, 25{\%} partial and 36{\%} a poor response to treatment. Combination treatment improved daytime sleepiness in 55{\%} of the patients with residual symptoms despite monotherapy. Sixty per cent of patients reported side effects, and 30{\%} reported treatment-limiting side effects. Drugs had similar side-effect incidence (P = 0.363) and their side-effect profile met those reported in the literature. Twenty-seven per cent of the patients received combination treatment and had fewer side effects compared to monotherapy (29.4{\%} versus 60{\%}, respectively, P = 0.001). Monotherapy appears to achieve satisfactory symptom control in most patients with central hypersomnia, but significant side effects are common. Combination therapy appears to be a useful and safe option in patients with refractory symptoms.",
author = "Chiraag Thakrar and Kishankumar Patel and Grainne D'ancona and Kent, {Brian D} and Alexander Nesbitt and Hugh Selsick and Joerg Steier and Ivana Rosenzweig and Williams, {Adrian J.} and Leschziner, {Guy D.} and Panagis Drakatos",
year = "2018",
month = "8",
day = "1",
doi = "10.1111/jsr.12627",
language = "English",
volume = "27",
journal = "Journal of Sleep Research",
issn = "0962-1105",
publisher = "Wiley-Blackwell",
number = "4",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Effectiveness and side-effect profile of stimulant therapy as monotherapy and in combination in the central hypersomnias in clinical practice

AU - Thakrar, Chiraag

AU - Patel, Kishankumar

AU - D'ancona, Grainne

AU - Kent, Brian D

AU - Nesbitt, Alexander

AU - Selsick, Hugh

AU - Steier, Joerg

AU - Rosenzweig, Ivana

AU - Williams, Adrian J.

AU - Leschziner, Guy D.

AU - Drakatos, Panagis

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Effectiveness and side-effect profile data on pharmacotherapy for daytime sleepiness in central hypersomnias are based largely upon randomized controlled trials. Evidence regarding the use of combination therapy is scant. The aim of this study was to examine the effectiveness and occurrence of drug-related side effects of these drugs in routine clinical practice. Adult patients diagnosed with a central hypersomnia during a 54-month period at a tertiary sleep disorders centre were identified retrospectively. Side effects were recorded at every follow-up visit. A total of 126 patients, with 3275 patient-months of drug exposure, were categorized into narcolepsy type 1 (n = 70), narcolepsy type 2 (n = 47) and idiopathic hypersomnia (n = 9). Modafinil was the most common drug used as a first-line treatment (93%) and in combination therapy (70%). Thirty-nine per cent of the patients demonstrated a complete, 25% partial and 36% a poor response to treatment. Combination treatment improved daytime sleepiness in 55% of the patients with residual symptoms despite monotherapy. Sixty per cent of patients reported side effects, and 30% reported treatment-limiting side effects. Drugs had similar side-effect incidence (P = 0.363) and their side-effect profile met those reported in the literature. Twenty-seven per cent of the patients received combination treatment and had fewer side effects compared to monotherapy (29.4% versus 60%, respectively, P = 0.001). Monotherapy appears to achieve satisfactory symptom control in most patients with central hypersomnia, but significant side effects are common. Combination therapy appears to be a useful and safe option in patients with refractory symptoms.

AB - Effectiveness and side-effect profile data on pharmacotherapy for daytime sleepiness in central hypersomnias are based largely upon randomized controlled trials. Evidence regarding the use of combination therapy is scant. The aim of this study was to examine the effectiveness and occurrence of drug-related side effects of these drugs in routine clinical practice. Adult patients diagnosed with a central hypersomnia during a 54-month period at a tertiary sleep disorders centre were identified retrospectively. Side effects were recorded at every follow-up visit. A total of 126 patients, with 3275 patient-months of drug exposure, were categorized into narcolepsy type 1 (n = 70), narcolepsy type 2 (n = 47) and idiopathic hypersomnia (n = 9). Modafinil was the most common drug used as a first-line treatment (93%) and in combination therapy (70%). Thirty-nine per cent of the patients demonstrated a complete, 25% partial and 36% a poor response to treatment. Combination treatment improved daytime sleepiness in 55% of the patients with residual symptoms despite monotherapy. Sixty per cent of patients reported side effects, and 30% reported treatment-limiting side effects. Drugs had similar side-effect incidence (P = 0.363) and their side-effect profile met those reported in the literature. Twenty-seven per cent of the patients received combination treatment and had fewer side effects compared to monotherapy (29.4% versus 60%, respectively, P = 0.001). Monotherapy appears to achieve satisfactory symptom control in most patients with central hypersomnia, but significant side effects are common. Combination therapy appears to be a useful and safe option in patients with refractory symptoms.

UR - http://www.scopus.com/inward/record.url?scp=85049851365&partnerID=8YFLogxK

U2 - 10.1111/jsr.12627

DO - 10.1111/jsr.12627

M3 - Article

VL - 27

JO - Journal of Sleep Research

JF - Journal of Sleep Research

SN - 0962-1105

IS - 4

M1 - e12627

ER -

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