Journal of Clinical Pediatrics ›› 2025, Vol. 43 ›› Issue (6): 475-482.doi: 10.12372/jcp.2025.24e1345
• Literature Review • Previous Articles
Received:
2024-12-12
Accepted:
2025-03-07
Published:
2025-06-15
Online:
2025-06-01
CLC Number:
ZHANG Yixin, HONG Siqi. Pharmacologic and upcoming treatment of pediatric narcolepsy[J].Journal of Clinical Pediatrics, 2025, 43(6): 475-482.
Table 1
Main drugs for excessive daytime sleepiness in narcolepsy"
药物 | 作用机制 | 药代动力学 | 作用症状 | 用法用量 | 不良反应 |
---|---|---|---|---|---|
替洛利生 | H3受体拮抗剂/反向激动剂 | Tmax 3.5小时 T1/2 20小时 | EDS、猝倒、睡眠幻觉、睡眠瘫痪 | 口服,每天早上1次 成人:9~36 mg·d-1,起始剂量9 mg·d-1 儿童(6岁及以上):4.5~36 mg·d-1,起始剂量4.5 mg·d-1 | 失眠、头痛、恶心、焦虑、易怒、头晕、抑郁、震颤、睡眠障碍、疲劳、呕吐、眩晕、消化不良等 |
莫达非尼 | 多巴胺再摄取抑制剂 | Tmax 2小时 T1/2 9~14小时 | EDS | 口服,每天早上1次 成人:200~400 mg·d-1,起始剂量100 mg·d-1 儿童:无推荐 | 头痛、恶心、腹泻、失眠等,严重不良反应:Stevens-Johnson综合征、重症多形性红斑 |
羟丁酸钠 | GABA-B受体激动剂 | Tmax 0.5~1.25小时 T1/2 0.5~1小时 | EDS、猝倒、睡眠幻觉、睡眠瘫痪、夜间睡眠紊乱 | 口服,每晚2次(睡前和半夜) 成人:6~9 g/晚,起始剂量4.5 g/晚 儿童(7岁及以上):最大推荐剂量6~9 g/晚,起始剂量≤4.5 g/晚 | 遗尿、恶心、呕吐、头痛、体重减轻、食欲下降、鼻咽炎、头晕等,严重不良反应:急性精神症状、自杀意念,大剂量引起呼吸抑制 |
索安非妥 | 多巴胺和去甲肾上腺素再摄取抑制剂 | Tmax 2~3小时 T1/2 7小时 | EDS | 口服,每天早上1次成人:75~150 mg·d-1,起始剂量75 mg·d-1 儿童:无推荐 | 头痛、食欲下降、失眠、恶心等 |
哌甲酯 (缓释片) | 多巴胺和去甲肾上腺素再摄取抑制剂 | Tmax 6~8小时 T1/2 3.5小时 | EDS | 口服,每天早上1次 成人:18~54 mg·d-1,起始剂量18或36 mg·d-1 儿童(6岁以上):18~54 mg·d-1,起始剂量18 mg·d-1 | 失眠、紧张、头痛、食欲减退等,罕见不良反应:精神疾病,避免在患心脏病患者中使用 |
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