Advancing Future Drug Development for Narcolepsy: Mihaela Nowak, MD

WATCH TIME: 3 minutes

"Histamine is probably where everybody's going to be looking to in the future for pharmacological options, because its role is clear but not entirely understood."

Narcolepsy, a chronic neurological disorder that affects the brain’s ability to regulate sleep-wake cycles, can have significant impacts on patients’ daily life, work, and relationships. While the exact cause of narcolepsy is not fully understood, it is often linked to a loss of hypocretin-producing neurons in the brain, a neuropeptide that regulates arousals and wakefulness. There are 2 different types of narcolepsy: narcolepsy Type 1, which is associated with cataplexy and low hypocretin levels in the cerebrospinal fluid, and narcolepsy Type 2, which has similar symptoms to Type 1, but without cataplexy or hypocretin deficiency.

Several medications, such as stimulants, sodium oxybate, and histamine-targeting drugs, have been used to manage symptoms associated with the disease. Other lifestyle changes like scheduled naps, good sleep hygiene, and maintaining a consistent sleep schedule, have also been shown to help manage symptoms. Over the years, there has been an increased awareness promoting the importance of good sleep habits, as well as an influx of industry leaders advancing drug development for patients with narcolepsy and other sleep conditions.

Mihaela Nowak, MD, a neurologist and sleep disorder specialist at Allegheny Health Network, recently sat down with NeurologyLive® to give an update on drug development and the future outlook for treating narcolepsy. Nowak, who also has expertise in generalized seizures and epilepsy, spoke on the limitations of traditional treatments and the promising advantages of newer-aged therapies. She also spoke on recent innovations, such as pitolisant (Wakix; Harmony Biosciences), a histamine-targeting drug, and how this therapeutic approach represents a promising shift in narcolepsy treatment. Lastly, Nowak talked about the novel approaches still in development, including autoimmune and hormone therapies, such as targeting thyrotropin-releasing hormone from the hypothalamus.