| Mazindol in narcolepsy and idiopathic and symptomatic hypersomnia refractory to stimulants: A long-term chart review. | |
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MedLine Citation:
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PMID: 23036267 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: Mazindol is a tricyclic, anorectic, non-amphetamine stimulant used in narcolepsy and obesity since 1970. This study aimed to evaluate the long-term benefit/risk ratio in drug-resistant hypersomniacs and cataplexy sufferers. METHODS: By retrospective analysis of the patients' files in the hospitals of Paris-Salpêtrière (n=91), Montpellier (n=40) and Lyon (n=8), the benefit (Epworth Sleepiness Score (ESS), cataplexy frequency, authorization renewal) and tolerance (side-effects, vital signs, electrocardiogram and cardiac echography) of mazindol were assessed. RESULTS: The 139 patients (45% men) aged 36±15years (range: 9-74) suffered narcolepsy (n=94, 66% with cataplexy), idiopathic (n=37) and symptomatic hypersomnia (n=8) refractory to modafinil, methylphenidate and sodium oxybate. Under mazindol (3.4±1.3mg/day, 1-6mg) for an average of 30months, the ESS decreased from 17.7±3.5 to 12.8±5.1, with an average fall of -4.6±4.7 (p<0.0001) and the frequency of cataplexy fell from 4.6±3.1 to 2±2.8 episodes per week. The cataplexy was eliminated in 14.5% of patients, improved in 27.5%, and unchanged in 29% (missing data in 29%). The treatment was maintained long term in 83 (60%) patients, and stopped because of a lack of efficacy (22%) and/or secondary effects (9%). There was no pulmonary hypertension in the 45 patients who underwent a cardiac echography. The most common adverse effects were dry mouth (13%), palpitations (10%, including one with ventricular hyperexcitability), anorexia (6%), nervousness (6%) and headaches (6%). CONCLUSION: Mazindol has a long-term, favorable benefit/risk ratio in 60% of drug-resistant hypersomniacs, including a clear benefit on cataplexy. |
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Authors:
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Nandini Nittur; Eric Konofal; Yves Dauvilliers; Patricia Franco; Smaranda Leu-Semenescu; Valérie Cochen De Cock; Clara O Inocente; Sophie Bayard; Sabine Scholtz; Michel Lecendreux; Isabelle Arnulf |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-1 |
Journal Detail:
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Title: Sleep medicine Volume: - ISSN: 1878-5506 ISO Abbreviation: Sleep Med. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100898759 Medline TA: Sleep Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier B.V. All rights reserved. |
Affiliation:
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National Reference Centre for Narcolepsy and Idiopathic Hypersomnia, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Unité des Pathologies du Sommeil, Paris, France; Université Pierre et Marie Curie - Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, UMR-S975, CNRS UMR7225, Paris, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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