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Antidepressants Like Vivactil May Ease Narcolepsy and Cataplexy

Narcolepsy is a rare condition that causes sudden episodes of extreme drowsiness during waking hours. Doctors believe a genetic abnormality may be the root cause, as narcolepsy has been shown to run in families. In severe cases, a person may lose all muscle tone for as long as several minutes. This condition is called cataplexy and can be quite distressing for the individual with narcolepsy. Other people experience auditory and visual hallucinations, as if they are dreaming while awake.

Sleep paralysis is yet another common symptom of narcolepsy. This happens when a person cannot move for several minutes before and after a period of sleep. Narcolepsy is a dangerous condition; sudden episodes of sleepiness or paralysis while driving or operating machinery can result in serious accidents. While narcolepsy cannot be cured, medications and behavioral changes can keep the symptoms under control.

Stimulant medications are the primary treatment option for narcolepsy. Powerful stimulants maintain a high level of activity in the brain, warding off drowsiness. However, some of the other symptoms of narcolepsy don’t always respond to stimulant medications. Cataplexy, for instance, often improves after treatment with low doses of antidepressant medications. Vivactil (protriptyline), a tricyclic antidepressant, is one of the drugs of choice for alleviating the unpleasant effects of cataplexy.

When prescribed for narcolepsy, Vivactil is provided in doses lower than those used for treating major depression or anxiety. This effectively avoids many of the undesirable side effects of this antidepressant. Doctors are not certain how Vivactil works to reduce episodes of cataplexy. In cases of major depression, Vivactil works by changing the balance of certain chemicals in the brain. It’s believed that a similar process accounts for the medication’s usefulness for individuals with narcolepsy.

Vivactil is only one element of a complete treatment regimen for narcolepsy. Other elements include taking steps to ensure healthy, normal sleep patterns. This means going to sleep and waking on a regular schedule and avoiding food and drink that disrupt sleep. Stimulant medications are beneficial in preventing sudden sleep attacks during the day. For some individuals, even with adequate treatment, simple tasks like driving are impossibly dangerous. However, medications like Vivactil do go a long way toward improving overall quality of life for those who suffer from narcolepsy.


  1. Narcolepsy – PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved from
  2. Roth, T. (2007). Narcolepsy: treatment issues. Journal of Clinical Psychiatry, 63, (Supplement 13), 16-19.
  3. Protriptyline – PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved from

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