Key points
- A strong emotion, including laughter, surprise, anger or excitement, nearly always brings on an episode.
- Most episodes pass in seconds or a few minutes and stop without treatment.
- Clomipramine is a tricyclic antidepressant used to reduce how often and how severely episodes occur.
What happens during an episode
The emotional trigger is central. Laughter at a joke, a shock or the expectation of something can bring on an episode. Some people have an early sign, such as twitching in the face or drooping eyelids, before control of the muscles is lost. Episodes usually resolve on their own. Narcolepsy can go unrecognised, so cataplexy may be present for years before a diagnosis is made.
Treatment
The aim is to lower the frequency and severity of attacks. Clomipramine belongs to the antidepressants group and dampens the REM-related muscle atonia that underlies cataplexy. It has been used for this purpose for several decades. The clomipramine ingredient is supplied as tablets. It is usually taken at a low daily dose, and several weeks may pass before the full effect is seen. Orders are prepared by pharmacy partners in India and shipped to Malaysia in discreet packaging.
When to seek medical help
Involve a sleep neurologist if episodes become severe, happen often or lead to injury. They can manage it alongside any medicine being used.
Further reading