Pharmacologic Management of Daytime Sleepiness
Jonathan R. L. Schwartz, M.D.
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Excessive daytime sleepiness and abnormal sleep-wake patterns are becoming increasingly pervasive
in modern society. The major causes of excessive daytime sleepiness include pathologic abnormalities
of the central nervous system, such as narcolepsy and idiopathic hypersomnia; deficiencies in
quality or quantity of sleep, such as those caused by sleep apnea and poor sleep hygiene; disturbances
to the body’s natural circadian rhythm, such as those caused by shift work or jet lag; and drugs, which
can increase sleepiness either therapeutically or as a side effect. Determining the cause of daytime
sleepiness is the first step in treating it. Setting appropriate and realistic treatment goals with the patient
and initiating treatment are the next steps. Although the medications available to improve daytime
wakefulness (e.g., amphetamines, methylphenidate, pemoline, and modafinil) are effective, they
are not a substitute for sleep. Finally, timely follow-up is necessary to monitor treatment adherence,
response, and side effects.
J Clin Psychiatry 2004;65(suppl 16):46-49
© Copyright 2004 Physicians Postgraduate Press, Inc.
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