Beneficial adjunctive therapy
Commenting on the findings, Sogol Javaheri, MD, MPH, who was not involved in the research, said that they confirm those of prior studies and are “consistent with what my colleagues and I experience in our clinical practices.”
Dr. Javaheri is associate program director of the sleep medicine fellowship at Brigham and Women’s Hospital and assistant professor of medicine at Harvard Medical School, both in Boston.
While sleep medicine specialists are more likely than others to prescribe these medications, “any clinician may use these medications, ideally if they have ruled out other potential reversible causes of EDS,” said Dr. Javaheri. “The medications do not treat the underlying cause, which is why it’s important to use them as an adjunct to conventional therapy that actually treats the underlying sleep disorder and to rule out additional potential causes of sleepiness that are treatable.”
These potential causes might include insufficient sleep (less than 7 hours per night), untreated anemia, and incompletely treated sleep disorders, she explained. In sleep medicine, modafinil is usually the treatment of choice because of its lower cost, but it may reduce the efficacy of hormonal contraception. Solriamfetol, however, does not. “Additionally, I look forward to validation of pitolisant for treatment of EDS in OSA patients, as it is not a controlled substance and may benefit patients with a history of substance abuse or who may be at higher risk of addiction,” said Dr. Javaheri.
The study was conducted without outside funding. Dr. Pitre and Dr. Javaheri report no relevant financial relationships.
A version of this article first appeared on Medscape.com.