Narcolepsy: A mysterious disorder

 

Narcolepsy is a peculiar sleep disorder, characterized by severe and persistent daytime sleepiness that is associated with functional impairments, accidents and injuries. It is a disorder that disrupts the sleep-wake process, as the brain is unable to properly regulate wakefulness and sleep.

 

Symptoms of narcolepsy include excessive daytime sleepiness, disrupted nighttime sleep, sleep paralysis, sleep related hallucinations and cataplexy. This is a sudden loss of muscle control, often in response to positive emotions such as laughter or joy.

 

Recently, it was discovered that a certain type of narcolepsy (Type I) is marked by the loss of neurons responsible for making hypocretin, also known as orexin, a chemical that helps regulate wakefulness and sleep. This may lead to novel therapeutics in the future. Fortunately, several medications are already available to treat many people who suffer with narcolepsy.

 

Wayne Macfadden MD has over 20 years of experience as a Psychiatrist, and is Board Certified by the American Board of Psychiatry and Neurology. Dr. Macfadden is a Fellow in the Philadelphia College of Physicians, and a former Fellow in the American College of Psychiatrists. Dr. Macfadden is also certified in Addiction Medicine by the American Board of Preventive Medicine and had Added Qualifications in Addiction Psychiatry. Dr. Wayne Macfadden has extensive clinical and research experience in the treatment of people with schizophrenia, bipolar disorder, and substance use disorders. Dr. Macfadden has worked in a variety of treatment, academic and research settings.

Increasing Adherence to Antipsychotic Medications

Before joining Spirit Lake Reservation as a Psychiatrist, Wayne Macfadden MD published several peer-reviewed studies. In 2010, Wayne Macfadden MD analyzed the use of the Medication Adherence Assessment Tool for patient non-adherence to antipsychotic treatment protocols.

Many patients who are prescribed antipsychotics do not take their medications consistently. As many as 68 percent of patients with Schizophrenia are not adherent to their medications. These high rates are attributed to unpleasant side effects, inability to remember taking their medications, and other factors, such as housing instability and co-occurring Substance Use Disorders.

Medical non-adherence is associated with higher rates of relapse and hospitalization. Without proper treatment, patients also have an elevated risk of engaging in self-harming behaviors or attempting suicide.

One way to improve adherence is to provide medication through long-lasting injections of antipsychotic medication. Some patients may also benefit from cognitive behavioral therapy to address harmful thought patterns and improve their attitudes toward medication.

Risk Factors for Alcohol Use Disorder

A former Assistant Professor at the University of Pennsylvania, Wayne Macfadden MD specializes in Psychiatric treatments for Substance Use Disorders. As a Psychiatrist for the Spirit Lake Reservation, Wayne Macfadden MD evaluates and prescribes medication for patients facing issues such as Alcohol Use Disorder (AUD).

Dependency on alcohol so severe that it negatively impacts health, employability, and relationships. AUD can occur in people from any socio-economic background or ethnicity. However, some risk factors can increase the chances of developing AUD.

Habitual binge drinking, defined as consuming five or more alcoholic beverages in one day, can lead to AUD. The disorder is also more common in men who routinely have more than 15 drinks a week or women who have at least 12 drinks a week.

AUD often runs in families. Having a close family member with AUD increases susceptibility. AUD is also comorbid with other mental issues such as Schizophrenia and Major Depression.

 

Medication for Alcohol Use Disorder

Wayne Macfadden MD, works at the Spirit Lake Indian Nation Tribe Health Center in Fort Totten, North Dakota, where his responsibilities include evaluating and treating Alcohol Use Disorder. Wayne Macfadden, MD, often uses medication-assisted therapy (MAT) when treating alcohol abuse.

Medication-assisted treatment is not always a widely used option for treating Alcohol Use Disorder, but there are FDA approved medications for this purpose. These drugs are for patients trying to prevent a return to heavy alcohol drinking. Only those trained in its administration should be using this treatment option.

Disulfiram, also known as Antabuse, was the first FDA approved drug for Alcohol Use Disorder. This medication, approved in 1951, induces adverse reactions in the alcohol drinker, causing nausea, vomiting, headaches, and hangovers. These adverse reactions may be serious, and have thus deterred many people from using this medication.

Naltrexone comes as a pill and a long acting injection solution. This drug blocks the high a substance user derives from drinking alcohol. It was previously used only for drug use, but was approved for the treatment of alcohol abuse by the FDA in 1994. It also reduces the craving for alcohol in some substance users.

Acamprosate, is the newest (oral) drug approved for alcohol abuse by the FDA (2004). However, it has been used in Europe since the early 1980s. This medication reduces the severity of the withdrawal symptoms like insomnia, restlessness, and anxiety felt by those who stop drinking alcohol.

 

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