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How does Wakix work for narcolepsy?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Feb 6, 2024.

Official answer

by Drugs.com

Key Points

  • Wakix (pitolisant) increases histamine levels in the brain. Histamine is a neurotransmitter (a natural chemical) in the brain that helps to promote wakefulness and stable muscle tone throughout the day.
  • Wakix has activity as an antagonist/inverse agonist at the histamine-3 receptors found primarily in the brain, but its exact mechanism is not fully known.
  • Wakix is not classified as a controlled substance.

Wakix is approved for the treatment of excessive daytime sleepiness (EDS) or cataplexy (sudden loss of muscle strength) in adult patients with narcolepsy. Narcolepsy is characterized by immense daytime drowsiness and sudden attacks of sleep. Cataplexy is a sudden, brief loss of voluntary muscle tone often triggered by strong emotions like laughter.

In the brain, histamine is a neurotransmitter (natural chemical messenger) that is important for wakefulness. Wakix binds strongly to H3 receptors. H3 receptors help to regulate the production and release of histamine in the brain.

Wakix is available as an oral tablet and is usually taken once daily when you wake up. It may take up to 8 weeks before your symptoms improve. Take your medicine exactly as prescribed by your doctor.

Related Questions

Can I take an antihistamine with Wakix?

Certain prescription or over-the-counter medicines can prevent histamine from working to promote wakefulness and may reduce the effectiveness of Wakix. You should avoid centrally acting H1 receptor antagonists. Examples of these medicines include:

  • pheniramine maleate
  • diphenhydramine (example: Benadryl)
  • promethazine (antihistamines)
  • imipramine
  • clomipramine
  • mirtazapine (tri- or tetracyclic antidepressants)

Ask your pharmacist about possible drug interactions with Wakix each time you start a new prescription, over-the-counter, vitamin or herbal medication.

Related: Wakix drug interactions (in more detail)

Do not take Wakix if you have severe liver disease.

This is not all the information you need to know about Wakix (pitolisant) for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full Wakix information here, and discuss this information and any questions you have with your health care provider.

References

Read next

Although narcolepsy and idiopathic hypersomnia both have excessive daytime sleepiness as a common symptom, people with idiopathic hypersomnia have no sleep-onset rapid eye movement (REM) period, naps are unrefreshing (unlike with narcolepsy) and idiopathic hypersomnia is not associated with cataplexy. Idiopathic hypersomnia can be difficult to distinguish from narcolepsy, but sleep laboratory studies can help differentiate between them. Continue reading

The main test used to help diagnose suspected narcolepsy is an overnight sleep study (called a polysomnogram) followed the next day by the Multiple Sleep Latency Test (MSLT). A polysomnogram records brain waves, eye movements, muscle tone, and breathing across a night of sleep. This evaluates the amount and quality of night-time sleep and can look for any evidence of an additional sleep disorder (such as sleep apnea or periodic limb movements in sleep). The MSLT is a series of five scheduled naps spread across the day and it is done the day after the polysomnogram so a doctor can determine whether the prior night’s sleep could be affecting the daytime naps. Every 2 hours, the person is allowed to sleep for 20 minutes or more. Continue reading

There is no cure for narcolepsy, but medications and lifestyle modifications can help manage symptoms such as excessive daytime sleepiness (EDS). Medications include: stimulants such as modafinil (Provigil) or armodafinil (Nuvigil) are usually tried first for narcolepsy because they are less addictive than older treatments such as methylphenidate (Aptensio XR, Concerta, Ritalin) or various amphetamines; solriamfetol (Sunosi), pitolisant (Wakix); selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac, Sarafem) or serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor XR); tricyclic antidepressants, such as protriptyline (Vivactil), imipramine (Tofranil), and clomipramine (Anafranil); and sodium oxybate (Xyrem). Continue reading

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