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How does Xyrem work for narcolepsy?

Medically reviewed by Carmen Pope, BPharm. Last updated on April 5, 2023.

Official answer

  • Xyrem is a CNS depressant.
  • The exact way Xyrem works for narcolepsy is not known but, once metabolized, it is thought to bind to GABAB and GHB receptors and enhance delta waves, improving the quality and quantity of deep sleep.
  • Taking Xyrem at night improves overnight sleep which reduces the number of sleeping periods during the day.

Narcolepsy is a sleep disorder that is characterized by excessive daytime sleepiness.

Xyrem (sodium oxybate) is the sodium salt of gamma-hydroxybutyrate (GHB) which is a central nervous system (CNS) depressant. CNS depressants slow down brain activity, which makes them useful for treating sleep disorders. Certain CNS depressants (not Xyrem) may also be used in the treatment of anxiety, panic disorders, or acute stress.

The exact way Xyrem slows down brain activity is not known, but it is thought to be because it is metabolized to a neurotransmitter called GABA which then binds to GABAB and GHB receptors.

This leads to changes in the activity of the brain, enhancing delta waves which are a type of high amplitude brain wave generally associated with slow-wave sleep (during the third stage of sleep).

By taking Xyrem at night, the quality and quantity of deep sleep is improved, which reduces the number of sleeping periods during the day. This improves the symptoms of narcolepsy.


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