REM changes in narcolepsy with selegiline

The purpose of this study was to establish the effects of selegiline HCl on sleep parameters in narcolepsy and to contrast these effects with the effects of methylphenidate. Eleven subjects with narcolepsy were studied drug-free and while receiving selegiline (15-30 mg/day) by polysomnography. The methylphenidate-treated group consisted of 11 age-matched subjects with narcolepsy. On overnight polysomnography, compared to pretreatment values, selegiline treatment resulted in a significant increase in rapid eye movement (REM) latency (138.1 +/- 62.8 vs. 48.7 +/- 42.3 minutes, p < 0.05) and sleep stage changes per hour. The increase in REM latency in subjects treated with methylphenidate was marginally significant (116.9 +/- 78.3 vs. 54.3 +/- 23.7 minutes, p = 0.054). Maintenance of wakefulness testing during treatment revealed the methylphenidate-treated group to be significantly more alert than the selegiline-treated group (18.4 +/- 1.9 vs. 9.4 +/- 4.8 minutes, p < 0.001); a retrospective survey of subjects treated with selegiline found that a majority reported clinical improvement with selegiline treatment. These results suggest that selegiline should be considered for further investigation as a treatment for narcolepsy.