Stiumlants for narcolepsy

[sydunisportsmed]

Good opinion piece article in the BJSM this month, on the Kelli White case. Plenty of analogies with ADHD here, as this is a case where a number of US sprinters have been taking Modafinil, an amphetamine, and claiming they suffer from that terrible condition narcolepsy, where you fall asleep on the spot unless you happen to have popped an amphetamine.

The questions asked in the editorial are:
"Firstly, should modafinil be considered a psychostimulant? Secondly, if it is a psychostimulant, and yet is required to treat a medical condition, should the athlete be disqualified? Thirdly, how should one verify the alleged medical diagnosis? Fourthly, what must the athlete do in order to maintain eligibility to compete when on a "banned substance?" Fifthly, should the punishments be specific or should they be tailored to specific situations? Sixthly, are we witnessing further doping scandals? "

http://bjsm.bmjjournals.com/cgi/content/full/39/4/241

This paragraph says it all though:

"The prevalence of narcolepsy is only 0.02–0.05% in the United States. To have an elite athlete with narcolepsy would be rare; however, when the 2003 US Track and Field Championship urines were retested, a total of six athletes were reported positive for modafinil during 2003. Although Kelli White is the only athlete to state that she has narcolepsy, it is not surprising that the IAAF has scoffed at "a narcolepsy epidemic.""

None one has Level 1 scientific evidence to prove that you run faster with stimulants on board, but whether or not you do, a large number of US Track & Field sprinters are prepared to run the gauntlet of the drug code to try to get on it.

Do we really need to get psychiatrists and sleep experts to come up with guidelines for the diagnosis of ADHD and narcolepsy in elite athletes or shouldn't we just say that all amphetamines are banned? Let's draw the line at a handful of Sudafeds.

[jess]

Well, in theory I agree with your concluding suggestion to "draw the line at a handful of Sudafeds", but, like many things, it's a little vague...How much is a handful? Some sportsplayers have larger hands, I'm guessing...

[injuryupdate]

An article in SMH last week quoted studies showing multiplication of sudafed and caffeine when taken together, so perhaps the combination should be banned.

[Unregistered]

Hello,
I am a mother of a 16 year old son that was recently diagnosed with Narcolepsy and all of its symptoms. First, let me say I knew nothing of this disorder except what I've seen in the movies ex: someone who fall s asleep basically anywhere at anytime. That actually is what occurs, but there is also so much more. Look up Cataplexy online. 70% of narcoleptics have it. or Sleep Paralysis. Or abnormal behaivior or Hypnogogic Hallucinations. There is a lot more to it.
My son is a 6'3" , 217lbs highschool wrestler, so far rated #1 in our county. We will have Regionals next weekend, then state if he places in the top 4.
My question is to you with regards to Provigil (Modafinil). (By the way, it is NOT an amphetimine, it is a Central Nervous System Stimulant, an alertness drug. It actually lowers his length of endurance but keeps him awake during the day.)
In order to start him on Provigil, he had to take a sleep study which showed the classic symptoms of Narcolepsy. Within 5 minutes he falls into REM sleep.(Active Dream State) Provigil has been a life saver for him. He can stay awake during class now. He can drive a car. WHY must athletes exploit this life saving medication??
My son wants to become a professional athlete, and from what I see and hear, he has the athletic ability to do just that. But what are his chances of succeeding when the very drug that keeps him alive is banned from his lifes dreams and desires?
Ok, my book is over, and I have vented, Thankyou!
MOM

[injuryupdate]

Narcolepsy obviously exists and if your son has had a sleep study he may actually be able to get permission to compete with his medication.

It is more suspicious when someone who is in their 20s and is a world-ranked athlete suddenly 'develops' a condition like this and then gets permission to use a banned drug which may offer them performance advantages.

[inc123]

I have narcolepsy. Had the sleep test, my DNA was positive, and the cebro-spinal fluid did indeed show almost non-existent levels of hypocretin. I would HOPE that a sleep test at a reputable center PLUS either the DNA or CFS test would be absolutely convincing for a diagnosis of narcolespy. I took Ritalin/methylphenidate for years & now take Provigil -- they would not have given me an unfair edge in any competition, the daily dose just brings me up to somewhere near normal. THe bit about narcolepsy being rare is WRONG too; it is amazingly common- just misdiagnosed, in many cases. Also severity varies considerably.