Abstract

ABSTRACT: Yohimbine was used in four men and four women ranging in age from 21 to 64 years with nocturnal polysomnography and multiple sleep latency test-verified narcolepsy. All achieved a stimulant response in doses ranging from 2.7 to 16.2 mg/day. The effective dose was defined as the amount of medication required to maintain subjective wakefulness for 8 consecutive working hours. The average effective dose was approximately 8 mg/day. While one subject became immediately tolerant, others maintained a response for several weeks. The first subject continued to have good control of sleepiness for 17 months. Mild and transient side effects were insomnia, diarrhea, dyspepsia, flushing, and tremor. Alpha-2 adrenergic receptor abnormalities are suspected in narcolepsy, which could explain the improvement in sleepiness for these patients.