May 26, 2010

Depression in Narcolepsy: High Probability

Hola everyone!  I have been looking for more and more info regarding Narcolepsy and Depression.  It seems from what people are searching for, this is a popular search, and so I am trying to find more interesting resources to give.  Narcolepsy and Depression, to me go hand in hand, and I think that most people with Narcolepsy already know this, right?  But it is interesting to find studies that give us percentages and figures.  Well, at least it is kind of interesting to me:)

Here is a link to a study done at Lesley College way back in 1996.  I do, however, think that it is quite relevant today.   Please click here to read it, or you can read the abstract below.

Depression in narcolepsy: concomitant or constituent?
LINDSLEY G, CRAWFORD B Sleep Research 1996; 25: 279.   Lesley College and Quintiles/Benefit Research

According to recent studies, the comorbidity rate of narcolepsy and depression is estimated to be between 30-52%, as compared with a depression prevalence rate of 8.1% in the general population. Our current study provides further support of the significantly elevated comorbidity rate of narcolepsy and depression, and extends these findings. Subjects were 22 men and 44 women between the ages of 17 and 76 (mean=49ñ15.24) who completed a survey intended to assess the financial burden of narcolepsy. Estimated age of narcolepsy symptom onset was 20 yoñ10.64. The mean age of diagnosis was 34 yo ñ 11.49 years, with a mean lag of 14ñ11.53 years from estimated year of onset. According to the subjects' retrospective reports, 46% carried an accurate diagnosis of depression prior to their diagnosis of narcolepsy. Strikingly, 56% of the sample continued to carry this diagnosis during this past year. There was also a high comorbidity with diagnoses of anxiety. 32% carried this diagnosis prior to identification of narcolepsy, which increased to a rate of 35% within the past year. Overall rate of moderate to severe mood disturbance was 58% of the sample pre-narcolepsy diagnosis, which stayed essentially the same, 57%, during the past year.

Looked at separately, the five subjects in the sample < 25 yo had a lag of 0-5 years from onset to diagnosis. The data showed essentially the same trends with respect to associated diagnoses of depression and severity of mood disturbance, except that anxiety frequency increased rather then remained the same during the past year.

With respect to co-relationships among potentially relevant variables, severity of depression was independent of reported severity of EDS, cataplexy, disruption of school or work life, and medication. As graphed below for the current year data, however, there was a striking relationship between severity of depressed mood and presence/absence of anxiety diagnoses, with anxiety diagnoses increasing as depressed mood increased. Severity of depression also had a similar relationship with difficulty focusing and concentrating (cognitive disturbance).

In conclusion: (1) The probability of depression in association with narcolepsy is very high; (2) Formal diagnoses of depression are significantly related to diagnoses of anxiety; (3) Severity of depressed mood appears also to be related to degree of cognitive disturbance; (4) Depression increased rather than decreased across the life span in these subjects whereas anxiety increased in our small sample of young people but decreased moderately from prediagnosis to the current year in the total sample; and (5) that there was no obvious relationship between subjectively reported severity of depressed mood and severity of EDS or cataplexy, degree of disruption of school or work life, or type of medication. These data reinforce how critical it is to address affective disturbance as well as the primary symptoms of narcolepsy when treating narcoleptic patients. In addition, the high comorbidity rate of depression with narcolepsy, even when EDS and cataplexy are more or less under control, raise the question of whether depression is actually a constituent rather than merely a concomitant of narcolepsy.

Research supported in part by Cephalon, Inc.
Interesting?  When research is supported by drug companies, I usually am a bit skeptical, but this study isn't surprising to me, nor does it seem unlikely.  What do you think about it?  Leave a comment if you like, I would love to hear your thoughts on this.

Until next time,
Via Con Dios,


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The Wades said...

Thanks for this informative post. I have found some info along the way, but this nicely sums it up. My ten year old son has had N since last November. Initially we considered depression which is the only thing his primary would consider, but I insisted on seeing neuro (who also said it wasn't N) and him having a sleep study. Sleep specialists also said it wasn't N--just wanted him to see a ENT because of large tonsils. I still insisted on the sleep study.

I can see how it takes people so long to get their diagnosis with doctors so closed down to the idea. I had FOUR specialists I suggested the diagnosis to only to tell me I was wrong.

My son's depression seems a lot better now that he is being treated with Provigil and naps. Our other biggest problem is weight gain. He had probably put on 15 or 20 lbs in last nine months.

Sorry--babbling on. Thanks again for the post.

Oh Hola I'm Ja:) said...

Dear Wades,

Great to hear from you again! Sorry to take so long to comment back to you!!! Isn't it nutty how long it takes most people to get their Narcolepsy dxed!?!? Mine took I think about 14 years. Depression was one of the things that was given to me too, as a dx. I am really glad that you were persistent and insisted on the sleep study for your son. Your son is a very fortunate young man to have your fervent support! About the weight issue...It seems that many folks with N have this issue too. For me, going gluten free, and cutting down on my carbs has helped very much. Have you ever checked out Heidi Lindburg's site. It is at

She has done some remarkable research, and is also very approachable if you need to ask questions. She is a fantastic writer, and has lots of info on Narcolepsy, and the gluten connection.

Thanks again for stopping by, let me know how you all are doing soon, ok?

Via con Dios,

Anonymous said...


You are right about people searching online for information about narcolepsy and depression - that is how I found your blog. I fit what I was told at time of dx is average: onset probably at about 15, dx at 30. But before dx, suggestion was depression. Tried Effexor, and I went from tired to useless. Now, I actually think my current depression symptoms are probably connected with Ritalin. I've slowly upped that med and tapered off Provigil, and as I have, I've become more flat - little feeling for anything. Thanks for an interesting perspective - I look forward to looking around your blog a bit more, but first, back to my search....


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