ABSTRACT

Sodium oxybate, most commonly known as gamma-hydroxybutyrate (GHB), has a three-decade history in the treatment of narcolepsy (1,2). Mamelak initially hypothesized that sodium oxybate could reduce sleep fragmentation in narcolepsy, through its known effects on increased sleep consolidation, slow-wave sleep augmentation, and rapid eye movement sleep facilitation (3). The seminal work of Mamelak and Broughton led to the beginnings of an understanding of sodium oxybate as a potent treatment, not only for improving sleep in patients with narcolepsy, but also for controlling cataplexy and enhancing daytime alertness. Further work by Mamelak, Scharf, Scrimma, Lammers and others provided long-term and controlled evidence supporting the efficacy of sodium oxybate for the treatment of narcolepsy (4-7). Recently, extensive research using large controlled and open-label studies has led to an appreciation of sodium oxybate as a primary treatment for the complex of narcolepsy symptoms (see reference list).