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• W2332728100 abstract "Basic experiments support the impact of hypocretin on hyperarousal and motivated state required for increasing drug craving. Our aim was to assess the frequencies of smoking, alcohol and drug use, abuse and dependence in narcolepsy type 1 (NT1, hypocretin-deficient), narcolepsy type 2 (NT2), idiopathic hypersomnia (IH) (non-hypocretin-deficient conditions), in comparison to controls. We hypothesized that NT1 patients would be less vulnerable to drug abuse and addiction compared to other hypersomniac patients and controls from general population. We performed a cross-sectional study in French reference centres for rare hypersomnia diseases and included 450 adult patients (median age 35 years; 41.3% men) with NT1 (n = 243), NT2 (n = 116), IH (n = 91), and 710 adult controls. All participants were evaluated for alcohol consumption, smoking habits, and substance (alcohol and illicit drug) abuse and dependence diagnosis during the past year using the Mini International Neuropsychiatric Interview. An increased proportion of both tobacco and heavy tobacco smokers was found in NT1 compared to controls and other hypersomniacs, despite adjustments for potential confounders. We reported an increased regular and frequent alcohol drinking habit in NT1 versus controls but not compared to other hypersomniacs in adjusted models. In contrast, heavy drinkers were significantly reduced in NT1 versus controls but not compared to other hypersomniacs. The proportion of patients with excessive drug use (codeine, cocaine, and cannabis), substance dependence, or abuse was low in all subgroups, without significant differences between either hypersomnia disorder categories or compared with controls. We first described a low frequency of illicit drug use, dependence, or abuse in patients with central hypersomnia, whether Hcrt-deficient or not, and whether drug-free or medicated, in the same range as in controls. Conversely, heavy drinkers were rare in NT1 compared to controls but not to other hypersomniacs, without any change in alcohol dependence or abuse frequency. Although disruption of hypocretin signaling in rodents reduces drug-seeking behaviors, our results do not support that hypocretin deficiency constitutes a protective factor against the development of drug addiction in humans. Experiments in animal models showed that disruption of hypocretin signaling reduced drug-seeking behaviors with a key impact of hypocretin on hyperarousal and motivated state required for increasing drug craving. Conversely, there is a lack of convincing human narcolepsy data on addiction. Our results emphasized the low frequency of addictive behaviors among patients with central hypersomnia, whether hypocretin-deficient or not, whether drug free or not, comparable to our control group and the general population. This observation was intriguing since psychostimulant drugs (methylphenidate, amphetamine, and modafinil to a lesser extent) are known to promote impulsivity, risk-taking behaviors and addiction. The absence of increased risk of addiction is reassuring for clinicians who manage patients with central hypersomnia, as they need to prescribe addictive drugs for years. Further research studies may focus on drug craving and relapse in these patients." @default.
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• W2332728100 date "2016-03-01" @default.
• W2332728100 modified "2023-10-07" @default.
• W2332728100 title "Smoking, Alcohol, Drug Use, Abuse and Dependence in Narcolepsy and Idiopathic Hypersomnia: A Case-Control Study" @default.
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• W2332728100 doi "https://doi.org/10.5665/sleep.5530" @default.
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