have to be housebound for nine months, then so be it. I don't want to have cataplexy while I'm out running errands," she adds. "I'm not taking any chances, for the baby or myself."
Joyce Walsleben, PhD, director of the Sleep Disorders Center at the NYU School of Medicine and author of A Woman’s Guide to Sleep , notes: "Before conception, women with narcolepsy need to first talk with their physician and evaluate their individual situation. A woman with narcolepsy needs to consider the health of the baby as well as her own health and safety."
There are risks associated with going off narcolepsy medication, though the degree of risk may vary by drug. The most serious effects are felt when the cataplexy treating anti-depressants are not taken. "To abruptly stop taking anti-depressants can lead to a very bad cataplexy rebound," says Dr. Mignot. "Going off short acting stimulants like Dexedrine® also causes rebound sleepiness. However, when Xyrem® and Provigil® are stopped, the change is less dramatic. The best thing to do is gradually come off medication," he advises.
Dugan's narcolepsy is treated with Dexedrine® for alertness and imipramine for cataplexy. Due to the seriousness of her condition, she was unable to completely stop taking the Dexedrine®, although the dosage was dramatically reduced. She did stop taking the imipramine. "As a result, I couldn't do my job as a systems engineer," she said. "I couldn't even drive or go to the grocery store by myself. When you are pregnant and have narcolepsy you will have to make sacrifices, like surrendering some independence."
There are resources available for narcolepsy and pregnancy. Bob Cloud, executive director of the Narcolepsy Network, notes that their Web site, www.narcolepsynetwork.org, has a "Medications and Pregnancy" question and answer board. He also recommends the section titled "Investigating your local support groups."
Dugan offers the following advice, "It's important that you also work closely with your doctors, your OB/GYN and sleep specialist. Do your research and consider your best course of action." "I urge anyone with narcolepsy who is considering motherhood to make sure that you have