Therapeutic Prospects of Ketamine for Cataplexy in Narcolepsy Type 1: Evidence from a Human Case and a Murine Model.
Francois Ricordeau, Sebastien Arthaud, Leila Langbour et al.
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Case in brief
A 34-year-old man with narcolepsy type 1 and cataplexy could not tolerate standard therapies. Morning intranasal ketamine was associated with a marked, sustained reduction in cataplexy; symptoms recurred after ketamine was stopped. In a separate crossover study in orexin-knockout mice, ketamine reduced time spent in cataplexy by 76% (p = 0.008) without affecting sleep architecture. The human observation and animal findings support further investigation of ketamine as a potential anticataplectic agent, but do not establish its efficacy or safety in broader clinical use.
What made this case unusual
The report pairs a human case of sustained cataplexy reduction with a crossover study in orexin-knockout mice, providing translational support for the observation.
Diagnostic / clinical pearl
In this patient with narcolepsy type 1, cataplexy improved with morning intranasal ketamine and recurred after discontinuation; this is a clinical observation, not established treatment evidence.
Why it matters
The concordant mouse findings provide a rationale for further clinical investigation, while the single-patient report cannot establish general efficacy or safety.