Fluoxetine suppresses human cataplexy: a pilot study.

We evaluated fluoxetine in six patients with poorly controlled cataplexy by beginning patients on a single 20 mg dose without any change in their current medications. Once benefit occurred, we discontinued or reduced other anticataplectic medication. Reduction in the number of cataplectic episodes per week after 20 weeks of treatment constituted the basis for efficacy determination. Patients experienced a mean reduction of 92% (a mean drop in frequency of 21.7 to 1.7 episodes per week). Although fluoxetine-induced headache occurred in one patient, the other five reported no side effects at the doses used. The results of this pilot study demonstrate that fluoxetine safely and effectively suppresses cataplexy and reduces the need for other, less desirable, anticataplectic agents.