Wakix vs. Sunosi for Narcolepsy: Important Differences and Potential Risks.

Key takeaways

Wakix (pitolisant) and Sunosi (solriamfetol) are both used to treat excessive daytime sleepiness in people with narcolepsy, but they work differently and have some key differences. Wakix is a histamine-3 (H3) receptor antagonist/inverse agonist that can also be used to treat cataplexy related to narcolepsy, while Sunosi is a norepinephrine-dopamine reuptake inhibitor that can also be used for excessive daytime sleepiness caused by obstructive sleep apnea (OSA). Wakix is not a controlled substance, but Sunosi is a Schedule IV controlled medication due to its potential for dependence and abuse. Both medications are taken once a day in the morning and Sunosi should not be taken within 9 hours of bedtime. Common side effects for both include headache, trouble sleeping, and heart problems. Wakix can cause life-threatening abnormal heart rhythms, while Sunosi can raise blood pressure and heart rate. Additionally, Wakix is not recommended for people with severe liver problems, while Sunosi should not be used with monoamine oxidase inhibitors (MAOIs).

Wakix

(pitolisant)

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Sunosi

(solriamfetol)

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Summary for Wakix

Prescription only

Wakix (pitolisant) is a medication that treats excessive daytime sleepiness in adults and children ages 6 and older with narcolepsy. It's also used to treat cataplexy, or sudden muscle weakness after having strong emotions, in adults with narcolepsy. This medication is taken by mouth once a day in the morning. You'll typically start the medication at a lower dose and then slowly raise the dose over time. Side effects include headache, nausea, and trouble sleeping.

Indications for Wakix

Excessive daytime sleepiness or cataplexy (sudden muscle weakness) in adults with narcolepsy
Excessive daytime sleepiness in children ages 6 and older with narcolepsy

Pros and Cons for Wakix

Pros

Lowers how many cataplexy attacks you get per week
A narcolepsy treatment that's not a controlled substance
Only need to take it once a day

Cons

Not the best medication if you have liver or kidney problems
Might need to take more than one tablet for your dose
Can take a couple months to see the full effects of this medication

Common Side Effects for Wakix

Adults:

Headache (18%)
Trouble sleeping (6%)
Nausea (6%)
Anxiety (5%)

Children:

Headache (19%)
Trouble sleeping (7%)

Warnings for Wakix

Life-threatening abnormal heart rhythm (QT prolongation)

Summary for Sunosi

Prescription only

Sunosi (solriamfetol) is used to improve wakefulness in adults with narcolepsy or obstructive sleep apnea. Sunosi (solriamfetol) belongs to the drug class called dopamine and norepinephrine reuptake inhibitors, and it's currently only available as a brand-name medication. Sunosi (solriamfetol) is available as tablets that are taken by mouth once daily when you first wake up. Common side effects include headache, a smaller appetite, and nausea.

Indications for Sunosi

Extreme daytime sleepiness caused by:

Pros and Cons for Sunosi

Pros

Taken once a day
Comes in two different strengths
Unlikely to cause withdrawal symptoms if you stop taking the medication suddenly

Cons

No lower-cost generic available
Can make your blood pressure go up
Is a controlled substance so there are special requirements to getting a prescription filled
Not approved for children

Common Side Effects for Sunosi

Headache (16%)
Having a smaller appetite (9%)
Nausea (7%)
Anxiety (6%)
Insomnia (trouble sleeping, 5%)

Note: Side effect percentages were reported from studies of adults with narcolepsy. These percentages might differ slightly for adults with obstructive sleep apnea.