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Neurological & Neuromuscular

Narcolepsy Type 1 Clinical Trials and Treatments

Also called narcolepsy with cataplexy, hypocretin deficiency, orexin deficiency

Narcolepsy type 1 (NT1) is a chronic neurologic disorder caused by selective loss of hypocretin (orexin)-producing neurons in the lateral hypothalamus, resulting in pathologically low cerebrospinal fluid (CSF) hypocretin-1 levels (typically <110 pg/mL). The presenting symptom complex includes excessive daytime sleepiness (EDS) with overwhelming sleep tendency, cataplexy (sudden loss of voluntary muscle tone triggered by emotional stimuli such as laughter or surprise), sleep paralysis upon awakening or sleep onset, and hypnagogic or hypnopompic hallucinations.

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About Narcolepsy Type 1

Narcolepsy type 1 (NT1) is a chronic neurologic disorder caused by selective loss of hypocretin (orexin)-producing neurons in the lateral hypothalamus, resulting in pathologically low cerebrospinal fluid (CSF) hypocretin-1 levels (typically <110 pg/mL).

The presenting symptom complex includes excessive daytime sleepiness (EDS) with overwhelming sleep tendency, cataplexy (sudden loss of voluntary muscle tone triggered by emotional stimuli such as laughter or surprise), sleep paralysis upon awakening or sleep onset, and hypnagogic or hypnopompic hallucinations. The pathophysiology appears autoimmune, supported by strong HLA-DQB1*0602 association (present in ~98% of NT1 patients versus 30-40% of general population), recent identification of hypocretin neuron-specific antibodies in some patients, and temporal association with H1N1 infection and vaccination. EDS and cataplexy profoundly impact safety, driving ability, employment, and quality of life.

Diagnosis requires polysomnography demonstrating sleep onset REM periods within 15 minutes and elevated REM sleep density, combined with low CSF hypocretin-1 levels. Prognosis is good with treatment; life expectancy is normal.

Common Symptoms of Narcolepsy Type 1

Recognizing the signs of Narcolepsy Type 1 early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.

  • Excessive daytime sleepiness despite adequate nighttime sleep
  • Sudden loss of muscle tone triggered by emotion (cataplexy)
  • Sleep paralysis
  • Hypnagogic/hypnopompic hallucinations
  • Fragmented nighttime sleep
  • Automatic behaviors during microsleep

Who Narcolepsy Type 1 Affects

NT1 typically manifests in adolescence or young adulthood with peak incidence between ages 15-25 years, though presentation can occur as early as childhood or as late as 50 years.

The condition affects males and females equally across all ethnic groups. Strong HLA-DQB1*0602 association is present in virtually all NT1 patients and approximately 25-40% of the general population, indicating that genetic predisposition combined with environmental triggers (possibly H1N1 infection, Pandemrix vaccination, or other infectious agents) is necessary for disease development. HLA-negative NT1 cases are rare.

Geographic variation in HLA haplotype frequencies influences disease prevalence by region. First-degree relatives of NT1 patients have approximately 5-10% lifetime risk of developing NT1, substantially higher than the general population risk of 0.05-0.1%.

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FDA-Approved Treatments for Narcolepsy Type 1

There is currently 1 FDA-approved medication for Narcolepsy Type 1. These therapies represent the current standard of care and may be used alongside or compared against investigational treatments in active clinical trials.

Source: openFDA drug labeling data. This list may not include all treatments. Always consult your doctor.

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Help Paying for Narcolepsy Type 1 Treatment

Charity funds and drugmaker programs for Narcolepsy Type 1, checked at the source. Pick your insurance to see what fits.

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Charity funds
  • From a charity · NORD RareCare
    Narcolepsy Medical Assistance fund
    Open

    Pays for: Medical and medication costs.

    The foundation says: “Accepting Applications”
  • From a charity · NORD RareCare
    Narcolepsy Premium Copay Assistance fund
    Open

    Pays for: Insurance premiums and copays.

    The foundation says: “Accepting Applications”
  • From a charity · The Assistance Fund
    Narcolepsy fund
    Open

    Pays for: Copays, coinsurance, deductibles and other health-related expenses.

    The foundation says: “OPEN — Accepting New Patients. TAF is currently accepting new patient enrollments for this program.”
  • From a charity · TotalAssist (formerly PAN Foundation)
    Narcolepsy fund
    Open

    Pays for: Out-of-pocket costs for approved medications, up to $5,000 per year. Requires health insurance (any kind).

Status as each foundation showed it on September 28, 2026.

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Side Effect Explorer

Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.

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Genetic Testing

Genetic testing can confirm a diagnosis, guide treatment decisions, and identify family members who may be at risk.

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Trusted Narcolepsy Type 1 Resources

Reputable organizations and medical references for learning more about Narcolepsy Type 1, including disease registries, foundation resources, and clinical guidelines.

FDA decision ahead
The FDA is due to decide on AXS-12 (reboxetine) (Axsome Therapeutics) for Narcolepsy (cataplexy) by May 1, 2027. Norepinephrine reuptake inhibitor targeting cataplexy in narcolepsy.
See all upcoming rare disease FDA decisions →

Active Clinical Trials for Narcolepsy Type 1

Use this Narcolepsy Type 1 clinical trial finder to see the 22 studies recruiting patients and 1 opening soon in the United States and worldwide, with eligibility criteria in plain English. These studies play a critical role in advancing care for neurological & neuromuscular conditions and may offer access to treatments not yet widely available. Each trial below is sourced directly from ClinicalTrials.gov, with eligibility criteria translated into plain English to help patients and caregivers evaluate whether a study may be a fit.

TrialsSite mapPipeline timeline

Note: Trial recruitment statuses on ClinicalTrials.gov may not immediately reflect recent FDA decisions, sponsor announcements, or enrollment changes. Always confirm a trial's current status directly with the study coordinator before making plans.

23 active trials worldwide
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RECRUITINGPHASE2, PHASE3Recently updatedNCT07598708

A Study to Investigate the Effects of Cleminorexton Compared With Placebo in the Treatment of Participants With Central Disorders of Hypersomnolence

Intervention: cleminorexton, Placebo

Sponsor: Centessa Pharmaceuticals (UK) Limited

Narcolepsy Type 1 (NT1) and Narcolepsy Type 2 (NT2) are rare conditions that make people feel very sleepy during the day (often referred to as excessive daytime sleepiness [EDS]). People living with these conditions might find it hard to stay alert and pay attention when they are...

Ages 18 Years – 70 Years23 locations
Started May 2026Updated yesterdayEst. Sep 2027 (~12 months)
RECRUITINGPHASE2, PHASE3Recently updatedNCT07646678

A Study of TAK-360 in People With Narcolepsy or Idiopathic Hypersomnia

Intervention: TAK-360, Placebo

Sponsor: Takeda

Central hypersomnia conditions are a group of sleeping disorders where the brain has trouble keeping a person awake during the day (called excessive daytime sleepiness or EDS). These conditions usually include narcolepsy (type 1 and 2) and idiopathic hypersomnia (IH). Narcolepsy ...

Ages 18 Years – 71 Years24 locations
Started Jun 2026Updated 2 weeks agoEst. Jun 2031 (~4y 8m)
RECRUITINGPHASE3Recently updatedNCT07455383

A Study to Evaluate the Efficacy and Safety of ALKS 2680 in Adults With Narcolepsy Type 1

Intervention: ALKS 2680 Dose 1, ALKS 2680 Dose 2, Placebo

Sponsor: Alkermes, Inc.

The purpose of this study is to measure decreases in daytime sleepiness, cataplexy (sudden loss of muscle tone), and disease symptoms in participants with NT1 when taking ALKS 2680 tablets compared with placebo tablets.

Ages 18 Years – 70 Years42 locations
Started Apr 2026Updated 1 month agoEst. May 2027 (~7 months)
RECRUITINGPHASE3Recently updatedNCT07540897

A Study to Evaluate the Efficacy, Safety and Tolerability of ALKS 2680 in Adults With Narcolepsy Type 1 (Brilliance NT1 - 304)

Intervention: ALKS 2680 Dose 1, ALKS 2680 Dose 2, Placebo

Sponsor: Alkermes, Inc.

The purpose of this study is to measure decreases in daytime sleepiness, cataplexy (sudden loss of muscle tone), and disease symptoms in participants with NT1 when taking ALKS 2680 tablets compared with placebo tablets.

Ages 18 Years – 70 Years17 locations
Started Aug 2026Updated 1 month agoEst. Jun 2027 (~8 months)
RECRUITINGPHASE3Recently updatedNCT07625280

A Study Evaluating the Efficacy and Safety of Xywav Expanded Dosing vs Placebo in Participants With Narcolepsy or IH

Intervention: Xywav, Placebo

Sponsor: Jazz Pharmaceuticals · Jazz Pharmaceuticals Ireland Limited

The purpose of this study is to evaluate the efficacy and safety of expanded Xywav dosing regimens in adult participants with narcolepsy or idiopathic hypersomnia (IH).

Ages 18 Years – 75 Years3 locations
Started Jul 2026Updated 1 month agoEst. Dec 2027 (~1y 2m)
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Active trial locations68 cities in the US
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Trial Pipeline

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Data from ClinicalTrials.gov, U.S. National Library of Medicine.
Always talk to your doctor before considering a clinical trial.

Patient Communities

Connect with other Narcolepsy Type 1 patients, caregivers, and advocacy groups across Facebook groups, Reddit communities, and YouTube channels. These patient communities offer peer support, shared experiences, caregiver resources, and real-time discussion about Narcolepsy Type 1 treatments, clinical trial participation, and day-to-day disease management.

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Related Neurological & Neuromuscular Conditions

Other rare diseases in the neurological & neuromuscular category. Patients with Narcolepsy Type 1 may find relevant research, shared treatment pathways, or overlapping clinical trials among these related conditions.

Companies Developing Narcolepsy Type 1 Treatments

4 pharmaceutical companies have Narcolepsy Type 1 in their rare disease portfolio

Frequently Asked Questions About Narcolepsy Type 1