Hip
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A patient who developed narcolepsy and severe psychiatric symptoms after a Pandemrix H1N1 vaccination was given rituximab, and his condition ameliorated dramatically.
However, the positive effects of rituximab unfortunately only lasted for 2 months, after which the patient relapsed, and subsequent treatments with rituximab did not produce any results. The study is here:
Transient Impact of Rituximab in H1N1 Vaccination-associated Narcolepsy With Severe Psychiatric Symptoms
People with narcolepsy have a diminished number of hypocretin-producing cells; hypocretin (aka: orexin) is a neurotransmitter that plays a role in regulating sleep-wake cycles. The evidence points to narcolepsy involving an autoimmune attack on the hypocretin cells, so this is why theoretically rituximab might help.
@Jonathan Edwards, would you know how we might explain the fact that rituximab was pretty effective initially, but then mysteriously stopped working?
However, the positive effects of rituximab unfortunately only lasted for 2 months, after which the patient relapsed, and subsequent treatments with rituximab did not produce any results. The study is here:
Transient Impact of Rituximab in H1N1 Vaccination-associated Narcolepsy With Severe Psychiatric Symptoms
People with narcolepsy have a diminished number of hypocretin-producing cells; hypocretin (aka: orexin) is a neurotransmitter that plays a role in regulating sleep-wake cycles. The evidence points to narcolepsy involving an autoimmune attack on the hypocretin cells, so this is why theoretically rituximab might help.
@Jonathan Edwards, would you know how we might explain the fact that rituximab was pretty effective initially, but then mysteriously stopped working?