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What is Xyrem®?

By S. Gadd
Updated: May 17, 2024

Xyrem® is a prescription drug manufactured by Jazz Pharmaceuticals to treat narcolepsy, a disorder that causes people to suddenly fall asleep even while performing normal daytime activities. This drug may also be useful for the treatment of cataplexy, which is the sudden onset of muscle weakness that may occur in people who also suffer from narcolepsy. Xyrem® has a strong depressant effect on the nervous system and has a relatively high risk of addiction if large doses are taken over a long period of time, and so should always be taken only under a doctor’s care.

The drug Xyrem® is a slight variation of a natural molecule that is produced by the body, called gamma-hydroxybutyric acid (GHB). GHB can be found at a low level in some alcoholic drinks and in some fruits. As a drug, GHB can be used as an anesthetic, to treat severe depression, or to treat alcoholism. GHB is a commonly abused illegal drug, and is one of the substances that have been classified as a date rape drug because it can result in a person having little memory of events occurring within three to five hours after ingestion.

Xyrem® is usually prescribed to be taken at bedtime on an empty stomach. Due to the fact that this drug can have a sudden and strong effect on the nervous system, most doctors suggest that the drug should be taken after the person is already sitting in bed. Normal dosing usually requires a patient to set an alarm for a second dose to be taken during the night, approximately three to five hours following the first dose.

The dosage amount will vary from person to person. This is based on the severity of the condition and how well a person responds to the drug. Usually, the dose will start small and be increased gradually so as not to shock the body with too strong of a dose.

Depending on the seriousness of their condition, many people with narcolepsy can’t perform normal daily tasks like driving or operating certain types of equipment due to the risk of falling asleep. People taking Xyrem® for this condition are advised to continue avoiding these types of tasks until they are certain the drug will successfully prevent these attacks of sleepiness, usually for at least two to three weeks after starting treatment. Although this drug helps many people with narcolepsy lead normal lives, a small percentage of patients will not improve with Xyrem® and will need to try other treatment methods.

Xyrem® is a strong drug that can produce a variety of side effects. These may be relatively minor like dizziness, stomach problems, or minor headaches. Side effects that are more serious may include severe headaches, sleepwalking, suicidal thoughts, or psychotic episodes.

A potential problem with this drug is that it may cause withdrawal symptoms if suddenly stopped. The seriousness of withdrawal will depend on the size of the dose and the length of treatment. Withdrawal symptoms may include mental agitation, difficultly falling or staying asleep, profuse sweating, or muscle aches. Serious withdrawal symptoms may involve convulsions or psychosis. For this reason, most doctors will slowly decrease the dose of this drug before ending treatment.

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