Eating and sleep disorders: drug for cataplexy: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Eating and sleep disorders: drug for cataplexy

Sample item

A man with narcolepsy is alert on modafinil but still has several episodes a week of knee buckling when he laughs. Which drug is most appropriate to reduce the cataplexy?

APropranololBVenlafaxine, a REM-suppressing antidepressantCModafinil at a higher doseDZolpidem at bedtime

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Venlafaxine, a REM-suppressing antidepressant

Cataplexy is REM-atonia intruding into wakefulness. Drugs that suppress REM sleep, such as venlafaxine, SSRIs, clomipramine and sodium oxybate, reduce it. Modafinil treats sleepiness but not cataplexy.

Option by option

A. Propranolol
Propranolol has no role in cataplexy.
B. Venlafaxine, a REM-suppressing antidepressant (correct)
Correct. REM-suppressing antidepressants reduce cataplexy.
C. Modafinil at a higher dose
Modafinil improves alertness but has little effect on cataplexy.
D. Zolpidem at bedtime
Zolpidem is a hypnotic and does not suppress REM-related atonia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Venlafaxine, a REM-suppressing antidepressant. Cataplexy is REM-atonia intruding into wakefulness.

Why is "Propranolol" not the answer?

Propranolol has no role in cataplexy.

Why is "Modafinil at a higher dose" not the answer?

Modafinil improves alertness but has little effect on cataplexy.

Why is "Zolpidem at bedtime" not the answer?

Zolpidem is a hypnotic and does not suppress REM-related atonia.

What concept does this question test?

It tests Eating and sleep disorders: drug for cataplexy in Psychiatry. Drugs that suppress REM sleep, such as venlafaxine, SSRIs, clomipramine and sodium oxybate, reduce it. Modafinil treats sleepiness but not cataplexy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Eating and sleep disorders: drug for cataplexy?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.