Using clarithromycin to treat excessive sleepiness in narcolepsy and idiopathic hypersomnia

Antibiotic-mediated Improvements in Vigilance: Mechanisms of Action of Clarithromycin in Hypersomnia Syndromes

Phase 2 Interventional Emory University · NCT04026958

This study is testing if the antibiotic clarithromycin can help reduce daytime sleepiness in people with narcolepsy and idiopathic hypersomnia.

Quick facts

PhasePhase 2
Study typeInterventional
Enrollment92 (estimated)
Ages18 Years to 60 Years
SexAll
SponsorEmory University Academic / other
Locations1 site (Atlanta, Georgia)
Trial IDNCT04026958 on ClinicalTrials.gov

What this trial studies

This study evaluates the effectiveness of clarithromycin in reducing excessive daytime sleepiness associated with narcolepsy and idiopathic hypersomnia. It aims to understand the mechanisms behind clarithromycin's effects by examining brain activity through MRI, inflammation, gut bacteria, and cerebrospinal fluid. A total of 92 participants will be randomized to receive either clarithromycin or a placebo for a duration of 14 days. The study seeks to address the unmet need for effective treatments in patients who do not respond adequately to current therapies.

Who should consider this trial

Good fit: Ideal candidates include adults aged 18-60 diagnosed with idiopathic hypersomnia or narcolepsy who are not currently using wake-promoting medications or are willing to discontinue them.

Not a fit: Patients with other causes of hypersomnolence, such as untreated sleep apnea or severe metabolic disorders, may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide a new treatment option for patients suffering from excessive daytime sleepiness due to hypersomnia syndromes.

How similar studies have performed: Previous studies have shown that clarithromycin can significantly improve sleepiness and related quality of life in similar patient populations.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* diagnosis of idiopathic hypersomnia or narcolepsy
* age 18-60
* free of wake-promoting medication, sleepy despite current wake-promoting medications, or willing to discontinue current wake-promoting medication for at least 5 half-lives prior to baseline measures

Exclusion Criteria:

* other potential causes of hypersomnolence, including untreated moderate or severe sleep apnea, severe periodic limb movement disorder with arousals, uncontrolled metabolic disorders
* contraindication to clarithromycin
* contraindication to any of the study procedures

Where this trial is running

Atlanta, Georgia

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Narcolepsy Without CataplexyIdiopathic HypersomniaNarcolepsy With CataplexyNeurology
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.