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**Sodium oxybate + modafinil** is a combination of two small molecule drugs—sodium oxybate, a central nervous system depressant that acts primarily as an agonist at GABA-B receptors, and modafinil, a wakefulness-promoting agent whose mechanism of action is not fully understood but is believed to involve inhibition of dopamine reuptake and effects on other neurotransmitter systems. This combination has been studied as adjunctive treatment in narcolepsy, both for excessive daytime sleepiness and, especially with sodium oxybate, for cataplexy. Clinical trial evidence suggests that combined therapy improves subjective and objective measures of sleepiness comparably to monotherapy, with some increase in adverse effects such as nausea, dizziness, and tremor in the combination group. This combination can be used for patients whose sleepiness is not adequately managed by monotherapy and has demonstrated complementary effects on sleep parameters and daytime wakefulness[2][3][7].
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