0601 An Atypical Cause of Hallucinations in Type 1 Narcolepsy

Abstract Introduction Narcolepsy is a disorder of hypersomnolence affecting between 1:5000-1:10,000 individuals. Type 1 can be differentiated from 2 by the presence cataplexy. Visual hallucinations are reported in 50-80% T1 Narcoleptics and ~25% T2 Narcoleptics. This thought to REM-related phenomenon occurring at transitions sleep wakefulness. Auditory or paranoid delusions more rare. We report case 17 year old patient who experienced psychotic symptoms after trialing than one class stimulants. Methods was primarily retrospective review. A subsequent literature search performed reviewing similar reports psychosis secondary medications used treat Narcolepsy. Results The female 10 years time her diagnosis T1. At onset, had cataplexy visual onset wakening. After finding minimal help with stimulants, age 15 she maintained on sodium oxybate 6 grams per night for started modafinil 200mg BID She then new auditory hyperreligiosity admitted inpatient psychiatry where both were discontinued. subsequently extended release methylphenidate within months recurrence resulting two consecutive hospitalizations psychosis. Conclusion Psychosis induced has been stimulants most common offending agents. Symptoms related armodafinil less frequently described. Most may directly indirectly act dopamine pathways, which theory have propensity lead symptoms. Small studies patients 1-2% Modafinil users. Larger meta-analyses Schizophrenia, not found an increased likelihood uncontrolled while modafinil. Further needed elucidate relationship risk patients. Support (if any)