0818 Psychosis associated with sodium oxybate

Abstract Introduction Sodium oxybate is commonly used to treat narcolepsy with cataplexy. At the approved doses, most common side effects are typically described as nausea, vomiting, dizziness, hypersomnia, urinary disturbances, and weight loss. Cases of medication-induced psychosis have been reported in literature but remain exceedingly rare. We present a case rapid-onset patient systemic lupus erythematosus, which added complexity evaluation, treatment clinical course. Report Cases: The 42 year old woman past history fibromyalgia, prior diagnosis evaluated for daytime hypersomnia poor night time sleep. Prior medications included sodium was effective; modafinil amphetamines created intolerable effects. sleep studies were not available repeat PSG/MSLT performed. PSG did show disordered breathing or nocturnal movements MSLT showed an average latency 5.4 minutes 4 SOREMs. HLA DQB10602 positive. reinitiated on titrated 4.5g twice nightly. A few weeks later developed visual hallucinations, persecutory delusions, insomnia 3 days. She admitted evaluation rule out cerebritis, auto-immune vs. infectious encephalitis. MRI/MRA, lumbar puncture, well inflammatory markers rheumatologic work up unrevealing. discontinued day admission patient’s mentation returned baseline over next Discharge secondary oxybate. Conclusion Psychosis extremely rare effect therapy among patients treated cataplectic narcolepsy. It remains exclusion, any alternative diagnoses must be explored making oxybate, particularly medically complex patient. Support (If Any) None