0985 Oxybate induced mania

Abstract Introduction Hypersomnia sleep disorders are characterized by overwhelming daytime sleepiness. Treatment options include sodium oxybate the salt of γ-hydroxybutyric acid (GHB). Oxybate, an endogenous metabolite GABA, acts through GABAB noradrenergic and dopaminergic neurons, as well at thalamocortical neurons. < 1% may experience suicidal ideations or psychosis. Report case(s) A 17-year-old female with obesity, spina bifida occulta follows for idiopathic hypersomnia long (TST 12.6 hours on polysomnography) a delayed circadian rhythm. Her typical zone is 11:00PM to 10:00AM, but she can easily until 2:00PM. She started minimize her burden improve wakefulness. initially developed insomnia concern mania migraines photophobia phonophobia. After 26 days, was discontinued. persisted daily. schedule mood returned baseline within 17 days thereafter. 48-year-old anxiety/depression, PTSD has since age 42 unspecified hypersomnia, either narcolepsy type 1 versus hypersomnia. Initial polysomnography/MSLT fluoxetine revealed AHI 1.6, mean latency 6.4 minutes without SOREMPs. 8:00PM 9:00AM. cataplexy had remarkable improvement in symptoms after 4 days. 35 9 grams nightly anxiety, extracorporeal sensations, paranoia. The dose decreased 7.5 nightly. By 7 months therapy paranoia progressed point where threatened landlord facing legal consequences. Sodium At 53-years-old trial mixed-salts oxybate. three therapy, became hypomanic severe pressured speech despite euthymic mood. reported going entirely 3-4 time using this Mixed-salts discontinued 36 later addition quetiapine, hypomania nearly resolved able get 8-9 restful sleep. Conclusion Hypomania appears be rare serious side effect long-sleepers. Discontinuing not sufficient therapy. Support (if any)