0998 Duloxetine as a Possible Effective Treatment of Klein-Levin Syndrome Case Report

Abstract Introduction Kleine Levin Syndrome (KLS), or recurrent hypersomnia, is a rare sleep disorder characterized by episodes of severe hyper-somnolence lasting several days to weeks. Because the etiology unknown, treatment mostly supportive. Some pharmacologic agents have been attempted treat symptoms during with limited success. Report case(s) Patient 17 year-old history attention-deficit hyperactivity and generalized anxiety who presented clinic due hypersomnolence associated derealization cognitive dysfunction all episodes, being alone, other in some such as altered taste affecting appetite, binge eating. The patient was diagnosed KLS tracked which lasted 11-12 (average) recurrence every 10-17 days. Labs, 72 hour EEG, MRI MRA were largely unremarkable. family declined trial Lithium. Pharmacogenetic testing showed significant gene-drug interaction duloxetine requiring higher drug dosage for effects. After psychiatry started duloxetine, experienced 7 month period without episodes. Then recurred unclear reason while on but slightly less duration (6-12 days) shorter time between Duloxetine discontinued lack mood Clarithromycin trialed next use changes. Episodes months predictability. restarted second after months, mild improvement event down 8-11 few months. Time also shortened 8-10 Anxiety only reduced though they still continued struggle ability focus that effected school work functioning. Interestingly, more insomnia duloxetine. Conclusion data effective treatments. To date, this first report prolonged brief remission Norepinephrine serotonin modulation may limit episode duration. More research needed determine whether can modulate effects KLS. Support (if any) None