Pathological Gambling Disorder Associated With Modafinil Therapy in a Patient With Type 1 Narcolepsy

We report the case of a 22-year-old man with type 1 narcolepsy who experienced pathological gambling after modafinil therapy. The patient was administered modafinil, which improved excessive daytime sleepiness (EDS). However, he heart palpitations and nervousness, eventually developing addiction. After six months therapy, engaged in various online activities, leading to significant financial loss stress. Consequently, replaced pitolisant, is potent selective antagonist/inverse agonist histamine H3 receptor. One month discontinuation, EDS symptoms were well controlled pitolisant urge resolved. Modafinil prescribed as first-line therapy for treating patients narcolepsy. it may cause psychiatric side effects via dopaminergic system. Alternatively, could be used avoid modafinil’s