Treatment-induced mania in a patient with narcolepsy with cataplexy case report

Roberto Galea, Elsa Cassar, Anthony Zahra
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Abstract

Modafinil is a psychostimulant primarily used to manage sleep disorders, multiple sclerosis, and both unipolar and bipolar depression. Despite the risk of precipitating mania and psychosis, it is also employed as a non-antipsychotic augmentation therapy in schizophrenia. Only two case reports documented managing mania and narcolepsy with co-prescribed lithium carbonate. Below we discuss a case of treatment-induced mania in a gentleman diagnosed with Bipolar Affective Disorder (BPAD) comorbid with type I narcolepsy who was prescribed modafinil, venlafaxine and fluoxetine. The successful mood stabilisation with lithium carbonate suggests a potential role for mood stabilisers in such cases. This case report underscores the complexity of treating narcolepsy with comorbid psychiatric conditions and the importance of comprehensive evaluation and tailored management.

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嗜睡症伴惊厥患者治疗诱发的躁狂症病例报告
莫达非尼是一种精神兴奋剂,主要用于治疗睡眠障碍、多发性硬化症以及单相和双相抑郁症。尽管莫达非尼有诱发躁狂症和精神病的风险,但也被用作精神分裂症的非抗精神病增强疗法。仅有两份病例报告记录了使用联合处方碳酸锂治疗躁狂症和嗜睡症的情况。下面我们将讨论一例被诊断为双相情感障碍(BPAD)并发I型嗜睡症的患者,在接受莫达非尼、文拉法辛和氟西汀治疗后诱发躁狂症的病例。使用碳酸锂成功地稳定了患者的情绪,这表明情绪稳定剂在此类病例中具有潜在的作用。本病例报告强调了治疗合并精神疾病的嗜睡症的复杂性,以及综合评估和定制管理的重要性。
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