title: Severe mania complicating treatment of narcolepsy with cataplexy.
abstract: We report the case of a 22-year-old male who exhibited severe manic behavior shortly after beginning treatment with modafinil and venlafaxine for narcolepsy with cataplexy. The manic episode persisted several weeks after medication cessation and required management with a mood stabilizer. Reinstitution of modafinil and an alternate antidepressant for recurrent sleepiness and cataplexy was well tolerated and very effective. Sleep physicians should be aware that psychostimulants, including modafinil, and antidepressant medications commonly prescribed for treatment of narcolepsy may precipitate mania in patients with underlying bipolar disorder.
authors.affiliation: Department of Mental Health, Naval Medical Center San Diego, San Diego, CA, USA.
authors.forename: Mark I
authors.initials: MI
authors.lastname: Crosby
authors.forename: David A
authors.initials: DA
authors.lastname: Bradshaw
authors.forename: Robert N
authors.initials: RN
authors.lastname: McLay
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001559:Benzhydryl Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000139:chemically induced*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003511:Cyclohexanols / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D000077408:Modafinil; D009290:Narcolepsy / Q000150:complications* / Q000188:drug therapy; D000069470:Venlafaxine Hydrochloride; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride; D000077408:Modafinil