ArticleFrontiers in neurology2014
Psychosis in patients with narcolepsy as an adverse effect of sodium oxybate.
Article in Frontiers in neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Narcolepsy and psychosis: A systematic review.Acta psychiatrica Scandinavica · 2021Pooled it
- Trial
- A Comprehensive Review of Current and Emerging Treatments for Narcolepsy Type 1.Journal of clinical medicine · 2025Review
- International Swiss Primary Hypersomnolence and Narcolepsy Cohort Study (iSPHYNCS): the impact of psychiatric comorbidities on daily life in central disorders of hypersomnolence-a vicious circle.Journal of sleep research · 2025Article
- Narcolepsy as a potential risk factor for Schizophrenia.Translational psychiatry · 2025Article
- Dosing Optimization of Low-Sodium Oxybate in Narcolepsy and Idiopathic Hypersomnia in Adults: Consensus Recommendations.Neurology and therapy · 2024Article
- Pediatric Narcolepsy-A Practical Review.Children (Basel, Switzerland) · 2022Review
- Neuropsychiatric Correlates of Narcolepsy.Current psychiatry reports · 2020Review
- Schizophrenia and sleep disorders: links, risks, and management challenges.Nature and science of sleep · 2017Review
- Absence of NMDA receptor antibodies in the rare association between Type 1 Narcolepsy and Psychosis.Scientific reports · 2016Article
- Brain circuitries involved in sleep disorders.Frontiers in neurology · 2015Article
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimHypnagogic and hypnopompic hallucinations are characteristic symptoms of narcolepsy, as are excessive daytime sleepiness, cataplexy, and sleep paralysis. Narcolepsy patients may also experience daytime hallucinations unrelated to sleep-wake transitions. The effect of medication on hallucinations is of interest since treatment of narcolepsy may provoke psychotic symptoms. We aim to analyze the relation between sodium oxybate (SXB) treatment and psychotic symptoms in narcolepsy patients. Furthermore, we analyze the characteristics of hallucinations to determine their nature as mainly psychotic or hypnagogic and raise a discussion about whether SXB causes psychosis or if psychosis occurs as an endogenous complication in narcolepsy.
methodWe present altogether four patients with narcolepsy who experienced psychotic symptoms during treatment with SXB. In addition, we searched the literature for descriptions of hallucinations in narcolepsy and similarities and differences with psychotic symptoms in schizophrenia.
resultsThree out of four patients had hallucinations typical for psychosis and one had symptoms that resembled aggravated hypnagogic hallucinations. Two patients also had delusional symptoms primarily associated with mental disorders. Tapering down SXB was tried and helped in two out of four cases. Adding antipsychotic treatment (risperidone) alleviated psychotic symptoms in two cases.
conclusionPsychotic symptoms in narcolepsy may appear during SXB treatment. Hallucinations resemble those seen in schizophrenia; however, the insight that symptoms are delusional is usually preserved. In case of SXB-induced psychotic symptoms or hallucinations, reducing SXB dose or adding antipsychotic medication can be tried.
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