The Association of Schizophrenia and Narcolepsy in Adolescents

Cavalier, Yefim; Kothare, Sanjeev V.

doi:10.1016/j.pediatrneurol.2018.01.001

Cited by 4 publications

(2 citation statements)

References 18 publications

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“… 102 In some case reports, olanzapine, clozapine, haloperidol, or quetiapine was effective. 30 , 47 , 103 , 104 The clinical management of these complex situations requires further study.…”

Section: Resultsmentioning

confidence: 99%

“… 29 Less comprehensive discussions have appeared recently in case reports or cohort studies. 4 , 30 , 31 , 32 We reviewed cohort reports, reports of cases with narcolepsy and psychotic features, and papers relevant to the treatment of cases with these features (including drug‐induced psychosis). We also report a statistical analysis of clinical differences between reported narcolepsy cases with psychosis‐like symptoms vs. those with comorbid psychotic diagnoses.…”

Section: Introductionmentioning

confidence: 99%

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Narcolepsy and psychosis: A systematic review

Hanin

Arnulf

Maranci

et al. 2021

Acta Psychiatr Scand

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Objective Narcolepsy is a rare sleep disorder in which psychotic‐like symptoms can present diagnostic and therapeutic challenges. We aimed to review the association between, and medical management of, narcolepsy and psychosis in children and adults. Methods We reviewed the full text of 100 papers from 187 identified by a PubMed search on narcolepsy plus any of these keywords: psychosis , schizophrenia , delusion , side effects , safety , and bipolar disorder . Results Three relevant groups are described. (i) In typical narcolepsy, psychotic‐like symptoms include predominantly visual hallucinations at the sleep‐wake transition (experienced as “not real”) and dissociation because of intrusion of rapid eye movement (REM) sleep phenomena into wakefulness. (ii) Atypical patients (“the psychotic form of narcolepsy”) experience more severe and vivid, apparently REM‐related hallucinations or dream/reality confusions, which patients may rationalize in a delusion‐like way. (iii) Some patients have a comorbid schizophrenia spectrum disorder with psychotic symptoms unrelated to sleep. Psychostimulants used to treat narcolepsy may trigger psychotic symptoms in all three groups. We analyzed 58 published cases from groups 2 and 3 ( n = 17 and 41). Features that were reported significantly more frequently in atypical patients include visual and multimodal hallucinations, sexual and mystical delusions, and false memories. Dual diagnosis patients had more disorganized symptoms and earlier onset of narcolepsy. Conclusion Epidemiological studies tentatively suggest a possible association between narcolepsy and schizophrenia only for very early‐onset cases, which could be related to the partially overlapping neurodevelopmental changes observed in these disorders. We propose a clinical algorithm for the management of cases with psychotic‐like or psychotic features.

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“… 102 In some case reports, olanzapine, clozapine, haloperidol, or quetiapine was effective. 30 , 47 , 103 , 104 The clinical management of these complex situations requires further study.…”

Section: Resultsmentioning

confidence: 99%