Treatment of idiopathic hypersomnia with modafinil in an individual at clinical high risk for psychosis: A case report.

BACKGROUND

Recent studies have shown that sleep disturbances are frequent at different stages of psychosis, including clinical high risk for psychosis (CHR-P). However, the comorbidity of hypersomnia with CHR-P and its treatment have rarely been reported or discussed.

CASE PRESENTATION

A 16-year-old female diagnosed with major depressive disorder and CHR-P experienced worsening excessive daytime sleepiness (EDS), including falling sleep in class. Polysomnography and multiple sleep latency tests confirmed the diagnosis of idiopathic hypersomnia (IH), and treatment with modafinil (100 mg/day) was initiated. EDS improved after increasing the modafinil dose to 200 mg/day. No side effects or exacerbations of psychotic symptoms were observed. EDS recurred after she entered university and was treated with 300 mg/day of modafinil without side effects or transition to psychosis.

CONCLUSION

This case demonstrates modafinil's efficacy and safety in treating IH in individuals with CHR-P. However, whether modafinil use increases the risk of transition to psychosis remains unclear. Further research is required on modafinil as a treatment for hypersomnia in individuals with CHR-P.