Narcolepsy is a disorder characterized by diurnal somnolence and episodes of short duration sleep. It can occur in 0.02–0.16% of adults, generally before the age of 30.

The aim of this work is to present tolerability and treatment response of Concerta in one adult suffering from narcolepsy.

We report the case of a 28 years adult female with narcolepsy. One year ago, after a strong social stress, she manifested some symptoms of narcolepsy: excessive daytime sleepiness, cataplexy, and visual hypnogogic hallucinations. There was no family history of sleep disorders and not experienced premorbid seizure or sleep disorder. Diagnosis of narcolepsy is based on DSM-IV criteria, polysomnography and Multiple Sleep Latency Test. Sleep latency, rapid eye movement sleep latency, and mean multiple sleep latency were 2.9, 70.1 and 1.5 min, respectively. Twenty-four hour EEG monitoring, MRI imaging of the brain and serum chemistries were normal. At the beginning because of the misdiagnosis the patient was treated with lithium and olanzapine. Patient started Concerta treatment after 1 year with 9 mg/day at the morning. Dose was increased maximum to 18 mg twice daily over a 2-weeks period.

Treatment of narcolepsy with Concerta lasted 6 month. Visual hypnogogic hallucinations and cataplexy started to improve 3 weeks after adjustments in methylphenidate dosing. Three months after the initiation of therapy, the patient is completely asymptomatic. Side effects included faster heart rate and nervousness.

This case support results from recent studies that methylphenidate is well tolerated and effective in narcolepsy.