The clinical picture, the results of the sleep study, the HLA phenotyping, and the patient’s significant response to nortriptyline and methylphenidate therapy confirm the diagnosis of narcolepsy rather than schizophrenia. When hallucinations and delusions are prominent, cases of narcolepsy can simulate schizophrenia (2). Hallucinations in narcolepsy are common and are usually visual or auditory (1, p. 677). Thought disorder is less common but can develop as a secondary delusional elaboration of narcoleptic hallucinations (2). Purposeful but inappropriate behavior, sometimes accompanied by hallucinations, can occur in narcolepsy, probably secondary to "microsleeps" (1, p. 531). A survey of 69 patients with schizophrenia (2) indicated that up to 7% of all patients with a diagnosis of schizophrenia may have a psychotic variant of narcolepsy. Larger studies are necessary to clarify this since, as illustrated by this case, the correct identification of this variant of narcolepsy and subsequent treatment can result in a remarkable reversal of symptoms.