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S180

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S116–S348

core depressive or residual symptoms during their clinical course.

Augmentation treatment with second-generation antipsychotics

(SGAs) has been one of the suggested approaches to overcome this

shortage of efficacy of antidepressant therapy.

Objectives

To reviewthe role of SGAs as an augmentation strategy

to antidepressant therapy in MDD.

Methods

A search of the MEDLINE/Pubmed database was con-

ducted for articles from 2010 to 2015, using the MeSH terms

“antypsichotics”, “depression” and “treatment”.

Results

There is a general consensus in the literature that antide-

pressant augmentation treatment with SGAs is more effective than

placebo in the management of patients with MDD who failed to

respond adequately to antidepressant therapy alone. The majority

of studies found no significant differences between the differ-

ent studied drugs (namely, aripiprazole, quetiapine, olanzapine

and risperidone). On the other hand, discontinuation rates due to

adverse effects are also higher with SGAs versus placebo. However,

it remains unclear if augmentationwith SGAs is more effective than

other therapeutic strategies, such as combination or switching to

other antidepressant or augmentation with other psychotropics.

Conclusions

There is strong evidence that SGAs augmentation is

an effective and generally safe therapeutic approach to patients

with MDD who respond poorly to antidepressants. Nevertheless,

more studies are needed to understand the efficacy of this treat-

ment comparing other therapeutic approaches.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.308

EW191

Antidepressant-induced

hyponatremia

L. Rodríguez Andrés

, S. Gómez Sánchez , A. Rodríguez Campos ,

R. Hernández Antón , L. Gallardo Borge , A. Álvarez Astorga

Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid,

Spain

Corresponding author.

Introduction

Hyponatremia is one of the electrolytic disorders

most comonly observed among general hospitalized populations

(2% of hospitalized patients). A form of hyponatremia is the syn-

drome of inappropriate antidiuretic hormone secrection (SIADH).

One of its diverse causes is medication. Selective serotonine reup-

take inhibitors (ISRSs) can cause hyponatremia due to SIADH,

particularly among elderly population.

Clinical case report

A 81-year-old female treated with paroxetine

20mg/day because of depression. Twoweeks later she starts feeling

nausea, somnolence and motor inhibition. The sodium level previ-

ous to the onset of treatment was normal but after two weeks it

has decreased to 121 mEq/L, pointing to SIADH induced by ISRSs.

Discussion

The incidence of hyponatremia among elderly

patients treated with antidepressants of ISRSs class has increased.

The prevalence varies between 0.5 and 25%. Although half of the

patients are asymptomatic, the mortality is rate may reach 25%.

It generally develops during the first month of treatment and is

reversible between 2 and 28 days after the suspension of the ISRSs.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.309

EW192

The effectiveness of exercise on

weight loss and postnatal depression:

A systematic review

M. Saligheh

1 ,

, D. Hackett

1

, P. Boyce

2

, S. Cobley

3

1

University of Sydney, Exercise and Sport Science, Lidcombe,

Australia

2

University of Sydney, Sydney Medical School, Camperdown,

Australia

3

University of Sydney, Discipline of Exercise and Sport Science,

Lidcombe, Australia

Corresponding author.

Introduction

Exercise has well-established benefits on depres-

sion and weight-management in normative populations. However,

its effectiveness at postpartum phase remains uncertain.

Objectives

Determine the effectiveness of exercise or physical

activity (PA) interventions on postnatal depression (PND) and

weight-loss.

Aims

Identify exercise and PAmodalities most effective in reduc-

ing PND symptoms and weight.

Methods

Systematic review of RCTs and experimental studies

comparing exercise or PA modalities (e.g., flexibility versus resis-

tance training) against control or alternative interventions (e.g.

social support, diet). Data search included Cochrane Library (CEN-

TRAL), MEDLINE, PsycINFO, EMBASE, CINAHL, Scopus and Science

Citation Index.

Results

Of 8099 studies retrieved, six fulfilled inclusion crite-

ria. Two implemented supervised exercise interventions, one

using ‘Yoga & Pilates’ (1

×

60 mins/session

×

12 weeks) and one

using resistance (v flexibility) training focusing on major mus-

cle groups (2/week

×

18 weeks). Yoga & Pilates decreased PND

and body mass index (BMI); though resistance training did not.

Four studies implemented PA interventions (e.g., walking) with

varying duration (i.e., 3-18 months (e.g., 30 mins per session

×

1/week). Two studies showed significant declines in BMI but

no changes in PND, while two showed no changes in PND and

BMI.

Conclusion

Limitations in the data available; research design

quality; inconsistencies in application of exercisemodalities aswell

as their structure and content; and, the standardization of PND

diagnosis, constrain the ability to determine whether exercise or

PA benefits PND and weight in postpartum women.

Keywords

Exercise; Depression; Postpartum; Weight-loss

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.310

EW193

The impact of neuroinflammation and

inflammatory cytokines in depression

and suicidal behavior

G. Serafini

1 ,

, M. Pompili

2

, P. Girardi

2

, M. Amore

1

1

Section of Psychiatry- San Martino Hospital- University of Genoa,

Neuroscience DINOGMI, Genoa, Italy

2

Sant’Andrea Hospital- Sapienza University of Rome, Neuroscience,

Rome, Italy

Corresponding author.

Introduction

It has been suggested that neuroinflammation and

inflammatory mediators may play a crucial role in the patho-

physiology of both major depression and suicidal behavior.

Immunological differences have been reported between both sub-

jects with major affective disorders and suicidal behavior.

Objectives

The main objective of this review was to deeply

investigate the nature of the association between inflammatory

cytokines in depression and suicidal behavior. Aims: The study

aimed to conduct a systematic review of the current literature

to investigate the association between inflammatory cytokines,

depression, and suicidal behavior.

Results

Generally, an imbalance between pro-inflammatory and

anti-inflammatory cytokines has been documented in both major

depression and suicidal behavior. The presence of major depres-

sive disorder (MDD)with suicidal ideation/attemptswas associated

with differences in inflammatory cytokine profile when com-

pared to that without suicidal ideation/attempts. However, not all