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S268

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

EW439

Utilization of psychotropic drugs in

Europe: Why is Portugal such a

particular case?

T. Alves-dos-Reis

1 , 2 ,

, M.A. Matias

3

1

Hospital do Espírito Santo de Évora, Psiquiatria e Saúde Mental,

Évora, Portugal

2

NOVA Medical School Faculdade Ciências Médicas, Mental Health,

Lisbon, Portugal

3

Nova School of Business and Economics, Universidade Nova de

Lisboa, Business and Economics, Lisbon, Portugal

Corresponding author.

Introduction

Psychotropic drugs are among the most utilized

medications in Europe.

Objectives

To perform an international comparison of the utiliza-

tion trends of antidepressants, anxiolytics, hypnotics and sedatives

(AHS).

Methods

We used data from the Organization for Economic

Cooperation and Development (OECD). We used the World Health

Organization’s Defined Daily Dosage (DDD) per 1000 inhabitants

per day (DHD) methodology. We performed a general comparison

between 14 European countries and a more detailed compara-

tive analysis between Portugal, Italy, Spain and Germany. These

countries were selected according to the following criteria: simi-

lar 12-month prevalence of mental health disorders, similar results

for negative mental health (SF-36 questionnaire) and similar stan-

dardized death rates for suicide.

Results

Portugal had the highest overall utilization of antidepres-

sants and AHS in 2011, amounting to 110.7 DHD, and the highest

increase in utilization of AHS (1.8%) from 2003 and 2011. Concern-

ing antidepressants, Portugal had the third highest utilization of

these drugs in 2011 (78.3 DHD). Regarding the more detailed com-

parative analysis, utilization of AHS was still significantly higher

in Portugal. Considering antidepressants, Portugal experienced an

increasing utilization, which grew by approximately 11.4% from

2003 and 2008. From 2009 onward the utilization increased but at

a slower pace.

Conclusion

The very high utilization of these drugs, especially of

AHS, is a worrying fact since this might indicate an inadequate

treatment choice for anxiety and depressive disorders. Further

research is needed to better understand the relationship of these

findings with regulations concerning utilization of psychotropic

drugs and compliance with best medical practices between distinct

European countries.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.557

EW440

Blonanserin augmentation in patients

with schizophrenia – who is

benefited from blonanserin

augmentation?: An open-label,

prospective, multicenter study

Y.S. Woo

1 ,

, J.E. Park

2

, D.H. Kim

3

, I.K. Sohn

2

, T.Y. Hwang

4

,

Y.M. Park

5

, D.I. Jon

6

, J.H. Jeong

7

, B.H. Yoon

8

, W.M. Bahk

1

1

Yeouido St. Mary’s Hospital, psychiatry, Seoul, Republic of Korea

2

Keyo Hospital, Keyo Medical Foundation, psychiatry, Uiwang,

Republic of Korea

3

Chuncheon Scared Heart Hospital, psychiatry, Chuncheon, Republic

of Korea

4

Yong-in Mental Hospital, psychiatry, Yong-in, Republic of Korea

5

Ilsan Paik Hospital, psychiatry, Goyang, Republic of Korea

6

Sacred Heart Hospital, psychiatry, Anyang, Republic of Korea

7

St. Vincent’s Hospital, psychiatry, Suwon, Republic of Korea

8

Naju National Hospital, psychiatry, Naju, Republic of Korea

Corresponding author.

Introduction

Evidences for antipsychotics augmentation for

schizophrenic patients with suboptimal efficacy have been lack-

ing although it has been widespread therapeutic strategy in clinical

practice.

Objectives

The purpose of this study was to investigate the effi-

cacy and tolerability of blonanserin augmentation with an atypical

antipsychotics (AAPs) in schizophrenic patients.

Methods

A total of 100 patients with schizophrenia partially

or completely unresponsive to treatment with an AAP recruited

in this 12-week, open-label, non-comparative, multicenter study.

Blonanserin was added to existing AAPs which were maintained

during the study period. Efficacy was primarily evaluated using

Positive and Negative Syndrome Scale (PANSS) at baseline, week

2, 4, 8, and 12. Predictors for PANSS response (

20% reduction)

was investigated.

Results

The PANSS total score was significantly decreased at 12

weeks after blonanserin augmentation (–21.0

±

18.1,

F

= 105.849,

P

< 0.001). Response rate on PANSS at week 12 was 51.0%. Pre-

mature discontinuation was occurred in 17 patients (17.0%) and 4

patients among themdiscontinued the study due to adverse events.

Nine patients experienced significant weight gain during the study.

Response to blonanserin augmentation was associated with severe

(PANSS > 85) baseline symptom (OR = 10.298,

P

= 0.007) and higher

dose (> 600mg/day of chlorpromazine equivalent dose) of existing

AAPs (OR = 4.594,

P

= 0.014).

Conclusions

Blonanserin augmentation improved psychiatric

symptoms of schizophrenic patients in cases of partial or non-

responsive to an AAP treatment with favorable tolerability. Patients

with severe symptom despite treatment with higher dose of AAP

were benefited from this augmentation. These results suggested

that blonanserin augmentation could be an effective strategy for

specific patients with schizophrenia.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.558

EW441

Nicotinic acetylcholine receptor

antagonists for treatment-resistant

depression: A meta-analysis

W.M. Bahk

1 ,

, Y.S. Woo

1

, H.J. Seo

1

, B.H. Yoon

2

, D.I. Jon

3

,

Y.J. Kwon

4

, K.H. Lee

5

, K.J. Min

6

, S.Y. Lee

7

, H.R. Wang

1

1

Yeouido St. Mary’s Hospital, psychiatry, Seoul, Republic of Korea

2

Naju National Hospital, psychiatry, Seoul, Republic of Korea

3

Sacred Hospital-Hallym University, Psychiatry, Anyang, Republic of

Korea

4

Soonchunhuang University, psychiatry, Cheonan, Republic of Korea

5

Dongguk University, psychiatry, Gyeongju, Republic of Korea

6

Chung-Ang University, psychiatry, Seoul, Republic of Korea

7

Wonkwang University, psychiatry, Iksan, Republic of Korea

Corresponding author.

Objective

Emerging preclinical and clinical evidence suggests a

potential role of nicotinic acetylcholine receptors in the patho-

physiology of depression. Several clinical trials have investigated

the efficacy of nicotinic acetylcholine receptor antagonists in

treatment-resistant depression. We performed this meta-analysis

to investigate whether nicotinic acetylcholine receptor antagonists

significantly improve symptoms in patients with major depressive

disorder who have an inadequate response to standard antidepres-

sant therapy.

Methods

A comprehensive literature search identified 6 ran-

domized controlled trials. These 6 trials, which included 2067

participants, were pooled for this meta-analysis using a random-

effects model.