European Psychiatry - Volume 33 - March 2016

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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 ∗, M.A. Matias
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.
EW440
Blonanserin augmentation in patients
with schizophrenia – who is
benefited from blonanserin
augmentation?: An open-label,
prospective, multicenter study
Y.S. Woo ∗, J.E. Park , D.H. Kim , I.K. Sohn , T.Y. Hwang ,
Y.M. Park , D.I. Jon , J.H. Jeong , B.H. Yoon , W.M. Bahk
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.
EW441
Nicotinic acetylcholine receptor
antagonists for treatment-resistant
depression: A meta-analysis
W.M. Bahk ∗, Y.S. Woo , H.J. Seo , B.H. Yoon , D.I. Jon ,
Y.J. Kwon , K.H. Lee , K.J. Min , S.Y. Lee , H.R. Wang
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.