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S510

24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805

Objective

To analyze the chronotherapeutic strategies in the

management of depression, regarding indications, contraindica-

tions and efficacy.

Methods

A literature review was made by searching for articles

in PubMED. Additional articles were included through review of

reference lists.

Results

In recent years some techniques (mainly light therapy

and sleep deprivation) have passed the experimental developmen-

tal phase and reached the status of powerful and affordable clinical

interventions for the treatment of depressed patients. About sixty

percent of all depressed patients improve after a single night of total

or partial sleep deprivation. It has been shown that a combination

of pharmacotherapy with antidepressants and sleep deprivation

is superior to pharmacotherapy alone. Light therapy with bright

artificial light is especially beneficial in patients with a fall/winter

pattern of depressive symptomatology that has been termed sea-

sonal affective disorder. Antidepressant chronotherapeutics target

the broadly defined depressive syndrome, with response and

relapse rates similar to those obtained with antidepressant drugs

and good results are obtained even in difficult-to-treat conditions

such as bipolar depression.

Conclusions

Chronotherapeutics offer a benign alternative to

more radical treatments of depression. Adding Chronotherapyto

the treatment choices may overcome drug-resistant Depression

and shorten treatment duration.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1488

EV504

Antidepressant efficacy and tolerance

of agomelatine in daily practice in

Switzerland

B. Guido

1 ,

, H .T

. Edith

2

1

HUG, Mental Health and Psychiatry, Geneva, Switzerland

2

Center for Affective- Stress and Sleep Disorders ZASS, Psychiatric

Clinics UPK of the University of Basel, Basel, Switzerland

Corresponding author.

Introduction

The antidepressant efficacy and tolerance of agome-

latine, MT1/MT

2

agonist and 5-HT

2C

antagonist, has been proven

in clinical trials. Non interventional studies give the opportunity to

evaluate these properties in real life.

Objective

To evaluate the efficacy and tolerance of agomelatine

in depressed outpatients in Switzerland.

Methods

Non-interventional study in 934 depressed (51.2%

severely) patients given 25–50mg agomelatine for 12 and 24

weeks. Main endpoints were change in MADRS score, and response

(

50% reduction in total score) and remission (MADRS

12) rates.

CGI was also assessed. Reported adverse drug reactions, sexual dys-

function, and weight changes were recorded. Liver function tests

were performed according to the summary of product characteris-

tics.

Results

MADRS total score decreased significantly (

P

< 0.0001)

from baseline (29.5

±

8.9) to weeks 12 (12.8

±

9.6) and 24

(9.7

±

8.6). Responder rate was 66.8% and 78.3% and remission

rate 54.2% and 70.2% at weeks 12 and 24, respectively. Results

corroborated by CGI scores, were similar for severely depressed

patients. Early improvers (MADRS

20% reduction after 2 weeks;

461 patients) had the highest responder and remission rates.

Agomelatine was well tolerated and no relevant weight changes

or deleterious sexual function was reported. Ten patients had

ALT/AST>3ULN, thereof 2 without baseline and one with elevated

baseline.Most physicians rated the efficacy and tolerance of agome-

latine as “good or very good”.

Conclusion

Long-term agomelatine treatment improved mood

symptoms of depressed patients with high levels of response and

remission and a favorable tolerance profile.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1489

EV505

Relation between major depressive

disorder as regards severity in a

sample of Egyptian population and

serum level of tumor necrosis factor

alpha

S. Harby

, T. Molokhia , H. Aboelwafa , D. Elneely

Alexandria Faculty of Medicine, Neuropsychiatry, Alexandria, Egypt

Corresponding author.

Introduction

Depression is a life threatening psychiatric dis-

order. STAR-D study stated that remission rates decrease, and

relapse rates increase. It produces chronic diseases and worsens

mean health when co-morbid with these diseases. The depres-

sive symptoms in humans are analogous to the ‘sickness behavior’

syndrome seen in animals when injected by pro-inflammatory

cytokines.

Objective

This study was done to clarify the relation between the

severity of depression and serum level of tumor necrosis factor

alpha (TNF), so improving the quality of pharmacological manage-

ment.

Aim

This study was done to prove that inflammatory process is

involved in the pathogenesis of depression by assessing the serum

level tumor necrosis factor alpha (TNF alpha)

Methods

Our study is comparing between 60 patients withmajor

depressive disorder and 30 healthy controls regarding the serum

level of tumor necrosis factor alpha. Patients were diagnosed by

a semi-structured interview using Diagnostic and Statistical Man-

ual of Mental Disorders, Fourth Edition. Patients were subdivided

into mild, moderate and severe depression according to Hamil-

ton Rating Scale for Depression (17 items). Assessment of serum

level of tumor necrosis factor alpha was done using enzyme- linked

immunoassay technique.

Results

Serum level of TNF alpha was significantly higher among

patients than among controls (

Z

= 4.710

*

P

0.001

*

) regardless the

severity of depression.

Conclusions

Serum TNF alpha can be used as a biomarker of

depression but not for the disorder severity. However, further study

is needed to detect if there is a relation between major depres-

sive disorder and serum level of other inflammatory markers as

C-reactive protein.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1490

EV506

Prevalence of major depression

among community pharmacists

practicing in Iran: A cross sectional

study

F. Hashemian

, E. R

oohi

Faculty of Pharmacy- Islamic Azad University- Pharmaceutical

Sciences Branch, Department of Clinical Pharmacy, Tehran, Iran

Corresponding author.

Introduction

Major depression is known to carry the heaviest

burden of disability among mental and behavioral disorders. It may

have negative impact on both personal and professional level. There

have been several studies investigating prevalence ofmajor depres-

sion among different population. However, its prevalence among a

group of healthcare professionals, namely community pharmacists

have not yet been studied.