European Psychiatry - Volume 33 - March 2016

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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.
EV504
Antidepressant efficacy and tolerance
of agomelatine in daily practice in
Switzerland
B. Guido ∗ . Edith
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/MT2 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.
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.
EV506
Prevalence of major depression
among community pharmacists
practicing in Iran: A cross sectional
study
F. Hashemian∗ 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.