European Psychiatry - Volume 33 - March 2016

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24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805 S551
EV630
Inhaled loxapine for the treatment of
agitation in borderline personality
disorder
R. Puente ∗, M.F. Rabito Alcon , S. Garcìa Jorge ,
H. Dolengevich Segal , M. Benítez Alonso ,
J. Gómez-Arnau Ramírez , A. Garrido Beltrán , J. Rodríguez Quirós ,
B. Unzeta Conde , O. Pecero García , J. Correas Lauffer
Hospital Henares, Psychiatry, Madrid, Spain
∗ Corresponding author.
Introduction Inhaled loxapine has shown efficiency in the treat-
ment of the mild-moderate agitation syndrome of schyzophrenia
and mania patients. Its rapid response and calming effect non-
sedative allow to hypothesize reasonable efficiency and tolerability
in borderline personality disorder diagnosed patients.
Aims Analyze the efficiency and tolerability of inhaled loxapine
as a pharmacological approach in the treatment of agitation in bor-
derline personality disorder (BPD) clinical diagnosed patients.
Materials and method An application was administered for every
agitation episode in BPD patients treated with inhaled loxapine in
the emergency room or the psychiatric ward, which included BARS
and CGI-S scales for the evaluation of each episode and its severity,
before and after its use. Other secondary measures of efficiency
were taken into account, such as requirement of physical restrain.
Results In the majority of evaluated episodes inhaled loxapine
decreased notably initial BARS and CGI-S values and no serious
clinical side effects attributable to this medication were observed.
Conclusion In our sample, inhaled loxapine was efficiency and
well tolerated pharmacological intervention for agitation in BPD
patients.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV631
Psychiatric emergency prehospital:
Incidence and management of
agitation in Valladolid (Spain)
R. Rodriguez Calzada ∗, M. Siesto Marcos , P. Roset Arisso ,
M.A. Suarez Fuentes , L. Delgado Alonso ,
M. Rodriguez Calzada , R. Rodriguez Calzada ,
E. Calzada Amorrortu
1 Gerencia de Emergencias Castilla Y Leon, Prehospital Emergency
Ume 1 Valladolid, Valladolid, Spain
2 Valladolid University, Nursing Department, Valladolid, Spain
3 Ferrer, Medical Department, Barcelona, Spain
4 Gerencia Atencion Primaria Valladolid Oeste, Medical Department,
Valladolid, Spain
5 Rc Clinic, Psychology, Valladolid, Spain
∗ Corresponding author.
Introduction Agitation is a frequent and complex emergency. Pre-
hospital management of agitation requires appropriate measures
to preserve patients’ safety, stabilize the patient and alleviate suf-
fering, and transfer to the hospital psychiatric services, including
involuntary admission if needed.
Objectives To describe the incidence and management of agita-
tion by the emergency medical service of Castilla y León (SACyL) in
an area of Valladolid.
Methods Retrospective study of all psychiatric emergencies
attended by a prehospital emergency medical service in 2014.
Results One hundred and twenty-one emergencies were
attended over a catchment area that covered 170,000 inhabitants
(1.4/1000 inhab.). Overall, 55% were men, mean age was 45
years, 60% were considered psychiatric, 29% organic and 11%
mixed. However, men had a higher frequency of organic (39%)
compared to psychiatric (48%) agitation than women (16% and
75%, respectively), and most of them were related to alcohol or
drug use. Among patients with psychiatric or mixed agitation 81%
had psychiatric history and the pharmacologic treatment most
frequently used was intramuscular midazolam.
Conclusions The incidence of acute agitation accounts for almost
half of the total psychiatric emergencies in the prehospital setting.
Since there are different healthcare providers in charge, specific
protocols aswell as treatment procedures are needed to provide the
most adequatemanagement, in order to ensure the best psychiatric
emergency chain.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV632
Do we know why we indicate a
mechanical restraint?
E.J. Pérez∗, L. Galindo , M. Grifell , F.N. Dinamarca , V. Chavarria ,
P. Salgado , V. Pérez
Institut de Neuropsiquiatria i Addiccions, Psychiatry, Barcelona, Spain
∗ Corresponding author.
Introduction and objectives Mechanical restraint is a therapeutic
procedure commonly applied in acute units in response to psy-
chomotor agitation. Its frequency is between 21 and 59% of patients
admitted. These patients represent a risk to both themselves and
for health workers. There are not clinical studies that compared if
there are differences of the frequency of the specific indication for
the mechanical restraint.
The aim of this study is to explore the differences of frequency of
each indication of mechanical restraint on patients on the psychi-
atry acute and dual pathology units.
Material and methods We reviewed retrospectively the infor-
matics record of all the mechanical restraints made and the total
discharges of the three acute care units and dual disorders of Neu-
ropsychiatry and Addictions Institute of the Parc de Salut Mar de
Barcelona, between January 2012 and January 2015. The episodes
of mechanical restraint, the specific indications for them and the
DSM-IV diagnostic were coded. Then, was calculated the frequency
and proportion of mechanical retrains in the most common diag-
nostic groups. An ANOVA was performed:
– risk of self-aggressiveness;
– state of self-aggressiveness;
– risk of hetero- aggressiveness;
– state of aggressiveness;
– risk of psychomotor agitation;
– state of psychomotor agitation;
– acute confusional state;
– fall risk;
– risk reduction on therapeutic interventions;
– avoid pulling out of life support systems;
– facilitate administration of drug treatment;
– patient voluntarily requests it;
– high-risk of escape.
Results The number of discharges analyzedwas 4659 fromwhich
838 had an episode of mechanical restraint associated.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
Acknowledgements L. Galindo is a Rio-Hortega-fellowship-(ISC-
III; CM14/00111).