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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1615

EV631

Psychiatric emergency prehospital:

Incidence and management of

agitation in Valladolid (Spain)

R. Rodriguez Calzada

1 ,

, M. Siesto Marcos

2

, P. Roset Arisso

3

,

M.A. Suarez Fuentes

3

, L. Delgado Alonso

4

,

M. Rodriguez Calzada

5

, R. Rodriguez Calzada

5

,

E. Calzada Amorrortu

5

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1616

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).

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1617