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S584

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

Methods

First group patients were treated with a single antide-

pressant, patients of the second group – with the same

antidepressant and intravenous infusions of ceraxone: 10 infu-

sions (500mg in 100mL isotonic sodium chloride solution) during

2 weeks, followed by transfer to the drug in solution at 3mL per os

two times a day for six weeks.

Results

A multimodal therapy with ceraxone leads to more rapid

and significant therapeutic response along with the reduction of

adverse events compared to antidepressant monotherapy.

Conclusion

Obtained data allows to recommend a multimodal

antidepressive therapy with ceraxone (citicoline) for the treatment

of elderly depressive patients to reduce the risk of adverse effects

of antidepressants and to shorten hospitalization period.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1716

EV732

A case report of Charles Bonnet

syndrome – the silent doubt: Am I

crazy?

A. Lopes

, P. Sales

Hospital Garcia de Orta, Psichiatry, Almada, Portugal

Corresponding author.

Introduction

The Charles Bonnet syndrome refers to symptoms

of visual hallucinations that occur in patients with visual acuity

or visual field loss. These are often called release hallucinations,

reflecting the most widely accepted theory about their pathogen-

esis. The syndrome is most found in elderly patients, 70–85 years,

and this probably reflect the mean age at which the most common

underlying conditions are seen. It is probablymore common than is

thought and because either it is misdiagnosed as psychosis and/or

dementia or it is not reported by patients because they fear that the

hallucinations represent psychiatric disease.

Objective and method

The authors present the clinical case of a

89-year-old woman, with no previous psychiatric disease, admit-

ted to hospital because of visual hallucinations in form of children

and animals. She experienced them during months until she told

someone. No psychiatric symptomswere found. The lady had a seri-

ous cataract on the left eye with total loss of the visual acuity, as

documented by ophthalmologic examination.

Results

The patient initiated quetiapine 300mg and will have

period appointments with a neurologist. Further future informa-

tion will be presented.

Conclusions

A correct diagnosis is essential to treat these patients

and explaining them the meaning of the hallucinations is generally

relieving. Many author disagree with antipsychotic agents, while

others report benefit.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1717

EV733

Very late-onset schizophrenia-like

psychosis: Case report and current

status of the issue

R. Martín Aragón

, M.

Gutiérrez Rodríguez , S. Bravo Herrero ,

C. Moreno Menguian , N. Rodríguez Criado , J.F. Cruz Fourcade ,

P. Mu˜noz-Calero Franco , B. Sánchez Sánchez

Hospital Universitario de Móstoles, Psychiatry, Móstoles, Spain

Corresponding author.

Introduction

Schizophrenia has traditionally been considered to

strictly be an early-onset disorder. Current nosologies, including

DSMV, are not restrictive with age of onset in schizophre-

nia and all patients that satisfy diagnostic criteria fall into the

same category. Since 1998, International Late-Onset Schizophre-

nia Group consensus, patients after 60 are classified as very-late

onset schizophrenia-like psychosis. Female overrepresentation,

lowprevalence of formal thought disorder, and a higher prevalence

of visual hallucinations are associated with later age at onset. Atyp-

ical antipsychotics represent the election treatment because of the

reduced likelihood of EPS and tardive dyskinesias, and should be

started at very low doses, with slow increases.

Objective

To review the current knowledge about very late-onset

schizophrenia through systematic review of the literature and the

analysis of a case.

Methods

Case Report. Review. Literature sources were obtained

through electronic search in PubMed database of last fifteen years.

Results

We present a case of a 86-year-old woman suffering

from delusions and hallucinations, diagnosed with very late-onset

schizophrenia-like psychosis, after differential diagnosiswith other

disorders. We analyze ethiology, epidemiology, clinical features

and treatment in geriatric patients with schizophrenia.

Conclusions

Reluctance to diagnose schizophrenia in old people

is still present today, probably in relation with the inconsistency in

diagnostic systems and nomenclature, and consideration of med-

ical conditions in the diagnosis. Identification of these patients is

really important in order to start an appropriate treatment, which

can lead to patient clinical stability.

Keywords

Very-late onset; Schizophrenia; Case report; Review

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1718

EV734

Paliperidone palmitate in

psychogeriatric patients and new

criteria STOPP-START

I. Martinez Perez

1 ,

, F . G

arcía Sánchez

2 ,

M.R. Raposo Hernandez

3 , A. G

il Sánchez

4 ,

A.L. Gonzalez Galdamez

3 , M.D

. Piqueras Acevedo

3 ,

J.M. Lujan Rico

1 , A. B

elmar Simo

3 , C.J.

Garcia Bri˜nol

3

1

Residencia Psicogeriatrica Virgen del Valle, Psiquiatría, Murcia,

Spain

2

Hospital Universitario Viren de la Salud, Anestesia, Elda, Spain

3

Hospital Universitario Santa Lucia, Psiquiatría, Cartagena, Spain

4

Centro Salud Mental Vicente Campillo, Psiquiatría, Murcia, Spain

Corresponding author.

The treatment of psychosis in the elderly should ensure effective-

ness and avoid side effects from combination therapy. Long acting

antipsychotic as paliperidone palmitate facilitates this work. Fur-

thermore, STOPP-START criteria, first published in 2008 (in Spanish

in 2009), are being adopted as reference criteria throughout Europe.

The Spanish version of the new 2014 edition is also recently pub-

lished [1]. A descriptive study of a total of 53 institutionalized

patients in psychogeriatric residence (> 60 to 97 years) with psy-

chotic disorder diagnosis and treatment with various neuroleptics

is done. In total, 26.4% of the sample admitted to treatment with

three different antipsychotics, and 47.1% with combination of two

antipsychotics. Only 26.4% worked with antipsychotic monother-

apy. In these patients, treatment with paliperidone palmitate starts

or sets the previous dose. A CGI scale is applied after six months

of treatment. Antipsychotic monotherapy in 66.66% of patients

on neuroleptic combination therapy was achieved, so that 75% of

the sample currently maintains monotherapy with paliperidone

palmitate. The paliperidone palmitate has shown effectiveness in

the symptomatic control and reducing the risk of inapropiate pre-

scribing in older patients with psicosis. The paliperidone palmitate

allows antipsychotic monotherapy in the psychogeriatric patient

with severe mental illness polymedicated as the STOPP-START cri-

teria recommends.

Reference not available.