European Psychiatry - Volume 33 - March 2016

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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.
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.
EV733
Very late-onset schizophrenia-like
psychosis: Case report and current
status of the issue
R. Martín Aragón ∗ 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.
EV734
Paliperidone palmitate in
psychogeriatric patients and new
criteria STOPP-START
I. Martinez Perez ∗ arcía Sánchez
M.R. Raposo Hernandez il Sánchez
A.L. Gonzalez Galdamez . Piqueras Acevedo
J.M. Lujan Rico elmar Simo Garcia Bri˜nol
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.