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

S671

Clinical Centre of Serbia and to compare it with the data from 10

years ago when similar research was conducted.

Material andmethods

This is a cross-sectional study conducted in

2015. The data were obtained from the patients’ charts and com-

pared with the results of a more extensive study conducted at the

same hospital during 2002–2005 period. Statistics was performed

using standard statistical methods.

Results

Of the total number of patients (

n

= 44), 81.8% (

n

= 36)

were on antipsychotic monotherapy, while in the previous study,

which included 198 patients, monotherapy was noted in just 32.3%

hospitalizations (

n

= 64) (Chi = 34.5;

P

< 0.001). Among patients

treated with polypharmacy, the majority was prescribed the com-

bination of a first- and second-generation antipsychotic (

n

= 7,

87.5%), while just one patient was treatedwith two first-generation

antispychotics (

n

= 1, 12.5%). In the 2002–2005 period, the combi-

nation of two first-generation antipsychotics was dominant (58.9%,

n

= 79).

Conclusion

This study indicates that in Serbian psychiatry there

is a strong tendency towards reduction of antipsychotic polyphar-

macy. However, this is a single-centre study with a relatively small

number of participants andmore extensive research on the national

level is warranted to confirm this trend.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1992

EV1008

Lithium-induced acute intermittent

dystonia in a patient with

schizoaffective disorder

A. Engel

, T. Bilbruck , S. Hossain , R. Leahy

University of Tennessee, Psychiatry, Memphis, USA

Corresponding author.

While lithium is well known for its neurotoxicity, there are very

few publications about lithium-induced acute dystonic reaction.

We are presenting a clinical case of lithium-induced acute inter-

mittent dystonic reaction in a patient with schizoaffective disorder

(SAD). The patient is a 69-year-old African-American male with a

long history of SAD, who was treated for many years with ziprasi-

done and divalproex and was admitted with SAD exacerbation.

Due to increased QTC interval, we switched patient to lurasi-

done. After 2 weeks, due to increased ammonia level, divalproex

was switched to lithium (600mg loading dose and then 450mg

twice/day). Three days later, patient developed a series of intermit-

tent episodes of acute dystonia, manifested as mutism, dysarthria,

upper and lower extremity muscle rigidity, dysphagia, and tremor

(Table 1). Dystonic reactions responded to benztropine. Eventually,

lithium was discontinued and patient did well on a combination

of carbamazepine and olanzapine. In this case, we would like to

emphasize not only the intermittent but also the atypical presen-

tation of acute dystonic reactions with involvement of large muscle

groups, the resemblance toNMS, and a “spectrum” of dystonic reac-

tions rather than one clear-cut presentation. We can only speculate

the role lurasidone played in this presentation but reoccurrence of

dysarthria on day 54 after lithiumwas restarted points to its major

role.

Table not available.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1993

EV1009

Tolerability and side effects of an

extended-release injectable

suspension of aripripazole in a series

of inpatients in a dual diagnosis unit

A. Farre

, A. Palma , G. Mateu , J.L. Perez de Heredia , R. Martinez ,

C. Castillo , M.G. Hurtado , J. Martí , R. Sanchez , M.T. Campillo ,

M. Torrens

Parc de Salut Mar, Institut Hospital del Mar d’Investigacions

Mèdiques-IMIM-UAB, Institut de Neuropsiquiatria i Addiccions,

Barcelona, Spain

Corresponding author.

Introduction

The integrated care in dual diagnosis units involves

selecting pharmacological treatment strategies for both substance

use disorder and the non-addictive psychiatric disorder. It is rec-

ommended to choose drugs with a favorable balance between

efficacy/tolerability, an adequate side effects profile and the mini-

mal drug interactions.

Objectives and aims

To evaluate the tolerability and side

effects after first administration-first dose of an extended-release

injectable suspension of aripiprazole in a group of patients admit-

ted to an acute dual diagnosis unit.

Methods

The study included a series of patients admitted in our

unit from May to August 2015 that received the first dose of the

aripiprazole preparation (400mg). Evaluations included different

scales for side effects (SAS, ESRS, UKU) and the clinical global

impression scale (CGI).

Results

A total of 9 patients were included and evaluated (all

men, mean age: 39-years-old). Diagnoses were: bipolar disorder

(5/9), schizophrenia (2/9), schizoaffective disorder (1/9) and delu-

sional disorder (1/9) with concomitant substance use disorder (6

cannabis, 2 alcohol, 1 cocaine). All of themwithout outpatient con-

trol and treatment at admission. The results of the clinical scales

conclude that none of them had significant side effects, including

extrapyramidal, with an improvement in the ICG scale.

Conclusion

Tolerability of extended-release injectable suspen-

sion of aripiprazole was good in all cases. In the future, new cases

should be included to extend the sample and to evaluate other

aspects such as the craving for substances.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

Acknowledgements

Red de Trastornos Adictivos (Instituto de

Salud Carlos III, FEDER, RD12/0029/009) and AGAUR-Suport Grups

de Recerca (2014 SGR790).

http://dx.doi.org/10.1016/j.eurpsy.2016.01.1994

EV1010

Treatment efficacy with paliperidone

palmitate in patients after the first

psychotic episode

S. Galiano Rus

1 ,

, A. Soler Iborte

2

, S. García Marín

3

1

Servicio Andaluz de Salud-UGC Jaén Norte, Unidad de Salud Mental

Hospitalaria San Juan de la Cruz, Úbeda-Jaén, Spain

2

Servicio Andaluz de Salud-UGC Jaén Norte, Unidad de Salud Mental

Comunitaria Linares, Linares-Jaén, Spain

3

Servicio Murciano de Salud, Unidad de Salud Mental Comunitaria

Lorca, Lorca-Murcia, Spain

Corresponding author.

Objectives

To evaluate factors of therapeutic efficacy of paliperi-

done palmitate, such as the speed of action and its maintenance

in patients who experienced a first psychotic episode that led to a

hospital admission in the acute unit.