European Psychiatry - Volume 33 - March 2016

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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.
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.
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).
EV1010
Treatment efficacy with paliperidone
palmitate in patients after the first
psychotic episode
S. Galiano Rus ∗, A. Soler Iborte , S. García Marín
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.