European Psychiatry - Volume 33 - March 2016

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S674 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV1015
The psychotropic effects of
anti-epileptic drugs: A review
A. Guerra ∗, D. Ferreira , C. Pereira , M. Carvalho
Hospital de Santa Maria – Centro Hospitalar Lisboa Norte, Psychiatry
and Mental Health Department, Lisbon, Portugal
∗ Corresponding author.
Anti-epileptic drugs (AEDs) are psychotropic agents that are
widely used for the treatment of a variety of neurological condi-
tions and psychiatric disorders. Although the association between
psychopathology and AED therapy has long been recognized, a sys-
tematic evaluation of its effects on mood and behaviour has taken
place only more recently. A literature review, based on a PubMed
research, takes stock of the studies that have investigated this sub-
ject in the latest years. Depending on the drug, its efficacy and the
individual’s biological and psychological predisposition, all AEDs
may lead to positive or negative psychotropic effects. The exact fre-
quency of psychiatric adverse events related to AEDs is difficult to
estimate, but behavioural problems seem to be the most common,
followed by depressive disorders. Psychosis is a relatively rare,
although severe, complication. The AEDs’ potential psychotropic
effects will be addressed in detail, with special focus on their mood,
behavioural and cognitive profile, aswell as themechanisms under-
lying these events. When recognized at an early stage, psychiatric
complications are in most cases mild and reversible. Risk factors
are not a strict indication for any particular drug, but side effect
profiles, including negative and positive psychotropic effects, must
be considered in the choice of the optimal drug for the individ-
ual patient. The studies regarding this subject are limited as they
are designed to test anti-epileptic efficacy and psychiatric adverse
events are not systematically reported. This subject also warrants
further research since many relevant aspects concerning patholog-
ical mechanisms, frequency, psychopathology and prognosis are
not well understood.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1016
Antipsychotic medications and
cardiometabolic risk – A review of
current literature
S. Gunturu ∗, K. Shah , P. Korenis , S. Lawler , M. Kucheria
1 New York, USA
2 Bronx Lebanon Hospital Centre, Psychiatry, New York, USA
3 American University of Caribbean, Psychiatry, Sint Maarten,
Trinidad and Tobago
∗ Corresponding author.
In the USA, 68% of adults and 31% of children are overweight or
obese. Obesity doubles mortality rates and has significant associ-
ated medical costs with an average obese person spending $1500
or more per year. In addition, 10% of all adults and 23% of adults
over 60 years have type 2 diabetes, with an average person spend-
ing $2257 or more per year. In 2009, 1 out of every 10 healthcare
dollars was spent on type 2 diabetes, totalling $174 billion. Peo-
ple with serious and persistent mental illness die on average 25
years earlier than the general population. Cardiovascular disease
is the primary cause of death in persons with mental illness and
accounts for 60% of the increased mortality. Furthermore, 46.24%
of individuals with cardiometabolic risk factors who are also on
antipsychotic medications take high- to moderate-risk antipsy-
chotics. The cluster of cardiometabolic syndrome includes: type
2 diabetes, hypertension, dyslipidemia, obesity and pre-existing
cardiovascular disease. There are, however, modifiable risk fac-
tors including smoking cessation, diet change, physical activity,
medical care and choice of antipsychotic medication (on which
the physician has direct control). More information is therefore
needed on various antipsychotic medications and their associ-
ated cardiometabolic risk factors in order to educate physicians.
In this review article, we examined 10 articles on antipsychotic
medications, and their effect on the 5 domains, including type 2
diabetes, hypertension, dyslipidemia, obesity and pre-existing car-
diovascular disease. Overall, there was a clear trend, which found a
significant difference in the associated risk factors amongst various
antipsychotic medications.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1017
Clinical predictors of clozapine
response
K. Hajji ∗, I. Laajmi , I. Marrag , S. Fathallah , M. Nasr
1 Boulogne Billancourt, France
2 Hospital of Mahdia of Psychiatry Mahdia, Mahdia, Tunisia
∗ Corresponding author.
Introduction Schizophrenia is a chronic, severe, and disabling
mental disorder. An evaluation of clinical predictors to clozapine
was described.
Object Identify clinical predicting factors to clozapine.
Methods This is a cross-sectional study including patients diag-
nosed with schizophrenia or schizoaffective disorder according to
the DSM 5 criteria and treated with clozapine.
Results Of the 33 patients, 78.8% were males and 69.7% of them
were single. The mean age was 36 years old. The mean age at the
onset of the disorder was 24 years old. The mean number of hospi-
talizations was 6. The beginning of themental disorder was acute in
21.2% of the cases. The mean duration of the disease course before
starting clozapine treatment was 11 years. The mean duration of
treatment was 19 months. The diagnosis according to DSM 5 crite-
ria was schizophrenia in 87.9 and schizoaffective disorder in 12.1%
of cases. The outcome was assessed by PANSS and BPRS scales with
a symptomatic remission in 63.63% of cases. The analytical study
revealed a significant correlation between favorable evolution and
the latest onset of the disorder ( P = 0.04), the number of previous
hospitalizations ( P = 0.009), disorder’s duration (P = 0.032), male sex
(P = 0.0004) and secondary resistance ( P < 10−3).
Conclusion The evaluation of clinical factors is important in our
practice in order to improve the response to clozapine. Otherwise,
adherence to treatment and quality of insight are determining fac-
tors of the treatment response.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1018
Paliperidone palmitate versus other
antipsychotics
P. Hervías Higueras ∗, L. Maroto Martín , S. Raffo Moncloa ,
M. Leonor del Pozo
1 Hospital Dr. R. Lafora, Psiquiatría, Madrid, Spain
2 Hospital Dr. R. Lafora, UHB Psiquiatría, Madrid, Spain
∗ Corresponding author.
The aim of the study was to describe the psychopharmacological
treatments received by inpatients diagnosed with spectrum disor-
ders schizophrenia and other psychotic disorders in Dr. Rodriguez
Lafora Hospital. It is an observational, descriptive and retrospec-
tive study. We collected information about patients aged 18 to
64 who were hospitalized during the month of January of 2015
in the acute psychiatric hospitalization by Selene software. We
reviewed treatments and number of psychiatric re-hospitalization
six months later and we analyzed the results by SPSS software.