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S676

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

EV1022

Delay in initiating clozapine therapy

in a Sri Lankan setting

C. Kapugama

, W. Kotalawala

National Hospital of Sri Lanka, Department of Psychological Medicine

– Ward 59, Colombo, Sri Lanka

Corresponding author.

Introduction

Treatment resistance occurs in one third of patients

with schizophrenia. The only licensed drug for this is clozapine.

Guidelines recommend that clozapine be offered at the earliest

opportunity for patients with treatment resistance. Sometimes,

delays occur in initiating clozapine.

Objectives and aims

To study the delay in offering clozapine to

patients with resistant schizophrenia.

Methods

Descriptive study. Random sample of patients on cloza-

pine attending NHSL, ‘clozapine clinic’ were interviewed, and their

clinical records reviewed.

Results

Sample 63 (25 males, 39.68%). Mean age: 34.95 years;

mean duration of illness: 13.42 years. Clinical diagnosis in all was

schizophrenia. Mean duration on treatment with clozapine was

6.80 years. In 28 (44.44%), two drug trials were tried prior to clozap-

ine; three drug trials in 26 (41.26%); four drug trials in 9 (14.28%). In

49 (77.77%) patients, two second-generation antipsychotics (SGAs)

tried prior to clozapine while in 14 (22.22%) three SGAs tried. Entire

sample was given both risperidone and olanzapine. Antipsychotic

polypharmacy was used in 18 (28.57%). Higher than recommended

doses of antipsychotics either alone or in combination, were used in

36 (57.14%). Olanzapine up to 30mg daily was tried in 25 (39.68%).

Conclusion

There is a considerable delay in offering clozap-

ine to patients with resistant schizophrenia. Multiple drug trials,

antipsychotic polypharmacy and administration of higher than

recommended drug doses seem to precede clozapine in a large

percentage of patients.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2007

EV1023

Aripiprazole is effective for the

improvement of psychotic symptoms

in patients with dementia with lewy

bodies

Y. Kikuchi

, T. Kanbayashi , T. Shimizu

Akita University School of Medicine, Neuropsychiatry, Akita, Japan

Corresponding author.

Objective

Dementia with lewy bodies (DLB) is commonly consid-

ered the second most common form of dementia. The purpose of

this study is to investigate the treatment effects of aripiprazole in

patients with DLB.

Methods

Eleven patients who had meet the criteria for DLB par-

ticipated in this study. The presence of psychotic symptoms was

confirmed by scores of either the delusions or hallucinations items

of the Neuropsychiatric Inventory (NPI) score. Patients who had 25

or more on the Mini-mental State Examination Scale (MMSE) at

the entry or having brain damage were excluded. Aripiprazole was

initiated at a low dose (3 or 6mg/day) and titrated to higher doses

at 2-weeks intervals or more rapidly based on investigator’s judg-

ment. Previous medications prior to aripiprazole administration

were not changed through this trial. Patient’s clinical status was

assessed at baseline, then 2 weeks during the study by using NPI,

Clinical Global Impression (CGI) and Brief Psychiatric Rating Scale

(BPRS) to measure psychotic behavioral symptoms, and Simpson-

Angus Scale (SAS) to measure parkinsonism symptoms. Clinical

Dementia Rating (CDR) and MMSE were carried out at screening

and end point to evaluate cognitive function.

Results

The mean scores of the SAS and CDR were significantly

decreased at the study endpoint compared to baseline. The mean

scores of the NPI and BPRS improved up until 4 weeks after hav-

ing started aripiprazole. After 4 weeks, improvements slowed. The

mean score of the CGI-S was decreased up until 8 weeks.

Conclusion

This study shows that aripiprazole may be effective

for the treatment of psychotic symptoms in patients with DLB.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2008

EV1024

Tropicamide eye drops reduce

clozapine-induced hypersalivation: A

case report

O. Kilic

1 ,

, H.M. Ozturk

2

, E. Ata

2

1

Beykent University, Psychology, Istanbul, Turkey

2

Abant Izzet Baysal University Izzet Baysal Mental Health Research

and Training Hospital, Psychiatry, Bolu, Turkey

Corresponding author.

Introduction

Clozapine-induced sialorrhea (CIS) is a common,

treatment-limiting and stigmatizing side effect. All systemic agents

that are used for hypersalivationmay increase clozapine side effects

such as blood pressure changes, constipation, or arrythmias. Oral

application of topical anti-muscarinic agents may be a low side

effect option for treatment of CIS.

Objective

The aim of this case report was to propose an off-label

treatment of tropicamide drops to CIS and to stimulate further

investigation.

Case report

A 33-year-old male inpatient with schizophrenia has

been on clozapine 800mg and amisulpride 600mg/day. His drool-

ing was occasional and severe as drool drips off his chin during

the day and night. Wet area over the pillow, visual analog scale

(VAS), the short form of health survey (SF-36), UKU side effect rat-

ing scale, scale for the assessment of negative symptoms (SANS),

scale for the assessment of positive symptoms (SAPS) were applied

at baseline and in one-week intervals. Oral application of one drop

of tropicamide % 0.5 (5mg/mL) to left and one drop to right side

before going to bed in the first week and two drops to each side

were administered subsequently. Informed consent was given by

the patient.

Results

No psychological, neurological, autonomic and other side

effects were observed associated with tropicamide. On VAS, the

patient rated hypersalivation 5/7 at baseline, 4/7 after one drop

each, 3/7 after two drops each.

Conclusions

The reduction of CIS by oral use of tropicamide eye

drops is promising and should be explored with randomized con-

trolled trials.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2009

EV1025

The therapeutic potential of natural

compounds against Alzheimer’s

disease: A preclinical pharmacological

study in both sexes

N. Kokras

1 , 2 ,

, M .

Dimitriadou

2 , I. S

otiropoulos

2 , 3 ,

A.L. Skaltsounis

4

, A. Tsarbopoulos

2 , 5

, C. Dalla

2

1

Medical School, University of Athens, First Department of

Psychiatry, Athens, Greece

2

Medical School, University of Athens, Department of Pharmacology,

Athens, Greece

3

School of Health Sciences, University of Minho, Life and Health

Sciences Research Institute ICVS, Braga, Portugal