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

S711

2

Laboratorios Farmacéuticos Rovi-S.A., R&D, Madrid, Spain

3

SGS Exprimo NV, Exprimo, Mechelen, Belgium

Corresponding author.

Introduction

Risperidone-ISMis a new long-acting intramuscular

formulation intended to achieve sustained plasma concentrations

over 4weeks without oral supplementation. The clinical efficacy

to risperidone has been associated with 65–80% occupancy of

dopamine D2 receptor (D2RO) and a mean C

max

between 7.5 ng/mL

and 80 ng/mL.

Aim

Use a population PK/PD model to predict the PK and the

D2RO for Risperidone-ISM in schizophrenic patients and to charac-

terize the relationship among doses, in order to guide dose selection

for a future Phase-III trial.

Methods

A population PK/PD analysis for Risperidone-ISM using

Monolix software was conducted based on 6641 plasma samples

from two Phase-I studies (17 healthy subjects and 31 schizophrenic

subjects, respectively) and 1 Phase-II study (60 schizophrenic sub-

jects). Simulations were subsequently undertaken predicting the

steady state PK and D2RO after multiple Risperidone-ISM doses

administered every 28 days for 12weeks.

Results

Doses of 75 and 100mg, administered either in gluteal or

deltoid muscle, were predicted to result in median C

max

and C

trough

that stayed between 7.5 ng/mL and 80 ng/mL. At steady state 75mg

and 100mg dose (gluteal) achieved a D2RO average [min–max]

of 70.8% [61.4–80.4] and 74.3% [66.2–82.1], respectively; a 75-mg

and 100-mg dose (deltoid) achieved a D2RO average [min–max] of

69.3% [56.5–80.3] and 73.0% [61.8–82.1], respectively. The model

estimated that the 65% D2RO occurs within first 8 h after treatment.

Conclusions

Simulations were carried out supporting doses of

75mg and 100mg Risperidone-ISM to show the greatest efficacy

and safety potential to be assessed in the future Phase-III trial.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2118

EV1134

Electroconvulsive treatment in

Parkinson’s disease and psychosis:

A case report

T. Aparicio Reinoso

, S. Gonzalez Parra

Hospital Dr. R Lafora, Psychiatry, Madrid, Spain

Corresponding author.

Background

Drug induced parkinsonism is a common side effect.

Objective

The present report describes the case of a

schizophrenic patient who developed a parkinsonism after receiv-

ing antipsychotic drugs and who had improved his schizophrenia

and parkinsonism after electrovulsive therapy.

Case summary

We report the case of a man, who is 35 years

old and was admitted to a psychiatric ward, due to decompen-

sated schizophreniawith psychotic features. The patient developed

pronounced parkinsonian features, which did not improve with

discontinuation of the drug or with carbidopa/levodopa. After sev-

eral unsuccessful treatments, the patient was treated with ECT and

showed improvement in both diseases.

Results

The patient’s response to this treatment justifies the use

of ECT in patients with both syndromes: a psychosis productive

and Parkinson’s disease. Even the maintenance therapy can estab-

lish the initial response achieved and keep it through time. We

should keep in mind that the management of these patients, can be

extremely difficult because the medications used to both disorders

are antagonistic.

Conclusion

ECT can be considered in patients with a psychiatric

illness associated with parkinsonism.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

Further readings

Popeo D, Kellner CH. ECT for Parkinson’s disease. Med Hypotheses

2009;73:468–9.

Haryan P, Adams CE. Terapia electroconvulsiva para la

esquizofrenia (Cochrane Review). La Biblioteca Cochrane

Plus,

número 3,

2008.

Oxford,

Update Software Ltd.

http://www.updatesoftware.com

[Translated by The Cochrane

Library, Issue. Chichester, UK: John Wiley & Sons, Ltd].

American Psychiatric Association. Andersen K, Balldin J, Gottfries

CG, et al. A double-blind ealuation of electroconvulsive therapy in

Parkinson’s disease with “on-off” phenomena. Acta Neurol Scand

1987;76:191–9.

Fink M. ECT for Parkinson’disease? (Editorial) Convul Ther

1988;4:189–91.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2119

EV1135

Intramuscular maintenance

treatment with ultra-high-dose

long-acting injectable aripiprazole in

an elderly patient suffering from

chronic refractory schizophrenia:

A case report

L. Bartova

, M. Dold , N. Praschak-Rieder , A. Naderi-Heiden ,

S. Kasper

Medical University of Vienna, Department of Psychiatry and

Psychotherapy, Vienna, Austria

Corresponding author.

Long-acting injectable (LAI) aripiprazole is increasingly appreci-

ated in the course of a maintenance treatment of schizophrenia

due to efficacy in delaying – and decreasing relapse, and low rates

of feared side effects. In line with the prescribing information, the

maximal starting – as well as maintenance dose was restricted to

400mg following a 26-day interval between the single doses.

We present a 72-year-old female inpatient (66 kg) with an

acute exacerbation of chronic refractory schizophrenia, exhibit-

ing primarily positive symptoms including excessive persecutory

delusions, self-care deficit, poor insight and insufficient adherence

to continuous intake of oral medication. Since she developed a

post-injection syndrome after an accidental intravascular adminis-

tration of olanzapine LAI 405mg, the antipsychotic treatment was

switched to aripiprazole LAI 300mg once monthly. Due to insuffi-

cient clinical response, aripiprazole LAI was gradually increased up

to 1200mg per month under continuous plasma level monitoring.

Here, 2 single injections of aripiprazole LAI 300mg were delivered

into both gluteal muscles concurrently, every 14 days.

Consequently, we observed a clinicallymeaningful improvement (a

total-score reduction from 111 to 75 on the Positive and Negative

Syndrome Scale), as well as no objectifiable side effects, assessed

by “The Dosage Record Treatment Emergent Symptom Scale” and

“The Barnes Akathisia Rating Scale”, despite multi-morbidity and

rather advanced age of the patient.

Our safe experience with applying the almost threefold higher

monthly dose over 12weeks may encourage researchers to further

investigate the efficacy, tolerability as well as handling of highly

dosed aripiprazole LAI in refractory schizophrenia.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2120