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S764

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

EV1301

Pregabalin augmentation in the

treatment of borderline personality

disorder with partial therapeutic

response – case report

D. Duisin

1 ,

, S. Milovanovic

2

, B. Batinic

3

1

Institute of Psychiatry Clinical Center of Serbia, Day Hospital,

Belgrade, Serbia

2

Clinic of Psychiatry, Clinical Centre of Serbia, Serbia School of

Medicine, University of Belgrade, Day Hospital, Belgrade, Serbia

3

Clinic of Psychiatry, Clinical Centre of Serbia, Faculty of Philosophy,

Department of Psychology, University of Belgrade, Belgrade, Serbia

Corresponding author.

Introduction

Emotional dysregulation is one of the core problems

of borderline personality disorder (BPD). Forty-one year-old mar-

ried female diagnosed with BPD at the age of 21, was admitted to

the partial hospitalization unit due to a depressive symptoms and

emotional dysregulation and poor overall functioning.

Objective

Patient was previously treated with numerous psy-

chotropic agents: antipsychotics (AP) – fluphenazine, levomepro-

mazine, risperidone, clozapine; antidepressants (AD) sertraline,

mirtazapine, maprotiline, amitriptyline; psychostabilizers – car-

bamazepine/valproate) without achieving the full therapeutic

response. After switching to combination of clomipramine and

aripiprazole, we have reached partial clinical response.

Aim

The aim of this treatment was to improve clinical response

and achieve emotional stability by augmentation with neuromod-

ulator pregabalin.

Method

Augmentation strategy was realized by gradual titration

and tapering of pregabalin (300mg/d) over a two-week period.

We started with pregabalin dose of 75mg/d, followed by gradual

increase to the dose of 300mg/d. The Beck Depression Scale (BDS)

and the Emotional Dysregulation Scale-short form (EDS) have been

used for efficacy monitoring.

Results

Mental state before augmentation therapy: the BDS

(score 30-moderate depression) and the EDS-short form (score

127). Parameter status after augmentation with pregabalin: BDS

score 16-mild mood disturbance, EDS score 87.

Conclusions

Augmentation strategy with pregabalin have

improved emotional control, maintained affective and behavioral

stability, with significant reduction of feelings of emptiness, as

well as the achievement and maintaining of emotional attachment.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2286

EV1302

Pharmacotherapy of acute psychotic

states: The reason for benzodiazepines

and valproic acid augmentation

A. Veraksa

1 ,

, A. Egorov

2

1

City Psychiatric Hospital N 3, Inpatient Unit N 24, St. Petersburg,

Russia

2

IM Sechenov Institute of Evolutionary Physiology and Biochemistry,

Laboratory of Behavior Neurophysiology and Pathology, St.

Petersburg, Russia

Corresponding author.

Acute psychotic states (APS) usually are diagnosed as schizophrenia

spectrum and affective disorders and make up about 45% of cases.

The goal of the study was to elucidate the effect of benzodiazepines

(BDZ) and valproic acid augmentation in the APS pharmacotherapy.

The studywas carried out on 102 inpatients diagnosed up to ICD-10

as schizophrenia (

n

= 24), acute and transient psychotic disorders

(

n

= 40), other mental disorders due to brain damage and dys-

function and to physical disease (

n

= 17), schizoaffective disorder

(

n

= 12), bipolar affective disorder (

n

= 9). Patients were randomized

into four therapeutic groups:

– benzodiazepines (BDZ);

– one neuroleptic or combination of one neuroleptic and one BDZ

(NBDZ);

– combination of valproic acid with BDZ or neuroleptic (VBDZN);

– polypragmasy (PP): from two drugs of one group up to four and

more drugs at the same time.

The mental state of the patients was evaluated daily and estimated

before, weekly and after APS termination by BPRS and CGI scale. The

APS in all groups lasted from 1 to 50 days (mean 11.4). The shortest

duration of APS was In BDZ group – 4.7 days; in VBDZN and NBDZ,

the duration was 7.0 and 7.4 days (

P

< 0.05); in PP group, the treat-

ment lasted 24.5 days (

P

< 0.001). Before therapy, average BPRS rate

was 43.5

±

8.1, CGI – 6.2

±

0.8; after APS, BPRSwas 18.9

±

2.1, CGI –

1.1

±

0.3. All rates did not differ among subgroups. APS therapy by

BDZ and its combination with neuroleptics and valproic acid was

effective compared to the polypragmasy.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2287

EV1303

It is possible to change clozapine by

another neuroleptic

F.X. Fluvia

1 ,

, R. Pastor

2

1

Home for the chronically mentally ill, Psychiatry, Xabia, Alacant,

Spain

2

Home for chronically mentally ill Xabia Bella, Psychiatry, Xabia,

Alacant, Spain

Corresponding author.

It is well known that when we have a schizophrenic patient who

do not respond to two batches of neuroleptics at full dosage for

more than six month, it may be wise to try with clozpine which is

believed to be one of the best neuroleptics we have but with two

main handicaps: it can produce leucopenia which can be fatal and

epileptic seizures as well. We do think that in many cases, clozap-

ine has been used too soon in the treatment of the schizophrenic

patient, before we can really talk of a resistant patient. To prove

that we have changed the clozapine treatment of four chronically

ill schizophrenic patients admitted to a home for the chronically

mentally ill. Two patientswere changed fromclozapine 400mg/day

to paliperidone 15mg/day along two months time. They both

improved in mental clarity and ability of thinking. Another patient

were changed from 600mg/day to 27mg/day of paliperidone. That

patient worsened a little bit mainly with hostility and social avoid-

ance but it was mandatory to change neuroleptic because he had

had two seizures and had low levels of platelets and therefore he

was at risk of developing leukopenia. The fourth one was taking

300mg of clozapine and was changed to 12mg of paliperidone. We

got no change in the clinical outcome.

Discussion

We discuss the different explanations for the results

we got.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2288

EV1304

Prescription profile of antipsychotics

in inpatients with psychotic disorders

M.D.C. García Mahía

, Á. Fernández Quintana , M. Vidal Millares

CHU A Coru˜na, Psychiatry, A Coru˜na, Spain

Corresponding author.

Introduction

Previous studies of prescribing in psychiatric ser-

vices have identified the relatively frequent use of combined

antipsychotics in schizophrenia.