European Psychiatry - Volume 33 - March 2016

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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 ∗, S. Milovanovic , B. Batinic
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.
EV1302
Pharmacotherapy of acute psychotic
states: The reason for benzodiazepines
and valproic acid augmentation
A. Veraksa ∗, A. Egorov
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.
EV1303
It is possible to change clozapine by
another neuroleptic
F.X. Fluvia ∗, R. Pastor
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.
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.