European Psychiatry - Volume 33 - March 2016

770 / 812

S766 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
treatment, we asked for an analytical with thyroid profile in which
no change was observed. After establishing treatment, a decrease
in total T4 and free T4 was observed, TSH remained unchanged.
Discussion It is important to note the need for systematic eval-
uation of thyroid function at the beginning of an antidepressant
treatment, and perform their monitoring controls. We cannot for-
get that the clinical of hypothyroidism sometimes presents with
depressive symptoms, which could mask the effectiveness of treat-
ment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1308
Clozapine induced blood dyscrasias
and a therapeutical approach
A. Gomez Peinado ∗, P. Cano Ruiz , S. Ca˜nas Fraile ,
M. Gonzalez Cano , G.E. Barba Fajardo
Hospital Nuestra Se˜nora del Perpetuo Socorro, Mental Health,
Albacete, Spain
∗ Corresponding author.
Introduction Clozapine is a neuroleptic commonly used in treat-
ments resistant to schizophrenia. However, despite the benefits,
clozapine might cause some serious side effects. Hence, it is of the
utmost necessity to keep an exacting control of the patients.
Objectives To study some of the therapeutical approaches to the
treatment of clozapine induced neutropenia and agranulocytosis.
Methods Review of some articles in Mental Health Journals.
Results The treatment with clozapine, substratum of aminergic
and muscarinic receptors, entails a 0.9% risk of causing agranulo-
cytosis, and approximately a 2.7% risk of causing neutropenia. Both
occur, over 80% of them, during the first 18 weeks of treatment.
Thus, before starting it, it is necessary to draw some blood and ana-
lyze the complete blood count (CBC). Also, we must analyze CBCs
weekly during the first 18 weeks. Other dyscrasias like leukope-
nia, leukocytosis, anaemia, eoshinophilia, thrombocythaemia or
thrombocytopenia can also be observed. When agranulocytosis
appears, it can be treated by discontinuing the clozapine treat-
ment, but also using granulocyte-colony stimulating factor or
lithium, both separated or combined with clozapine. Lithium pro-
duces reversible leukocytosis onceplasma levels of > 0.4mmol/L are
reached. Despite the simultaneous treatment with lithium, clozap-
ine can trigger some neurological side effects, it seems that seizure
risk remains invariable.
Conclusions Some of the clozapine’s side effects, like neutropenia
or agranulocytosis, are potentially lethal. Their treatment consists
of discontinuing clozapine or initiating granulocyte-colony stimu-
lating factor or lithium. These are good options that can give rise to
a later continued treatment with clozapine.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1309
Misuse of trihexyphenidyl: Factors
associated to the prescription
K. Hajji ∗ ilyes oumaya amira mohamed
1 Boulogne-Billancourt, France
2 Hospital Of Mahdia, of Psychiatry, Mahdia, Tunisia
∗ Corresponding author.
Introduction Trihexyphenidyl (THP) is an anti-Parkison and anti-
cholinergic drug. It is essentially prescribed by psychiatrists in
order to treat abnormal movements and Parkinsonism induced by
antipsychotics. However, in unusual practice, the THP is widely
used by patients.
Aims To assess different factors associated to the prescription of
trihexyphenidyl in patients treated with neuroleptics.
Methods A cross-sectional, descriptive, comparative and analyt-
ical study among 153 patients followed in outpatients clinics and
treated by antipsychotics.
Results During a six-month period, 153 patients were interested
by the study. In total, 79.73% of them were receiving a treat-
ment by THP. Mean age was 47.79 years old. Almost patients
were married (44.1%), having a primary level education (46.7%)
and jobless (66.7%). Mean factors associated to THP prescription
were: hospitalization in a psychiatry unit (P = 0.025), good evolu-
tion of mental disorder during hospitalization (P = 0.008), regular
follow-up (P = 0.005), episodic evolution and existence of residual
symptoms (P = 0.001), personality disorder (P = 0.025) and somatic
comorbidities (P = 0.001). Prescription was crucial in order to indi-
cate necessity of THP. Doses of neuroleptics were a determinant
factor (P= 0.0001). Forty-one percent of patients were receiving
more than one treatment (P = 0.0001). In most cases, prescription
consists of classic antipsychotics (67.60%).
Conclusion Prescription of THP should be argued, considering dif-
ferent factors associated to the prescription, in order to prevent
misuse of the drug.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1310
Light as an aid for inpatient recovery:
A systematic review
J. Henriksen ∗, N. Okkels
Aarhus University Hospital, Psychiatric Research Academy,
Department of Affective Disorders Department Q, Risskov, Denmark
∗ Corresponding author.
Introduction The indoor light environment of hospital wardsmay
affect functions and symptoms that are central to the process of
inpatient recovery, including sleep, anxiety, well-being, and mood.
Objective To assess whether interventions in light improves
recovery in hospitalized patients across all medical specialties.
Methods We systematically searched and reviewed the literature
for RCT’s on adult inpatients where any light intervention were
compared to standard care or placebo. We reviewed effects of light
on various outcomes, and compared differences in administration,
timing, color, and intensity of the light.
Results We identified 2330 titles, of which 32met our predefined
selection criteria. Choice of administration, timing, wavelengths,
and intensity varied. However, most studies investigated bright
light therapy with high intensity and short exposure time, others
low-intensity light at night filtered of wavelengths in the blue spec-
trum, and yet others the use of dawn simulation. Comparators were
either placebo lamps with low intensity or regular indoor light.
Most studies were performed on psychiatric inpatients, showing
that bright light therapy is an effective aid in recovery of major
depression. Across medical specialties, several studies reported
improved sleep quality during the light intervention. Other studies
found a lower rate of delirium. In elderly patients with dementia,
studies found light interventions to relieve agitation and confusion.
Conclusions Light may ease a broad range of symptoms and
behaviors across inpatient categories. The intervention is inex-
pensive, well tolerated, and non-invasive. This study underlines
intelligent lighting design as an interesting, yet under-explored,
non-pharmaceutical treatment.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.