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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2292

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2293

EV1309

Misuse of trihexyphenidyl: Factors

associated to the prescription

K. Hajji

1 ,

, M .

ilyes

2 , F. S

oumaya

2 , Y. S

amira

2 , N.

mohamed

2

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2294

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2295