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

S769

EV1318

A systematic review on

pharmacological treatment in

delusional disorder

J.E. Mu˜noz Negro

, J. Cervilla-Ballesteros

Andalusian Health Service, Mental Health Unit, CIBERSAM.

University of Granada, Granada, Spain

Corresponding author.

Introduction

Pharmacological treatment is the gold standard in

DD. None SGA is authorized for the treatment of DD. To date, only

one systematic review-addressing treatment of DD has been per-

formed. However, it was only reported data about CBT therapy.

Methods

A systematic review on pharmacological treatment of

DDwas conducted. We selected the best evidence available, mainly

searching in online databases. Then, we analyzed them critically,

assessing its biases and quality, finally performed a narrative and

quantitative synthesis.

Results

The quality of the evidence was very low. There were not

randomized clinical trials and most of the studies were observa-

tional or case series reports. We could collected a good number of

cases, (

n

= 336) 137 FGA, 189 SGA and 10 antidepressants. Antipsy-

chotics achieved a good response in a 61.35% of the patients.

Moreover, SGA (65.08% good response) were more effective than

FGA (56.20% good response) although the difference did not

reach statistical significance. (Chi

2

= 2.6384,

P

0.10). Haloperidol

(88.14% good response), risperidone (69.60% good response) and

olanzapine (71.64% good response) were the most effective treat-

ments, although the difference in favour of haloperidol it might be

biases by the methodology used.

Conclusions

Although the quality of the evidence was very low

to make strong recommendations, antipsychotics appear to be an

effective treatment for DD. We need to develop clinical trials in DD

and SGA might be the best candidates to do.

Keywords

Paranoia; Delusional disorder; Treatment; First

generation antipsychotics; Second generation antipsychotics.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2303

EV1319

Lamotrigine induced DRESS syndrome

in bipolar disorder: Multiple snares

behind a potentially life-threatening

adverse reaction

G. Oriolo

1 ,

, A. Brugués

2

, J.M. Goikolea

1

, L. Pintor

1

1

Hospital Clínic de Barcelona, Psychiatry, Barcelona, Spain

2

Hospital Clínic de Barcelona, Dermatology, Barcelona, Spain

Corresponding author.

Background

Lamotrigine is widely used to prevent bipolar

depression. Drug Reaction with Eosinophilia and Systemic Symp-

toms (DRESS) is a rare, potentially life-threatening adverse effect.

The long latency between drug exposure and disease onset, added

to the high variability of its clinical presentation, can increase the

risk of misdiagnosis lamotrigine withdrawal delay.

Objective

To highlight potential risk factors that can be related to

a worse clinical onset and evolution of lamotrigine-induced DRESS

syndrome.

Methods

We report the case of a 25-year-old-man, with a type

I bipolar disorder, treated with lithium and lamotrigine 50mg per

day during the first 13 days of treatment, progressively increase up

to 200mg. Thirty-five days after the treatment initiation, a pruritic

rash appeared in his upper arms, and scabies infestation was diag-

nosed. After 72 hours, the patient required urgent hospitalization

due to hemodynamic instability.

Results

On admission, facial edema and erythrodermia were

involving 70 to 80% of the body surface. DRESS diagnosis due to lam-

otriginewasmade following RegiSCAR criteria (Table 1). Psychiatric

medication was stopped and DRESS treatment established. Com-

plete recovery without recurrence was achieved after 2 months.

Conclusions

The lamotrigine up titration faster than recom-

mended may have facilitated the DRESS syndrome reaction.

Moreover, the latency between lamotrigine introduction and the

rash onset could have increased the possibilities of misdiagnosis.

In light of this, physicians need to consider at least the last 3months

treatment history when assessing a rash, as the delay of DRESS

syndrome diagnosis can fastly lead to a fatal event.

Table not available.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2304

EV1320

Long-acting injectable antipsychotics:

Diagnostics and patient profile

L. Pérez Gómez

1 ,

, A. Gónzalez Fernández

2

, D.F. Frías Ortíz

3

,

O.W. Muquebil Ali Al Shaban Rodríguez

4

,

C.M. Rodríguez Mercado

5

, M. Jalón Urbina

6

, L. García González

6

1

Centro de Salud Mental El Coto, Psiquiatría, Gijón, Spain

2

Hospital de San Agustín, Unidad de Hospitalización Psiquiátrica,

Avilés, Spain

3

Hospital Fundación de Jove, Unidad de Psiquiatría, Gijón, Spain

4

Centro de Salud Mental de Mieres, Psiquiatría, Mieres, Spain

5

Hospital Fundación de Jove, Psiquiatría, Gijón, Spain

6

Hospital Universitario Central de Asturias, Unidad de Psiquiatría,

Oviedo, Spain

Corresponding author.

Introduction

Long-acting injectable antipsychotics (LAIs) were

developed in the sixties with the purpose of improving schizophre-

nia maintenance treatment. The main advantages are: the ability

to ensure compliance, maintaining stable plasma concentrations

and allowing better clinical management of drug therapy. Long-

acting atypical injectable antipsychotics start to develop in the late

nineties. Currently, they are the most widely used depot treatment

for severe mental illness.

Objective

Checking patient profile and diagnosis where we use

LAIs.

Methods

Review of 217 patients treated with LAIs in CSM El

Coto–Gijón.

Results

In our sample, the average age of the patients was 48.94

years old. Most of them were men (135 vs. 82). More than half

of treated patients were diagnosed with schizophrenia (112), the

paranoid subtype was the most repeated (93). Other severe mental

illnesses were also treated with LAIs: emotionally unstable per-

sonality disorder (31), delusional disorder (19), bipolar disorder

(15), schizoaffective disorder (12) and other less frequently. For

all groups, paliperidone palmitate was the most used injectable

antipsychotic. The new aripiprazole long-acting injectable starts

being used in psychotic patients with a significant affective com-

ponent.

Conclusions

The schizophrenic patient remains being the prime

candidate for this therapy although other severe mental disor-

ders may also benefit of LAIs treatment. Most classical long-acting

injectable antipsychotics have been replaced by new atypical

injectable antipsychotics with a more tolerable side effects profile.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2305