European Psychiatry - Volume 33 - March 2016

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S774 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV1334
Integrated treatment for opioid
addiction complicated with
neuroophthalmic pathology due to
codeine and levomycetin abuse
narcoassociated phenomenon
I. Sosin ∗, Y. Chuev , O. Goncharova
Kharkov Medical Academy of Postgraduate Education, Narcology,
Kharkov, Ukraine
∗ Corresponding author.
Introduction Among drug addicts cohort in Ukrainian popula-
tion, the phenomenon of codeine narcotic effect intensification and
prolongation with antibiotic levomycetin simultaneous combined
dose was identified. Current narcology encounters the insuffi-
ciently studied problem of drug addicts who lost vision due to
levomycetin abuse at chronic codeine intoxication. Continuous lev-
omycetin abuse was proved to cause optic nerve neuritis followed
with eyesight loss. This is connected with discrete loss of eyesight
pathogenesis in opioidaddicts.
Aims and objectives To elaborate integrated method of treatment
considering main pathogenic links of this narcotic addiction.
Method It is based on combined therapy at traditional detoxi-
cation and includes membrane plasmapheresis 2–5 times at once
every 3 days. Everyday 2.0mL pyridoxin hydrochloride 5% solu-
tion for 15 days. Capillary stabilizer l-lysine aescinat in drops once
in 24 h for 5–8 days. Transorbital medicinal electrophoresis (thi-
amine bromide 2.5% solution), 15–20min exposure, daily, 10–12
procedures. Peroral retinol acetate, 1 capsule 3–4 times daily, for
7–10 days. Enterosorbent atoxil, 10–12 g daily, for 3–5 days.
Results Five codeine addicts with neuro-ophtalmic disorders due
to levomycetin abuse as a narco-associated phenomenon were
examined. The addicts explained additional levomycetin compo-
sition in individual narcotization schemes by the aim to intensify
and prolong codeine effects maintaining its stable dose. Combined
comprehensive therapy restored the eyesight partially; renewed
capacity tomove independently, the patients’ disabilitywas ceased.
Conclusions Membrane plasmapheresis in the proposed method
integrates in therapy the prescribed pharmaceuticals and corre-
sponds numerous tasks of detoxication at continuous combined
codein and levomycetin abuse.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1335
Nutrition interventions in people with
severe mental illness: Novel strategies
for addressing physical health
co-morbidity in a high-risk
population
S. Teasdale ∗, P. Ward , K. Samaras , S. Rosenbaum , J. Curtis ,
O. Lederman , A. Watkins , B. Stubbs
1 South Eastern Sydney Local Health District, Mental Health, Bondi
Junction, Australia
2 University of New South Wales, Psychiatry, Sydney, Australia
3 Garvan Institute of Medical Research, Diabetes and Obesity
Program, Darlinghurst, Australia
4 Kings College, London, Psychosis Studies, London, United Kingdom
∗ Corresponding author.
Introduction Nutrition interventions are critical for weight man-
agement and cardiometabolic risk reduction inpeople experiencing
severemental illness (SMI). Asmental health teams evolve to incor-
porate nutrition interventions, evidence needs to guide clinical
practice.
Aims A systematic review and meta-analysis was performed to
assess whether nutrition interventions improve:
– anthropometric and biochemical measures,
– nutritional intake of people experiencing SMI.
To evaluate the effectiveness of a dietician-led nutrition interven-
tion, as part of a broader lifestyle intervention, in the early stages
of antipsychotic prescription.
Method An electronic database search was conducted to identify
all trials with nutritional components. Included trials were pooled
for meta-analysis. Meta-regression analyses were run on poten-
tial anthropometric moderators. Weekly individualised dietetic
consultations plus group cooking classes were then offered to
clients attending a Community Early Psychosis Programme, who
had recently commenced antipsychotics for a 12-week period.
Results From pooled trials, nutrition interventions resulted in
significant weight loss (19 studies, g = –0.39, P < 0.001), reduced
BMI (17 studies, g= –0.40, P < 0.001), decreasedwaist circumference
(10 studies, g= –0.27, P < 0.001) and lower blood glucose levels (5
studies, g = –0.37, P = 0.02). Dietician-led interventions (g = –0.90)
and trials focussing on preventing weight gain (g = –0.61) were the
most effective. The 12-week nutrition intervention resulted in a
47% reduction in discretionary (junk) food intake (P < 0.001) and
reductions in daily energy (–24%, P < 0.001) and sodium intakes
(–26%, P < 0.001), while improving diet quality (P< 0.05).
Conclusion Evidence supports the inclusion of nutrition inter-
ventions as part of standard care for preventing weight gain and
metabolic deterioration among people with SMI.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1336
Acute dystonia and dyskinesia
progressing in the patient with
fibromyalgia upon the use of
duloxetine
C. Tüz
Erenköy FTR Hastanesi, Psychiatry, Istanbul, Turkey
Purpose In this article, a case who was prescribed duloxetine
(30mg capsule) upon the fibromyalgia diagnosis by a physical ther-
apist and had acute dystonia and dyskinesia after approximately
1.5 hours from duloxetine intake shall be presented.
Case It was learnt that a married female patient aged 38 con-
sulted a physical therapist with the complaint of back pain and
duloxetine (30mg capsule) was prescribed. It was reported that,
the patient applied to our hospital with the compliant of involun-
tary movements around the mouth, on the lips and neck, spasm,
inability to open the mouth completely, spasm in jaw, gritting
teeth, mumbling and aphasia after approximately 1.5 hours from
her duloxetine intake. The patient was conscious. Her psychomotor
activity was natural. As a result of cranial MR, EEG, BT examina-
tions hemogram and the routine biochemistry examinations, any
abnormality in zinc and iron levels was not detected. Complaints
of the patient regressed after 1 hour from the discontinuance of
duloxetine and the administration of biperiden 5mg/mL ampoule
1000 cm3 in SF. After 72 hours, any symptoms were not found.
Discussion Dopamine neurotransmission can be inhibited
through the increase in serotonin and norepinephrine
Additionally, dystonia may originate from the prevailing of nora-
drenaline as a result of the failure of dopaminergic–noradrenergic
balance
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
References
[1] Leo RJ. Movement disorders associatedwith the serotonin selec-
tive reuptake inhibitors. J Clin Psychiatry 1996;57:10.