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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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2319

EV1335

Nutrition interventions in people with

severe mental illness: Novel strategies

for addressing physical health

co-morbidity in a high-risk

population

S. Teasdale

1 ,

, P. Ward

2

, K. Samaras

3

, S. Rosenbaum

2

, J. Curtis

1

,

O. Lederman

1

, A. Watkins

1

, B. Stubbs

4

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.

http://dx.doi.org/10.1016/j.eurpsy.2016.01.2320

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 cm

3

in SF. After 72 hours, any symptoms were not found.

Discussion

Dopamine neurotransmission can be inhibited

through the increase in serotonin and norepinephrine

[1] .

Additionally, dystonia may originate from the prevailing of nora-

drenaline as a result of the failure of dopaminergic–noradrenergic

balance

[2] .

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.