bluuebunny/crossref_metadata_2025_split huggingface dataset:
P03-321 Antipsychotic Polipharmacy in Schizophrenic Inpatients
Authors: Batalla A. , Undurraga J. , Grande I. , Pons A. 
Published: June 2010

ObjectivesConcomitant antipsychotic prescription is common in clinical psychiatry, although it is not an evidence-based practice. The aim of the study was to describe the prescription of antipsychotics in inpatients with schizophrenia and identify which are the factors associated with this tendency.MethodsWe reviewed retrospectively the psychotropic drugs prescribed at the time of discharge of 177 inpatients who met criteria for schizophrenia [DSM-IV-TR] on an acute psychiatry unit from 2007 to 2008.ResultsOne hundred and two patients (57.6%) were male. Mean age (SD) was 38.1 (14.6) years. The percentage of patients discharged on treatment with two or more antipsychotics was 43.5%. Although in the strict sense we should not consider it as polipharmacy, the most frequent combination was long acting injectable risperidone with oral risperidone (21.5%), followed by long acting injectable typical antipsychotic with oral risperidone (3.4%). There was a significant association between the number of prescribed antipsychotics and the total number of previous hospitalizations and the number of hospitalizations during the previous year (ANOVA p=0.001 and p< 0.001 respectively). No correlation was found between polypharmacy and age. There was a significant association between the number of antipsychotics prescribed and the use of anticholinergic treatment (t-test p=0.005).ConclusionsOur polypharmacy rates are comparable with prior European data (30-76%). Despite of the clinical guidelines, antipsychotic polipharmacy is an extended therapeutic strategy not necessarily related with resistant schizophrenia. Most of the antipsychotic associations identified are not evidenced-based practice. More clinical trials are needed to determine the efficacy of different combinations.
P03-329 - Impact of Transition to Atypical Antipsychotics in the Course and Outcome of First-time Admittances in a Psychiatric Clinic
Authors: Floros G. , Grammatikopoulos I. , Girouki M. , Amanatiadis V. , Ntouros E. , Pahumis G. , Nikolaidis N. , Garyfallos G. , Giouzepas I. 
Published: June 2010

ObjectivesWe examined the course of patients admitted for the first time in the Acute mental health ward of a Psychiatric Clinic in a Psychiatric Hospital within a ten-year hiatus. During this time the sociodemographic characteristics of the population were altered due to migration from former Eastern Europe countries, the transition from typical to atypical antipsychotic medication was completed and attempts were made to promote community psychiatry.MethodsWe compared two groups of 77 and 87 patients admitted for the first time during 1997 and 2007 respectively. Prescribed medication when given an exit diagnosis was calculated to haloperidol equivalency, following guidelines described in Kane et al.ResultsResults indicate that the groups were comparable as to size, sex, age, entry diagnosis and length of stay. The groups differed significantly as to origin, with the 2007 group having significantly more migrants but also patients originating from more distant provinces within Greece. There was a significant increase in involuntary admissions. While there was an increase in the use of atypical antipsychotics there was no significant difference in treatment potency.ConclusionsIntroduction of atypical antipsychotics enabled the clinician to provide treatment of similar antipsychotic potency with better tolerance profile, but failed to reduce length of stay. The increase in involuntary admissions and number of admissions from more remote regions raises doubts on the efficiency of the psychiatric reforms attempted during that time in order to promote community psychiatry.
P03-332 - Effect of Treatment with Lisdexamfetamine Dimesylate on Self-Reported Quality of Life in Adults with Attention-Deficit/Hyperactivity Disorder
Authors: Giblin J. , Brams M. , Gao J. , Gasior M. , Squires L. , Wigal T. 
Published: June 2010

ObjectiveTo assess the impact of lisdexamfetamine dimesylate (LDX; Vyvanse®, Shire US Inc.), which is the first long-acting prodrug stimulant indicated for treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adults in the United States, on performance and quality of life (QOL) in adults with ADHD.MethodsSubjects (n=142; aged 18 to 55 years) with ADHD entered a 4-week open-label dose-optimisation phase, then a 2-week, double-blind crossover phase. The primary efficacy measure was the average postdose total score on the Permanent Product Measure of Performance (PERMP) math test given predose and 2, 4, 8, 10, 12, and 14 hours postdose. The Adult ADHD Impact Module (AIM-A) was self-administered during the dose-optimisation phase. Safety was assessed by monitoring adverse events (AEs).ResultsIn the intention-to-treat population (n=105), postdose average PERMP least squares mean (SE) scores were higher (P< .0001) for LDX (312.9 [8.59]) vs placebo (289.5 [8.59]) and at every postdose time point ≥14 hours (P≤.0017 for each). Mean change from baseline scores on AIM-A subscales (n=127) showed improvement (P< .001) with LDX in 6 measured QOL domains (living with ADHD; general wellbeing; work, home, and school performance and daily functioning; relationships and communication; interference with life; and concern caused by symptoms). Treatment-emergent AEs (≥10%) in the dose-optimisation phase were decreased appetite (36.6%), dry mouth (30.3%), headache (19.7%), and insomnia (18.3%).ConclusionsLDX improved QOL and performance (up to 14 hours) and demonstrated a safety profile consistent with long-acting stimulant use.Supported by funding from Shire Development Inc., Wayne, PA, US.
P03-333 - Electrocardiographic Alterations in Patients in Treatment with Clozapine
Authors: Grande I. , Pons A. , Torras Á. , Baeza I. , Bernardo M. 
Published: June 2010

ObjectivesCardiovascular side effects of antipsychotics are been studied both in typical and atypical antipsychotics but, in particular, with clozapine few systematic studies of these effects have been performed. In this study, we reviewed electrocardiographic (ECG) data from patients treated with clozapine.MethodsObservational, retrospective study in our Clozapine Day Clinic from 2000 to 2008. We recluted 197 patients (70% men) with mean age 31,75 ± 9,0 years who began treatment with clozapine. All of them had an electrocardiogram taken before starting treatment and after 18 weeks of follow-up. None suffered from heart diseases. QTc was evaluated by Bazett formula (QT/ (R-R’)1/2). Treatment prescribed was taken down and drug serum levels were detected. Statistical analysis was executed by SPSS 17.0.ResultsThere was significant correlation between doses prescribed and levels of clozapine and norclozapine (r=.304, p=.023; r=.354 p=.007), between levels of clozapine, norclozapine and QTc enlargement (r=.348, p=.008; r=.268 p=.046) and between levels of clozapine, norclozapine and heart rate (r=.390, p=.003; r=.326 p=.014). There were no differences between QTc and treatment with clozapine or other antipsychotic (p=0.902), between sex or if polypharmacy existed. ECG alterations were a case of supraventricular extrasystoles, another of Wolf-Parkinson -White Syndrome and other inespecific alterations like repolarizations or left hypertrophy.ConclusionWe did not find either major incidence on cardiological effects or significative QTc enlargement during treatment with clozapine in contrast to other antipsychotic previously prescribed. Therefore clozapine may be in the same cardiologic safety rank than other antipsychotics.
P03-334 - Neuroleptic Malignant Syndrome Diagnosis: an International Consensus Study Using the Delphi Technique
Authors: Gurrera R. , Caroff S. , Cohen A. 
Published: June 2010

ObjectivesTo develop consensus-based clinical diagnostic criteria for neuroleptic malignant syndrome (NMS).MethodsA 17-member international expert panel of psychiatrists, neurologists, anesthesiologists and emergency medicine specialists was asked to identify clinical features that are most important or valuable in diagnosing NMS; when the feature was quantitative in nature, they were also asked to provide the corresponding critical value. The Delphi technique is a formal consensus procedure that employs a postal survey method to solicit opinions from each panel member, and to feed this information back to the entire panel in the form of anonymous, statistically aggregated data. This iterative process of information exchanges (opinions collected, group responses analyzed, feedback given to panel), or “rounds”, continues until consensus has been reached. In the present study, the predetermined consensus criterion was a round-round mean change of 10% or less for any survey item, and 5% or less across all items.ResultsThe expert panel reached consensus on the following diagnostic criteria in five iterations:(1)exposure to a dopamine antagonist, or dopamine agonist withdrawal, within past 72 hours;(2)hyperthermia;(3)rigidity;(4)mental status alteration;(5)creatine phosphokinase elevation;(6)sympathetic nervous system lability (2 or more of blood pressure elevation, blood pressure fluctuation, diaphoresis, urinary incontinence);(7)tachycardia and tachypnea; and(8)negative work-up for infectious, toxic, metabolic and neurological causes.ConclusionsThese are the first consensus-based diagnostic criteria for NMS, and may be preferred to previous ad hoc approaches to diagnosing this disorder.
P03-336 - Characteristics of Patients with Depression in the UK Initiating Treatment with Duloxetine and Venlafaxine XR
Authors: Durden E. , Happich M. , Shi N. , Torres A. 
Published: June 2010

ObjectivesTo describe and compare the demographic and clinical characteristics of adult patients with depression in the UK treated with duloxetine and venlafaxine XR.MethodsDepressed adults treated with duloxetine or venlafaxine XR between 1/1/2006 and 9/30/2007 were identified using the General Practice Research Database (GPRD), which represents all primary care practices in the UK. Demographic (age and sex) and clinical characteristics (psychiatric and physical comorbid conditions and concomitant medication use) were examined and the characteristics of the two treatment groups were compared using chi-square or t tests, as appropriate.ResultsOf 2,195 patients identified (mean age 47.2 years; 65.8% female), 41% were prescribed duloxetine and 59% were prescribed venlafaxine XR. On average, patients treated with duloxetine were older than patients treated with venlafaxine XR (49.6 years versus 45.5 years; p< 0.001). Compared to patients treated with venlafaxine XR, patients treated with duloxetine had higher prevalence of a variety of comorbid physical health conditions, including diseases of the circulatory, digestive, respiratory systems, as well as a higher prevalence of diabetes (p< 0.01 for all). Additionally, patients treated with duloxetine had higher prevalence of unexplained pain (p< 0.001). Greater proportions of patients treated with duloxetine had prescription utilization of medications in a variety of classes, including anticonvulsants, analgesics, migraine medications, as well as medications used to treat cardiovascular and gastrointestinal disorders (p< 0.01 for all).ConclusionsDepressed patients treated with duloxetine in the UK are slightly older and appear to be in poorer health overall than patients treated with venlafaxine XR.
P03-349 The Potential Effects of Antidepressants in Attenuating Synaptic Degeneration in Depression and Alzheimer's Disease
Authors: Wuwongse S. , Chang R. , Law A. 
Published: June 2010

Depression is a highly prevalent psychiatric disorder. Furthermore, it is one of the most common neuropsychiatric presentations in Alzheimer's disease (AD). Common underlying neuropathological processes appear to exist between these conditions. Synaptic degeneration has been implicated in AD pathogenesis, while its role in depression is not well understood.ObjectivesThis study aims to investigate synaptic degeneration as a possible underlying mechanism for depression and whether antidepressants could alleviate the stated pathology.MethodsPrimary rodent hippocampal neurons treated with corticosterone were used as an in vitro model of depression. Toxicity of corticosterone was determined through the lactate dehydrogenase and caspase-3 activity assays. Immunocytochemical analysis of synaptic proteins was employed to investigate effects of corticosterone on synapses.ResultsNeurotoxicity was observed in hippocampal neurons after treatment with corticosterone (10μM) for 24 hours. Aggregations of synaptotagmin and synaptophysin were observed 24 hours after treatment with corticosterone (10μM). Similar effects were observed after sub-lethal treatments with corticosterone (0.5μM and 1μM) for 48 and 72 hours. Pre-treatment for 1 hour with imipramine and escitalopram (20μM and 40μM for both agents) were able to alleviate these toxic effects.ConclusionsThese results suggest the involvement of synaptic degeneration in corticosterone-induced toxicity and that commonly used antidepressants are able to alleviate synaptic derangements. Taken together, synaptic degeneration could be a common pathway for neuronal demise occurring in AD and depression, which can be attenuated by antidepressant administration. Future research to elucidate the precise mechanism for the synaptic protective effect of antidepressants is warranted.
P03-352 Aripiprazole in Prodromal Syndrome of Schizophrenia at the Male Patients with Obstetrical Traumas in Personal Medical History
Authors: Marinescu D. , Marinescu I. , Pirlog M. , Chimorgiachis A. 
Published: June 2010

ObjectivesThe prodromal syndrome in schizophrenia can be correlated with a series of neurobiological risk factors, the obstetrical traumas having an important role. The antipsychotic therapy at the male patients with obstetrical traumas in personal medical history can amplify the risk of cerebral structural changes.MethodWe have studied 12 male patients (age 18-20 years), with prodromal schizophrenia syndrome or ARMS, negative symptoms, cognitive disabilities and poor social cognition. All the studied patients present obstetrical traumas in medical personal history, soft extrapyramidal symptoms, facial immobility and facial incapacity to express emotions (behavioral marker for poor social cognition and frontal-amygdala disconectivity). We administered aripiprazole (5mg/day) for 12 months associated with psychokinetotherapy technics, a series of facial mobility standard exercises.ResultsThese patients were evaluated at 6 and 12 months with PANSS, GAF, BARNES scales. The final results are: on the PANSS scale the evolution of negative and cognitive symptoms was ameliorated. The facial mobility and the capacity of emotional expression are also significantly ameliorated. The cognitive abilities and the level of social cognition are evaluated as very good. The extrapyramidal symptoms evaluated on the BARNES scale are not amplifying during the treatment.ConclusionThe facial imobility and the facial incapacity to expressed emotions may be a clinical marker for neurodevelopmental abnormalities in the schizophrenia prodrome. Aripiprazole associated with the psychokinetotherapy technics improve in a significantly way the prodromal symptoms of schizophrenia at the male with obstetrical traumas in medical personal history.
P03-354 How Frequently are Atypical Antipsychotics used to Treat OCD in a British Community Mental Health Team?
Authors: Birtwhistle M. , Agius M. , Zaman R. 
Published: June 2010

IntroductionAfter initial psychological treatment patients with Obsessive Compulsive Disorder are treated with selective serotonin re-uptake inhibitors (SSRIs). Treatment may later be augmented with clomipramine and/or an antipsychotic. This study focuses on the biological treatment received after, or in parallel to, the psychological.AimTo collate and evaluate the levels of biological treatment currently received by OCD outpatients in the Bedford east catchment of Bedfordshire and Luton mental health and social care partnership NHS trust.ObjectivesIn particular we wished to establish how many of the patients were receiving an atypical antipsychotic as well as maximal SSRIs.MethodAn anonymised database of 45 outpatients with symptoms of OCD was prepared. Treatment groups were identified and the percentage of the cohort occupied by these groups was calculated. The possibilities for increased medication were noted.ResultsOnly 7% of patients had one SSRI, at maximum dose, plus clomipramine, plus an antipsychotic, even here the dosing was not maximal. Another 7% had a second SSRI instead of the tricyclic and may benefit from a trial of clomipramine. In the remaining 86% there was further scope for increasing biological therapy.DiscussionRelatively few of our patients were having maximal SSRI treatment and an antipsychotic, despite guideline recommendations.ConclusionThere is plenty of leeway for the escalation of patients’ biological therapy. Given the number of patients currently receiving secondary care, an escalation of their treatment should result in better patient health and a subsequent increase in discharges.
P03-357 Hepatitis C, Insomnia and Mirtazapin
Authors: Miljatovic A. , Simic S. 
Published: June 2010

ObjectivesHepatitisC, a viral infection,is one the most important causes of the chronic liver disease.As a consequence of interferon alpha 2a treatment of chronic hepatitis C, there is a number of side effects:headache, muscle aches, exhaustion, weight loss, hair loss, irritability, insomnia and other.AimThe aim of this study was to establish the frequency and the level of insomnia in patients with chronic hepatitis Cthat were treated with Interferon and Ribavirin for 24 weeks. We also evaluated the efficacy of Mirtazapin in the treatment of insomnia,in these patients.Method30 patients in all, with serologically and patohistologically established diagnosis of hepatitis C, were included in this study. These patients were treated with 180mg of Pegasus interferon injected subcutaneously, once a week. They also received 800mg of Ribavirin perorally a day. This treatment lasted 24weeks.PITTSBURGH SLEEP QUALITY INDEX-PSQI was used as a measuring instrument for the evaluation of the level of insomnia.All the patients tested were at the beginning of the Interferon treatment,and after 3,5,and 7 months of treatment.Patients with diagnosed severe sleeping disorders were given small doses of Mirtazapin-15 mg every evening for 6 weeks.ResultsOn the initial rounds,two patients had a PSQI score higher than 5.After a three month long Interferon treatment,five patients had a PSQI score higher than 5. After 7 months from the beginning of interferon treatment, ten patients had a PSQI score higher than 5, which indicates a significant sleeping disorder.ConclusionThe administration of small doses of Mirtazapin/15 mg every evening shows useful effects in reduction of sleeping disorders caused by the Pegasus interferon treatment in patients suffering from chronic hepatitis C.
P03-359 Randomized, Double-Blind, Placebo-Controlled Study of Risperidone Long-Acting Injectable in Relapse Prevention in Patients with Bipolar I Disorder
Authors: Montgomery S. , Vieta E. , Sulaiman A.H. , Cordoba R. , Huberlant B. , Schreiner A. , Martinez G. 
Published: June 2010

ObjectivesTo evaluate risperidone long-acting injectable (RLAI) versus placebo in prevention of mood episodes in adults with bipolar I disorder.MethodsA 12-week open-label period with RLAI (N=585) was followed by an 18-month randomized, double-blind period with RLAI (25, 37.5 or 50 mg/2 weeks; N=137) or placebo (N=140); a third group (N=138) was randomized to olanzapine for reference and exploratory comparisons. Primary efficacy endpoint: time to relapse of any mood episode for risperidone LAI vs. placebo in the double-blind period (Kaplan-Meier analysis). Relapse was defined by criteria including DSM diagnosis, further treatment, hospitalisation, or Clinical Global Impression score ≥4 combined with YMRS or MADRS >12.ResultsDosing was fixed during the double-blind period at patients’ final open-label dose (25 mg, 66%; 37.5 mg, 31%; 50 mg, 4%). Time to recurrence (any mood episode) was longer with RLAI versus placebo (log-rank test stratified by region and patient type, p=0.062; stratified by region only, p=0.032); the difference was significant for time to recurrence of elevated mood episodes (p=0.005) but not depressive episodes (p=0.587). Discontinuations due to adverse events (AEs) occurred in 2% of patients in the open-label period, and 4% and 1% in the RLAI and placebo groups, respectively, in the double-blind period. The most frequently reported AE in the open-label period was insomnia (15%). During double-blind treatment, the most frequently reported AEs with RLAI were weight increased (24%; placebo, 9%) and insomnia (16%; placebo, 17%).Table 1.Type of recurrenceType of episode, n (%)Risperidone LAI (N=135)Placebo (N=138)All mood episodes52 (38.5)77 (55.8)Elevated mood episode27 (20.0)54(39.1)Hypomanic2(1.5)4 (2.9)Manic17(12.6)43(31.2)Mixed8 (5.9)7(5.1)Depressive25(18.5)23(16.7)ConclusionRLAI significantly delayed time to relapse of elevated mood episodes and was well tolerated.
P03-360 - The Effect of Lamotrigine Augmentation to Haloperidol Deaconate in the Treatment of Resistant Schizophrenia: Randomized, Double-Blind, Placebo-Controlled, Study
Authors: Aliyev N. 
Published: June 2010

ObjectiveThe current paper reports on a double-blind, randomized study of the role of lamotrigine as an augmentation agent to haloperidol deaconate in the treatment of out patient's schizophrenia with verbal resistant hallucinosis.MethodThree hundred fifty patients were studied. The patients were then randomly divided into two groups on 175 subjects in each group. First group patients received either haloperidol deaconate 100 mg in month intramuscular and lamotrigine 150-200 mg in day per so for 12 weeks. Second group patients were given haloperidol deaconate 100 mg in month intramuscular and placebo per os for 12 weeks. The expressiveness of psychopathology was estimated on PANSS.Results75 (44%) of the 168 first group participants responded by 12 weeks, versus one (0.6%) of the 167 second group treated participants.ConclusionsOur data suggest that haloperidol with the combination of lamotrigine was more effective than placebo.