bluuebunny/crossref_metadata_2025_split huggingface dataset:
P03-324 - Clinical Remission in Schizophrenia Patients Treated Wiht Ziprasidone for up to One Year
Authors: Campos Mangas M.C. , Ruiz Feliu M.A. 
Published: June 2010

IntroductionSchizophrenia is a debilitating and cronic disease for which full recovery is typically not considered to be a realistic treatment endpoint. Symptomatic remission, however, may be an objectively attainable treatment goal.ObtectivesWe wanted to assess remission rates over 52 weeks in patients with schizophrenia treated with ziprasidoneMethodsRemission rates were calculated using data from a 52 week study in which patients diagnosed with acute schizophrenia were stabilized with ziprasidone (n=30, dose 120-140mg/day) For this analysis, remission was operationalized according to the consensus-based symptomatic remission criteria established by the Remission in Schizophrenia Working Group. Accordingly, patients were required to achievescores Syndrome Scale (PANSS) items (delusions, unusual thought content, hallucinatory behavior, conceptual disorganization, mannerisms/posturing, blunted affect, social withdrawal, lack of spontaneity) and to maintainthe item score threshold for at least 6 consecutive months.ResultsThirty-seven percent of ziprasidone treated patients satisfied the criteria for symptomatic remission within the 52-week trial period. Approximately 7% of patientslost their remission status prior to the end of thetrial, with mean time in remission of 6.5 months. Forty-six percent of patients never met the PANSS item threshold. During the 52-week study, few patients discontinued due to adverse events other than worsening of symptoms(7%) or received concomitant medication for EPS (18%)ConclusionsNearly one third of the patients treated with ziprasidone achieved remission status within 6 months. Most patients who achieved remission remained in remission for more than 9 months until trial termination. Overall CGI-Is of these patients were significantly better than for patients without remission.
P03-325 - Functional and Symptomatic Improvement in Adults with ADHD - Data from the Open Label Extension of the Lamda Trial
Authors: Casas M. , Trott G.-E. , Kooij S. , Ramos-Quiroga J.A. , Dejonckheere J. , van Oene J. , Schaeuble B. , Buitelaar J. 
Published: June 2010

ObjectiveTo explore the relationship between symptomatic and functional outcomes in adults (age 18-65 years) with ADHD during open label treatment with PR OROS MPH.MethodsPost hoc analyses of a 7-week open-label extension (OLE) (N=370) of a 5 week, placebo controlled double-blind study (DB) which explored safety, efficacy, functional and quality of life outcomes in subjects with a diagnosis of ADHD (DSM-IV). Medication was flexibly dosed (18-90 mg/day) and adjusted individually to best effect during OLE. Regression analyses were performed on the change from DB baseline at OL endpoint in functionality and quality of life as measured by the Sheehan Disability Scale (SDS) and Quality of Life (Q-LES-Q). Baseline score, country, randomization group, sex, change from baseline in CAARS Hyperactivity / Impulsivity, CAARS Inattention and CGI-S at DB endpoint were included as covariates in the analyses.Results337 / 370 patients completed the 7-week open label treatment. Improvement on CAARS Hyperactivity / Impulsivity at DB endpoint was significantly related with improvement in SDS “work”, “social life”, “family life” (at least p< 0.005) and “total score” as well as quality of life (p< 0.05) at the end of open label treatment. Change in CGI-S and CAARS Inattention at DB endpoint vs. DB baseline were not related with improvements in any of the functional or quality of life scales at OL endpoint (p>0.05).ConclusionThese results indicate that improvement in daily functioning and QOL under active treatment may be particularly related to improvement in hyperactivity symptoms.
P03-327 - What About Dosing Olanzapine Plasma Concentration in Mania? Plasma Threshold Determination
Authors: Denizot H. , Blanc O. , Libert F. , Dubray C. , Schwan R. , Llorca P.-M. 
Published: June 2010

ObjectivesOlanzapine plasma concentration ≥ 23, 2 ng/ml have been identified as a predictor of clinical response in acutely ill patients with schizophrenia. Aim was to determine relation between plasma concentration of olanzapine in a sample of inpatients or outpatients with acute mania by defining a plasma threshold (above which a better clinical response was obtained).MethodsOpen label, longitudinal, multicentric study including patients with acute mania and treated by olanzapine for 6 weeks; plasma concentration of olanzapine was measured at 3 and 6 weeks by high-performance liquid chromatography. Patients were considered “responsive” if they showed at least a 50% reduction in Young Mania Rating Scale score and a Clinical Global Impression Severity scale score of ≤ 3.ResultsTwenty patients were including (13 men and 7 women), mean age 57.4 yr. The mean olanzapine dosage was 11.46 mg/day (SD=2.49) at the same dosage for 16.8 days (SD=6.5). Receiver operating characteristic curve analysis determined a plasma threshold to be 15, 9 ng/ml.ConclusionsIt's the first time that a threshold of Olanzapine is determined in bipolar mania into a consequent population. This result could be considered as additional tools to adjust posology for improve cares, when manic patients are resistant.
P03-335 - Clinical Controlled Study of Venlafaxine and Fluoxetine in Treatment of Obsessive-Compulsive Disorder
Authors: Liu H. , Ji C. , Xiao W. , Wang G. 
Published: June 2010

ObjectiveThe aim of this study was to compare the clinical efficacy and the safety of venlafaxine and fluoxetine in the treatment of obsessive-compulsive disorder (OCD).MethodsOne hundred and Eight inpatients who met the Diagnostic and Statistical Manual of Mental Disorders, the Forth Edition(DSM-IV) for OCD were involved in this study. The subjects were randomly divided into venlafaxine group or fluoxetine group. Efficacy of venlafaxine and fluoxetine in treatment of OCD were assessed with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Clinical Global Impression-Severity(CGI-S), the side effects were evaluated with Treatment Emergent Symptom Scale (TESS).ResultsThe therapeutic efficacy in venlafaxine group was similar to that in fluoxetine (70.36%vs68.29%, P>0.05) after eight weeks’ therapy. The improve-rates of Y-BOCS after 2 weeks’ therapy of venlafaxine were significant higher than those of baseline, while the improve-rates of Y-BOCS after 4 weeks’ therapy of fluoxetine were significant higher than those of baseline(P< 0.05). The side effects of venlafaxine group were similar to fluoxetine group (P>0.05).ConclusionThe results indicate that both venlafaxine and fluoxetine is effective in the treatment of OCD, but venlafaxine work faster than fluoxutine.
P03-337 - Escitalopram in Treatment of Poststroke Depression
Authors: Havle N. , Altunkaynak Y. , Dayan C. , Ilnem M.C. , Arpaci B. 
Published: June 2010

ObjectivePoststroke depression (PD) occurs in approximately one third of the patients within first two years of a cerebrovascular event. However, no definite consensus has been reached on the best treatment option. The aim was to determine the efficacy and safety escitalopram, a selective serotonin reuptake inhibitor, in PSD treatment.MethodsPatients with symptoms of depression within 6 months of a cerebrovascular event were included. Patients with Hamilton depression (HAM-D) score of < 13, mini mental standardized test score of < 23, schizophrenia, behavioral disorders, substance abuse, history of alcoholism, current use of antidepressants, and history of stroke or major depression within the last one year were excluded. Patients were administered escitalopram 10 mg/day for 3 months. HAM-D scores, stroke severity and extent of functional impairment were assessed and side effects were recorded; the relationship between HAM-D scores and sociodemographic variables and stroke localization was investigated.ResultsTotaly,35 patients (60% female; mean age, 67± 6) were included. Depression was diagnosed 3±1.2 months after the stroke. HAM-D scores decreased significantly in all visits (days 15, 30, 45 and 90). The mean HAM-D score decreased from 27.5±4.7 to 4.65±2.47 at day 90 (p< 0.0001). No significant correlation was found between HAM-D scores and cerebrovascular event localization, sociodemographic variables and medical history (p>0.05). Escitalopram was well tolerated. A total of 9 patients reported nausea, anxiety, drowsiness and dyspepsia.ConclusionIn this open-label study escitalopram was found to be safe and effective for use in poststroke depression patients.
P03-343 - Treatment Choice in Psychiatry? How Would European Trainees Treat Psychosis for Their Patients and Themselves, and what Influences Decision-Making?
Authors: Jauhar S. , Guloksuz S. , Gama Marques J. , Bendix M. , Lydall G. , Andlauer O. , Gerber S. , Roventa C. , Van Zanten J. , De Vriendt N. , Nawka A. , Nwachukw I. , Dobrzynska E. , Mufic A. , Nazaraliev A. , Dumitrescu I. , Mendonca L. , Riese F. ,   European Federation of Psychiatric Trainees (EFPT) Research Group
Published: June 2010

ObjectivesRecent evidence has questioned modern psychiatric clinical practice, specifically the prescribing of “atypical” antipsychotics. Our Pan-European Research Group wished to ascertain clinical practice amongst European trainees, which treatments trainees would desire for themselves, and factors influencing this.MethodsA semi-structured survey was constructed from prior literature, piloted, and a homogenous sample size of at least 50 was agreed upon from each country, with 50% minimum response rate. It was distributed via web-link, with questions on preference of antipsychotic for patients in given scenarios, and factors influencing choice. Physicians were asked for their preference should they develop psychosis.Resultsi)Treatment choice of antipsychotic for patients93% (n=600) of respondents chose to prescribe “atypical” antipsychotics (excluding Clozapine), 6% (n=42) choosing “typical” antipsychotics, 1% (n=6) choosing Clozapine as first-line therapy.ii)Treatment choice if trainees developed psychosis89% (n=530) of responders chose to prescribe “atypical” antipsychotics (excluding Clozapine), 7% (n=40) choosing “typical” antipsychotics, 4% (n=23) choosing Clozapine as first-line therapy.iii)Factors influencing choiceThese mapped onto three domains: cost, efficacy and side-effect profile (less than 5% other reasons). 79% (n=458) of those who responded felt efficacy most important, 46% (n=270) felt side-effect profile most important and 3% (n=16) considered cost of paramount importance.38% (n=272) of those who responded to the survey stated that the CATIE trial had influenced their decision-making.ConclusionsPsychiatry trainees’ choice of antipsychotic medication for both patients and themselves is based on perceived benefits, as opposed to evidence base and recent literature.
P03-344 Epileptic Seizures Associated with Quetiapine use: Report of two Cases
Authors: Karslioglu E. , Manisali Erkek B. , Peker S. , Ulusoy Kaymak S. , Özalp E. , Cankurtaran E. , Soygür H. 
Published: June 2010

Approximately 1.7% of all epileptic seizures are induced by drugs, mostly psychotropics. Although the risk is known to be the lowest, a few reports notified quetiapine-induced epileptic convulsions. We report two additional cases.Case 1Twenty-five-year old man suffering from paranoid psychosis was given quetiapine for persisting symptoms. He also had myoclonic disorder which has become worse just after administering quetiapine. Physical, neurological and laboratory findings were normal. He once had a generalized seizure in our clinic. The electroencephalography (EEG) revealed an epileptic focus on frontal region. He has been diagnosed as frontal lobe epilepsy exacerbated by quetiapine. He has recovered and was doing well after withdrawn the drug.Case 2Twenty-three-year old women who had bipolar disorder was hospitalized due to a manic episode. Physical examination and routine laboratory tests were normal. Lithium at 600mg/d and quetiapine at 300 mg/d were started. Quetiapine has been gradually increased up to 900 mg/d at which the myoclonic symptoms first noted. They were disappeared after quetiapin was tapered to 600 mg/d. To control manic symptoms, quetiapine dosage had to be increased up to 700 mg/d again, but myoclonus was reappeared. Quetiapin was replaced with risperidon and manic symptoms subsided. No myoclonic seizures were noted during follow-up.ConclusionEEG abnormalities particularly likely with clozapine and olanzapine, moderate with risperidone, and the lowest with quetiapine. The risk of quetiapine-induced epilepsy was estimated as 0.75%. Evaluating of patients for the epileptic background is important in selecting proper antipsychotic medication.
P03-346 Effects of Placebo-Controlled Withdrawal After Long-Term Open Label Treatment with OROS MPH in Adults with ADHD
Authors: Kooij S. , Nyrerod H.J. , Casas M. , Dejonckheere J. , Waechter S. , van Oene J. , Schaeuble B. , Buitelaar J. 
Published: June 2010

ObjectiveTo explore maintenance of effect with OROS MPH in adults with ADHD.MethodsMulticenter study randomizing adult subjects with ADHD who completed open-label (OL) treatment with OROS MPH (18-90mg/day) for at least 52-week and consented to a 4-week, randomized, double-blind (DB), placebo-controlled (PLC) withdrawal period. Efficacy measures included total CAARS score, CAARS-S:S, GAE, CGI-S and CGI-C. Endpoint analyses were performed using LOCF.Results99/155 patients completed the OL OROS MPH treatment phase, only 45/99 patients consented to double-blind randomization. At DB baseline, mean ± SD TCS was 12.1±5.34 (n=23) in the continued OROS MPH group and 16.5±7.49 (n=22) in the placebo group. CAARS changed from DB baseline to DB endpoint by 4.0±7.61 and 6.5±7.82, respectively (p = 0.2586 between groups). CGI-C scores indicated more worsening of symptoms in the placebo group compared to the continued PR OROS MPH (p = 0.0422). Median (range) GAE scores at endpoint were 2.0 (0-3) and 0.5 (0-3), respectively (p=0.0254). Other efficacy endpoints were numerically in favor of OROS MPH. The randomized withdrawal phase may have been underpowered to show statistical significance between treatment groups for the primary outcome. The incidence of treatment-emergent AEs during the DB phase was comparable between groups.ConclusionsThe results indicate that treatment discontinuation after long-term exposure of adults with ADHD to OROS MPH is associated with worsening of clinical symptoms. Statistical significance for several outcomes was not reached, possibly due to study limitations.
P03-347 Transitioning Onto OROS MPH is Associated with Improved Functioning and Quality of Life in Children and Adolescents with ADHD
Authors: Kordon A. , Hultzsch W. , Mattejat F. , Dichter S. , Schaeuble B. 
Published: June 2010

ObjectiveTo explore functionality and quality of life outcomes in children and adolescents with ADHD transitioning from IR MPH, ER MPH or ATX onto OROS MPH.MethodsPooled analyses of two similar 12 week open label, flexibly dosed studies including children (6-18 yrs) diagnosed with ADHD (ICD-10) transitioning from shorter acting stimulants or Atomoxetine onto OROS MPH. Connor's parents rating scale, children's global assessment scale and quality of life (ILC, LQ-0-28) were applied.Results822 patients (84.9% boys; median age 10 yrs) were analyzed. 81% of patients concluded the study. Starting and final dose was based on physician's judgment. Median dose at baseline and endpoint was 36mg/day. On average, C-GAS ratings improved by 12 points (p< 0.001). The percentage of children showing “variable functioning with sporadic difficulties” at baseline or worse decreased from 57,2% to 43,3% at endpoint. 61% of patients improved by at least 30% on CPRS. The percentage of children meeting educational demands at school at least “rather good” increased from 26,6% to 47,4% at endpoint. Results were similar for “social interaction with other children”, “emotional status”, “occupying with him or herself”. Burden of disease (patients or care givers) decreased (p< 0.001). Improved C-GAS and LQ 0-28 correlated with decreased CPRS. Treatment emergent AEs occurred in 35.6%. AEs ≥ 4%: insomnia (8%), muscle twitches (5%) and anorexia (4%).ConclusionTransitioning onto OROS MPH was associated with clinically relevant improvements in daily functioning, aspects of quality of life and decreased burden of disease in patients and their cares.
P03-350 Pharmacotherapy of Generalized Anxiety Disorders Under Conditions of Routine Treatment
Authors: Linden M. , Pyrkosch L. 
Published: June 2010

BackgroundGeneralized anxiety disorders (GAD) are characterized by persistent excessive worrying about minor hassles. GAD patients are high utilizers of medical services and medication.According to an analysis of 21 double-blind placebo-controlled trials by of Hidalgo et al. (2007) highest effect sizes are reproted for pregabalin (0.50), hydroxyzine (0.45), venlafaxine XR (0.42), benzodiazepines (0.38), SSRIs (0.36), buspirone (0.17) and herbal medicines (-0.31). The question is how GAD is treated under conditions of routine treatment. This was studied in patients were admitted to inpatient treatment.MethodPsychotropic premedication and changes in medication during the inpatient treatment were analyzed in 107 patients.ResultsBefore admission, 27,1% of GAD patients got tricyclic antidepressants, 25,2% SSRI, 8,4% benzodiazepines, 7,4% atypical antidepressants, 1,9% anticonvulsants/pregabaline, 1,9% herbal drugs. Furthermore, 20,6% got betablocker, preferably because of hypertension.During the inpatient stay changes in medication were made according to the clinical discretion of the therapist. At discharge 41,1% of GAD patients received SSRI, 23,4% tricyclic antidepressants, 22,4% pregabaline, 9,4% atypical antidepressants.ConclusionSSRI and tricyclic antidepressants play the major role in the drug treatment of GAD. Under clinical conditions there has been an optimization of treatment by increasing preferably the rate of SSRI treatments and of pregabaline treatment, while reducing benzodiazepine treatment and to some degree tricyclic antidepressants.LiteratureHidalgo RB, Tupler LA, Davidson JRT (2007): An effect-size analysis of pharmacologic treatments for generalized anxiety disorder. J Psychopharmacol 21(8):864-872.
P03-351 Benzodiazepines in Primary Care
Authors: Ruiz Peña M. , Sanchez Guerrero J. , Iglesias Hernández M.I. , Dominguez Dominguez J.A. , Gomez Diaz I. , Gallego Castillo E. 
Published: June 2010

IntroductionIn Spain, consumption of psychotropic drugs is high and benzodiazepines represent 74% of the total. His prescription in primary care is very common and their use continues to grow. They are safe and effective drugs, but patients with prolonged use are elaborating the most adverse effects, particularly the dependency.DesingDescriptive ans cross-sectional.ScopePrimary Health Care.SubjectsWe seleted 202 patients treated with benzodiazepines, consecutive sample, belonging to the health center Los Barrio who were seen in consultation during 2009.MethodsWe conducted through a questionnaire that cointained the treatment and demographic characteristics.ResultsWe detect a frequency of use of benzodiazepines 9% (95% CI 4,7-12,1%). The profile of the consumer responds to middle-aged woman, with primary and housewives. Somatic diseases were associated in 72.6% (CI 67,2-77,5%) and had mental pathology at 59.7% (CI 53,9-65,3%). 35% (95% 29,6-40,6%) of prescribed benzodiazepines were clorazape dipotassium. Consumption was constant for over a year. The prescription from primary care represents 81% (95% 76,3-85,4%) and in 65% (CI 59,3-70,3%) is associated with other psychoactive drug.ConclusionsIn our area, highlights the prescription of benzodiazepines from primary care on demand and consumption during prolonged time. Interventions should be conducted on the prescription of benzodiazepines in medical and other interventions for patient support.
P03-353 Neuroprotective Effect of Haloperidol vs. Aripiprazole at Hippocampal and Frontal Cortex at Rats
Authors: Marinescu D. , Mogoanta L. , Udristoiu T. 
Published: June 2010

ObjectivesThe hypofrontaliety syndrome and the hippocampal alterations are correlated with the dopamine deficit secondary to D2 receptors blockade by the antipsychotic substances. The dopamine deficit amplifies the cognitive deficit, which is an important predictor for poor outcome in schizophrenia. The psychopharmacological action of aripiprazole is a dopamine modulator compared to haloperidole which is a highly potent D2 receptors blocker.MethodWe have studied 3 groups, each consisted of 5 male adults Winstar rats each (200-250g), held through the study in temperature, humidity, food and ambient stressless conditions: N1 - control group; N2 - intraperitoneal administration of haloperidol (equivalent of 3mg); N3 - administration of aripiprazole (equivalent of 10mg). After 14 days, the rats were sacrificed and sections of their frontal cortex and hippocampus. The sample brain was histopathologically processed.ResultsCompared with control group N1, the rats of group N2 (haloperidol) have shown significant alterations in frontal cortex (neuronal loss, pinocytosis and neuronal depopulation in III, IV and VI layers) and hippocampal areas (neuronal loss). The rats of group N3 (aripiprazole) have shown minimal, non-significant changes in frontal cortex and minimal loss in hippocampal areas.ConclusionThe decrease of neuroprotection realised by haloperidole in frontal cortex and hippocampal areas suggest the aggravation of the structural cerebral abnormalities comparative to the aripiprazole action which presented a high level of neuroprotection.
P03-361 - Determination of CYP2C19 and CYP2D6 Genotpes in a First-Episode Psychotic Sample
Authors: Nascimento M. , Berge D. , Mané A. , Hernández J. , Merino A. , Bulbena A. 
Published: June 2010

Genetic factors Genetic factors contribute to psychotropic drug response. Some CYP2D6 and CYP2C19 genes polymorphisms have been described to have an important influence on the required therapeutic doses of antidepressants and antipsychotics. The knowledge on this can help to avoid and manage drug-drug interactions.ObjectivesTo describe the prevalence of the different phenotypes for genes CYP2C19 and CYP2D6 in a population of first episode psychotic patients and its relation to clinical outcome, dose and race during a 2 years follow-up period.MethodsPatients with a first psychotic episode were recruited form January 2006 to January 2009. Clinical and treatment related variables were registered at baseline and during a 2 years follow up period. CYP2D6 and CYP2C19 genotype were determined.ResultsFrom the 48 initially recruited patients, 21 (44%) were genetically determined. Amongst them, 13 subjects (62%) presented an efficient phenotype for the CYP2D6, 3(14%) presented an increased phenotype (ultra rapid metabolizers), 3 (14%) were intermediate metabolizers and 2 (9%) were poor metabolizers. All the patients presented an efficient phenotype for CYP2C19. The patients were Caucasian (71%) and other ethnic groups (29%). Patients were treated with risperidone (42,85%), olanzapine (47,61%), clozapine (4,76%) and aripiprazol (4,76%).ConclusionsMost of the patients presented an efficient phenotype. However a considerable proportion were ultrarapid or poor metabolizers. Due to the small sample size, differences between ethnic groups, relapse or drug intolerance could not be found, however first glance differences were not apparent. Further studies using larger samples and considering other confounding factors would be needed.