European Psychiatry - Volume 41 - April 2017

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S642 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S583–S644
in both groups. A stimulatory response following ISO in all subjects
even without -antagonists was also observed.
Discussion No difference in the basal AC activity in platelet
membranes of healthy subjects and OCD patients was found. Our
findings showed that there is an inhibitory component of ISO effect
on platelet AC, due to the agonist interaction with 2 receptors,
at its higher concentrations (>1 M), as well as a condition of
supersensitive -receptors. Our study suggests the presence of
cathecolamine system disturbances in OCD.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0731
Antipsychotic adjuvant treatment in
OCD
L. Montes Reula∗ , H. Saiz García , A. Portilla Fernández
Biomedical Research Center CIB, Psychiatric, Pamplona, Spain
∗ Corresponding author.
Antidepressant drugs selective inhibitors of serotonin reuptake
(IRS) are the drugs effective in obsessive compulsive disorder. It has
not been provenmore effective none of themexcept clomipramine.
Around 40–60% of the Patients with obsessive-compulsive disorder
(OCD) remain unimproved by serotonin reuptake inhibitors (SRIs).
Two cases are presented in relation to this disorder and its treat-
ment.
Twenty-three year oldwoman begins to present anhedonia, apathy,
isolation and lowmood. Treatment was initiatedwith escitalopram
with partial improvement.
Obsessive component traits Thirty year old man with obsessive
clinic of years of evolution, with worsening in recent months treat-
ment with 200mg sertraline.
In both cases treatment with oral aripiprazole it was associated
with a dose of 5mg daily with improvement in obsessive symp-
toms.
Results The efficacy of aripiprazole as adjunctive drug treatment
and obsessive anxiety is observed. However, we must take into
account the potential risks posed as neuroleptic malignant syn-
drome and QTc prolongation.
Conclusion Aripiprazole is an antipsychotic which has a novel
mechanism of action to be a partial agonist of dopamine D2 recep-
tors. This fact has led to its inclusion in the group of antipsychotics
called third generation, also called partial dopamine agonists,
dopamine stabilizers or “dopamine-serotoninmodulators system.”
Its most common side effects such as nausea, headaches, agi-
tation and akathisia were observed in studies on schizophrenia,
schizoaffective disorder and bipolar disorder. Unlike other atypical
antipsychotics, is considered a relatively neutral drug to weight
gain, hyperprolactinemia, changes in metabolic parameters and
sedation.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0732
Ect combined with clomipramine and
rTMS in an OCD patient with
secondary severe depression
D. Mota ∗, F. Almeida , A. Oliveira , J. Silva , M. Gonc¸ alves ,
J. Ribeiro , V. Martins , J. Andrade , A. Macedo
Centro Hospitalar e Universitário de Coimbra, CRI Psiquiatria e Saúde
Mental, Coimbra, Portugal
∗ Corresponding author.
Introduction Obsessive-compulsive disorder (OCD) has high
rates of comorbiditywithmood disorders, mainlymajor depressive
disorder (MDD). Symptoms of depression are usually secondary to
severe and disablingOCD. Electroconvulsive therapy (ECT) has been
an effective and well tolerated therapeutic alternative in the man-
agement of refractory MDD. Other neuromodulation techniques,
such as repetitive transcranial magnetic stimulation (rTMS), have
well known efficacy in MDD and also have shown positive results,
in clinical trials, treating other psychiatric disorders such as OCD.
Objectives/aims To determine the efficacy of combining rTMS,
ECT and clomipramine in the treatment of severe OCD with com-
orbid severe MDD.
Methods The authors report a case of a 54-year-old male patient
diagnosed with severe OCD for 23 years. He has been submitted to
several drug treatments and intensive cognitive-behavioural ther-
apy (CBT) always with poor response. The patient was admitted
in the beginning of 2016 in our inpatient unit. Besides continuing
drug treatment (clomipramine IV) and CBT, he was submitted to 12
ECT sessions during one month (3 sessions per week) and to daily
sessions of rTMS during the following month.
Outcomemeasures were obtained using Y-BOCS for OCD and HAM-
D for depression.
Results Our patient responded to ECT with mood improvement
after session 4 to full euthymic state at the final session. He also
responded well to rTMS with Y-BOCS score reduction.
Conclusion Combined ECT and rTMS treatment with clomipra-
mine IV and CBT was effective in our patient with a severe form of
both disorders (OCD and MDD).
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV0733
Neuroleptic-induced parkinsonism in
patient with obsessive compulsive
disorder: A case report
J. Nunes ∗ rigadeiro ndrade issarra da Costa
1 Hospital Sousa Martins, Department of Psychiatry and Mental
Health of Sousa Martins Hospital- U.L.S. Guarda, Guarda, Portugal
2 Centro Hospitalar de Universidade de Coimbra, Department of
Psychiatry and Mental Health of CHUC, Coimbra, Portugal
∗ Corresponding author.
Obsessive-compulsive disorder (OCD) is a neuropsychiatric dis-
order characterized by either obsessions (recurrent unwanted
thoughts, images or impulses) or compulsions (repetitive behav-
iors often performed to relieve anxiety or distress). In some cases, it
is considered antipsychotic enhancement. However, in high doses,
it can exacerbate OCD symptoms and cause extrapyramidal effects
such as neuroleptic-induced Parkinsonism.
Here, the authors present a clinic case of a single male patient
with 50 years old, in which with the age of 42, started with a
obsessive-compulsive framework about the developed task at the
work place (production of fabric) followed by several verifications
of the assembled pieces, which interfered with his work perfor-
mance. This patient was admitted to the psychiatric hospital due
to the deterioration of the symptoms with obsessive ideas of HIV
contamination resulting in rigid cleaning rituals. He was medicated
with several OCD medications including Clozapine 50mg.
In the following years and complaining of insomnia, the clozap-
ine dose was increased by the patient reaching the dose of 200mg.
In 2016 he started secondary Parkinsonism framework to antipsy-
chotics, characterized by akinesia, facial hypomimia, stiff, coarse
tremor and stooped posture. Therapeutic setting was made with
a reduction of clozapine at doses of 50mg occurring fading of
extrapyramidal symptoms and decrease the symptoms of OCD.
The authors intend with this presented case to highlight the impor-
tance of surveillance of patients receiving antipsychotics for OCD to
avoid worsening of symptoms and the development of extrapyra-