European Psychiatry - Volume 41 - April 2017

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S750 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S710–S771
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1063
SSRIs and QT interval prolongation
management. A review
A. Ballesteros ∗ Saiz . Rosero Portilla ontes
R. Elorza
1 Osasunbidea, Psychiatry, Madrid, Spain
2 Osasunbidea, Psychiatry, Pamplona, Spain
∗ Corresponding author.
Introduction In 2011, the FDA issued an alert recommending not
to prescribe citalopram high doses, due to QT prolongation risk.
We explored the clinical background of QT interval prolongation
related to serotonin selective reuptake inhibitors (SSRI) use and
the clinical implications of safety issues.
Methodology A review was conducted to clarify the mechanisms
associated with the occurrence of TdP when using SSRI and inves-
tigating therapeutic measures to avoid/minimize these effects. The
literature search was conducted in PubMed data reviewing articles
between 2001 and 2016.
Results (1) Related to risk factors/intraclass differences: risk fac-
tors are increase in QTc interval ≥60ms from the pretreatment
value, advanced age, female sex, acute myocardial infarction and
electrolytic abnormalities among others. Citalopram appears more
likely than others to induce this phenomenon but its importance
is under current debate. (2) Related to dose: drug-induced QTc
interval prolongation and TdP was associated to citalopram in
doses > 40mg/day. However, psychotropic drug-induced sudden
cardiac death may be an outlier in the absence of identified risk
factors for QTc interval prolongation and TdP. (3) Related to poly-
pharmacy/management: there is an additive effect when using SSRI
and antipsychotics (EKG control is recommended in those cases).
Cross-sectional studies showed that SSRI use was not associated
with QT interval prolongation. This could be explained by the EKG
intra-intersubject variability.
Conclusions There is little evidence that drug-associated QTc
interval prolongation by itself is sufficient to predict TdP. Future
research needs to improve its precision to better understand the
factors that facilitate/attenuate that progression. Clarifying this
may lead to a safer SSRI use.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1064
Lithium and EKG abnormalities. A
review
A. Ballesteros ∗, Á.S. Rosero , H. Sáiz , E. García-Parre˜no , G. Carlos ,
E. Manrique
Osasunbidea, Psychiatry, Pamplona, Spain
∗ Corresponding author.
Introduction The literature concerning possible cardio-toxic
effects of lithium therapy in man is reviewed.
Methodology A review was conducted to clarify the mechanisms
associated with the occurrence of conducting abnormalities when
using lithium and investigating (if so) whether these alterations
depend on the dose. The literature searchwas conducted in PubMed
data reviewing articles between 1982 and 2015.
Results (1) Related to pathopsychiology/risk factors: reports
indicate T wave morphology changes with lithium therapy. Of par-
ticular concern are cases of sinus mode dysfunction or sinoatrial
block and the appearance or aggravation of ventricular irritabil-
ity. The incidence of cardiac complications, in general terms,
may increase with age. Recent findings (a retrospective study
of bipolar patients) of lithium-associated hypocalcaemia showed
that hypocalcaemia resulting from medical diseases and bipolar
patients with lithium-associated hypocalcaemia had significantly
higher frequencies of conduction defects. (2) Related/unrelated to
dose: therapeutic and toxic levels of lithium have infrequently
been associated with serious cardiac dysfunction. Several case
reports demonstrate two important points about Brugada syn-
drome unmasking: electrocardiograph abnormality severity may
correspond to lithium levels and unmasking may occur in the ther-
apeutic range of lithium. Other report shows a case of lithium
induced sinus-node dysfunction in a patient with serum lithium
levels in therapeutic range.
Conclusions Lithium abnormalities are rare and mostly not
related to dose. Conducting heart anomalies may occur, especially
when several factors are present (such as age or co-morbid illnesses
that affect calcium serum levels).
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1065
Prolactin levels in patients with
severe mental disorders: Are we doing
well? An observational study of Seville
area population
P. Blanco Ramón∗, N. Gomez-Coronado Suarez de Venegas ,
I. Martinez
Hospital Universitario Virgen del Rocio, Psychiatry, Sevilla, Spain
∗ Corresponding author.
Introduction It is well known that hyperprolactinemia increases
the risk of hypogonadism, osteoporosis and cardiovascular dis-
eases. Atypical anti-psychotics are directly related with its
development. Despite its importance, pharmacological hyperpro-
lactinemia it is not considered and treated by psychiatrists as much
as expected. Nowadays, long-acting aripiprazole is one of the main
treatments that barely increase the prolactin (PRL) levels.
Objectives To determine the number of cases in which PRL levels
are detected. To quantify the reduction of PRL levels with patients
treated with long-acting aripiprazole.
Methods Observational, descriptive study, from February 2015
to July 2016, of 52 patients treated with anti-psychotics, in two
Sevillian community mental health centers.
Results In 56% of cases, PRL level was measured at least one time:
in 77% of cases with prescription of long-acting aripiprazole, PRL
levels are reduced.
Conclusion First step to reduce the impact of hyperprolactine-
mia in patients is to determine the PRL levels in a systematic way
being this practice a must to be considered. In the study carried
out and described in this abstract, reduction of PRL levels in target
populations using long-acting aripiprazole is observed.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1066
Eosinophilia associated with
clozapine – A case report
T. Abreu , A. Carvalho∗ on Doellinger
Centro Hospitalar Tâmega e Sousa, Psychiatry and Mental Health
Department, Porto, Portugal
∗ Corresponding author.
Objectives Clozapine is an atypical anti-psychotic used in the
treatment of schizophrenia and other psychotic disorders. It is
associated with several side effects, namely, hematologic disor-
ders, the more common being agranulocytosis. Some cases of