European Psychiatry - Volume 41 - April 2017

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S752 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S710–S771
the safest SSRIs. Although most SSRI’s have a mild side-effect pro-
file, care should be taken when initiating SSRIs since unpredictable
adverse effects may occur.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1070
Anti-psychotics: To withdraw or not
to withdraw?
C. Ferreira ∗ lves , C. Oliveira , M.J. Avelino
Centro Hospitalar Psiquiátrico de Lisboa, SETA, Lisbon, Portugal
∗ Corresponding author.
Introduction Anti-psychotics constitute a class of psychotropic
drugs used for the treatment and prophylaxis of several disorders,
including schizophrenia, bipolar disorder and psychotic depres-
sion. Frequently, clinicians are asked by their patients to withdraw
this medication. In some cases, that may be related to notable side
effects. However, it may actually indicate an inadequate control of
the psychiatric disorder with poor insight.
Aims The goal of this work is to systematically review the scien-
tific literature in order to understand if there are consistent data
that support anti-psychotics withdraw in specific clinical situa-
tions.
Methods The literature was reviewed by online searching using
PubMed®. The authors selected scientific papers with the words
“anti-psychotics” and “withdraw” in the title and/or abstract, pub-
lished in English.
Results and discussion Anti-psychotics improve prognosis and
enhance patients’ quality of life. There are few data in the lit-
erature regarding recommendations that support anti-psychotic
withdraw in psychiatric patients. Very specific conditions must
exist for withdrawing anti-psychotics, like neuroleptic malignant
syndrome, cardiac side effects, and change of diagnosis or pro-
longed remission after a first and single psychotic event. When that
decision is made, it should be done slowly and carefully and both
the patient and his family should be involved.
Conclusions There is no evidence in the literature that supports
withdraw of anti-psychotics for the majority of psychiatric situa-
tions. When specific conditions are present that possibility must
then be considered, however, with careful consideration and after
discussion with the patient and parties involved in patient’s care.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1071
Selective serotonin reuptake
inhibitors, anti-psychotics and
metabolic risk factors in
schizophrenia and bipolar disorder
K.K. Fjukstad ∗, A. Engum , S. Lydersen , I. Dieset ,
N.E. Steen , O. Andreassen , O. Spigset
1 Nord–Trøndelag Hospital Trust, Department of psychiatry,
Levanger, Norway
2 Norwegian University of Science and Technology, Department of
Laboratory Medicine, Children’s and Women’s Health, Trondheim,
Norway
3 St. Olav University Hospital, Department of Psychiatry, Trondheim,
Norway
4 Norwegian University of Science and Technology, Regional Centre
for Child and Youth Mental Health and Child Welfare, Trondheim,
Norway
5 University of Oslo, Norment, KG Jebsen Centre for Psychosis
Research, Oslo University Hospital, Oslo, Norway
6 Vestre Viken Hospital Trust, Drammen District Psychiatric Center,
Clinic of Mental Health and Addiction, Drammen, Norway
7 St. Olav University Hospital, Department of Clinical Pharmacology,
Trondheim, Norway
∗ Corresponding author.
Objective The aimof this studywas to investigate the relationship
between metabolic factors and use of selective serotonin reuptake
inhibitors (SSRIs) combined with olanzapine, quetiapine or risperi-
done.
Method Data from a cross-sectional study on 1301 patients
with schizophrenia or bipolar disorder were analyzed. The main
outcome variables were levels of total cholesterol, low – and high-
density lipoprotein (LDL and HDL) cholesterol, triglycerides and
glucose.
Results One defined daily dose (DDD) per day of an SSRI in
addition to olanzapine was associated with an increase in total
cholesterol of 0.16 (CI: 0.01 to 0.32)mmol/L (P = 0.042) and an
increase in LDL–cholesterol of 0.17 (CI: 0.02 to 0.31)mmol/L
(P = 0.022). An SSRI serum concentration in the middle of the
reference interval in addition to quetiapine was associated with
an increase in total cholesterol of 0.39 (CI: 0.10 to 0.68)mmol/L
(P = 0.011) and an increase in LDL-cholesterol of 0.29 (0.02 to
0.56)mmol/L ( P= 0.037).When combinedwith risperidone, no such
effects were revealed. No clear-cut effects were seen for HDL-
cholesterol, triglycerides and glucose.
Conclusion The findings indicate only minor deteriorations of
metabolic variables associated with treatment with an SSRI in
addition to olanzapine and quetiapine, but not risperidone. These
results provide new insight in the cardiovascular risk profile asso-
ciated with concomitant drug treatment in patients with severe
mental illness, and suggest that SSRIs can be combined with
anti-psychotics without a clinically significant increase of adverse
metabolic effects.
Disclosure of interest Co-author Dr. Ole Andreassen has received
speakers’ honoraria from GSK, Lundbeck and Otsuka.
EV1072
Clozapine: Since the very beginning?
L. Garcia Ayala ∗, M. Gómez Revuelta ,
C. Martín Requena , E. Saez de Adana Garcia de Acilu ,
O. Porta Olivares , M. Juncal Ruiz , N. Nu˜nez Morales ,
M. Zubia Martín , M. Laborde Zufiaurre ,
B. González Hernández , A. Aranzabal Itoiz , M.P. López Pe˜na ,
A.M. González-Pinto Arrillaga
1 Osakidetza, Psychiatry, Salvatierra-Agurain, Spain
2 Osakidetza, Psychiatry, Vitoria, Spain
3 Marqués de Valdecilla, Psychiatry, Santander, Spain
∗ Corresponding author.
Introduction Psychosis in childhood and adolescence could be
defined as having hallucinations, with the hallucinations occurring
in the absence of insight. A broader definition includes symp-
toms such as delirious thoughts, disorganized speech, disorganized
behavior, cognitive and mood symptoms and what is called nega-
tive symptoms. Several researches have been done focused in the
treatment of first episode of psychosis showing clozapine as a key-
stone in the treatment of psychosis, especially in refractory first
episodes.
Objectives Clozapine has unique efficacy in improving treatment-
resistant patients with chronic schizophrenia but the moment of
instauration remains unclear. There have always been doubts about
the right moment to start clozapine, after two or more previous
anti-psychotics or as first option.
Materials and methods We report a 18-year- old woman with
family history of severe psychosis. Her mum reasserted patient’s
symptoms contributing to a longer period of non-treating psychosis
(about 10months). Auditory hallucinations, incongruent mood and