European Psychiatry - Volume 41 - April 2017

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S756 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S710–S771
overweight including: physical passivity, unhealthy diet and
anti-psyhotic treatment. The prevalence of anti-psychotic-related
metabolic disturbances has been reported to vary from 23% to 50%
and clozapine and olanzapine had the most pronounced potential
to cause metabolic syndrome. We present the case of 32-year-old
male who has been diagnosed with first episode schizophrenia
spectrum psychosis and has been treated for 3months in the com-
munity mental health center. He was medication–compliant and
was prescribed olanazapine 10mg a day and had initial remission of
symptoms. The reason behind referral to our department of psychi-
atry was development of metabolic syndrome. Immediately upon
admission to our department basic panel blood tests (minerals, cre-
atinin, glucose, tryglicerides and cholesterol) as well as complete
blood count were done. Patient reported gaining weight of more
than 5 kilograms since the initiation of the olanzapine treatment.
Results of the performed metabolic tests in addition to abnormal
BMI and slightly higher blood pressure have indicated presence of
metabolic syndrome. In order to try to reverse metabolic syndrome
aripiprazole was commenced adjunctive to olanzapine. During the
first week the dosage of aripiprazole was 2.5mg/day, second week
5mg/day and then increased to 10mg a day. Three weeks after
adding aripiprazole to olanzapine lab values of holesterol, triglyc-
erides, fasting glucose aswell as BMI were significantly lowered and
symptoms of the metabolic syndrome were mitigated. Treatment
was well tolerated.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1083
Amisulpride-induced agranulocytosis:
A case report
H. Maatallah ∗, H. Ben Ammar , A. AIssa , R. Nefzi , M. Said ,
Z. El Hechmi
Razi Hospital, Psy F, Tunis, Tunisia
∗ Corresponding author.
Introduction Agranulocytosis is a potentially life-threatening
haematological side effect induced by typical and atypical neu-
roleptic. When agranulocytosis is associated with a specific
anti-psychotic, the medication should be discontinued. This severe
side effect is troublesome.
Case report We report the case of a 60-year-oldman, treatedwith
amisulpride for schizophrenia, who developed an agranulocytosis.
This patient had been treatedwith first and second generation anti-
psychotic drugs during his life and had already been exposed to
many neuroleptics without any signs of toxicity. However, after
three days of the introduction of amisulpride he presented a rapid
onset agranulocytosis (leukocytes 1.2G/L and neutrophils 0.4G/L).
After discontinuation of amisulpride, blood count returned to nor-
mal. The favorable evolution after discontinuation of treatment: the
normality of biological and cytological examinations is in favor of a
causal relationshipbetween this severe neutropenia al introduction
of amisulpride.
Conclusion This case report highlights the risk of amisulpride
in inducing agranulocytosis, a risk underestimated in regard of
the clozapine risk to induce agranulocytosis or neutropenia. For
this reason, it seems reasonable to recommend performing a
blood count before introduction and during the treatment by anti-
psychotics.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1084
Hepatotoxicity related to
anti-depressive
psychopharmacotherapy:
Implications of quantitative signal
detection
M. Gahr ∗, R. Zeiss , D. Lang , B.J. Connemann ,
C. Schönfeldt-Lecuona
1 University Hospital of Ulm, Psychiatry and Psychotherapy III, Ulm,
Germany
2 University Hospital of Ulm, Psychosomatic Medicine and
Psychotherapy, Ulm, Germany
∗ Corresponding author.
Introduction Drug-induced liver injury is a major problem of
pharmacotherapy and is also frequent with anti-depressive psy-
chopharmacotherapy.
Objectives/aims However, there are only few studies using a con-
sistent methodologic approach to study hepatotoxicity of a larger
group of antidepressants.
Methods We performed a quantitative signal detection analysis
using pharmacovigilance data from the Uppsala monitoring cen-
ter from the WHO that records adverse drug reaction data from
worldwide sources; we calculated reporting odds ratios (ROR) as
measures for disproportionality within a case-/non-case approach
for several frequently prescribed anti-depressants.
Results Both positive controls, amineptine (ROR 38.4 [95% CI:
33.8–43.6]) and nefazodone (ROR 3.2 [95% CI: 3.0–3.5]), were sta-
tistically associated with hepatotoxicity. Following amineptine,
agomelatine (ROR 6.4 [95% CI: 5.7–7.2]) was associated with the
second highest ROR, followed by tianeptine (ROR 4.4 [95% CI:
3.6–5.3]), mianserin (ROR 3.6 [95% CI: 3.3–3.4]) and nefazodone.
Conclusions In line with previous studies our results support the
hypothesis that agomelatine and several other anti-depressants
may be associated with relevant hepatotoxicity. However, the used
data and applied method do not allow a quantitative evaluation
of hepatotoxicity or assessment of substance–specific differences
regarding the extent of hepatotoxicity.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1085
Trazodone in treatment of
interferon-induced anxiety in persons
with viral hepatitis C
A. Miljatovic
Clinical Hospital Center “Zvezdara”, Psychiatric Hospital, Belgrade,
Serbia
Introduction The interferon therapy is associated with numerous
adverse psychiatric effects, such as tension, irritability, insomnia,
etc.
Goal The goal of this study was to examine the severity and the
frequency of anxiety in persons with chronic hepatitis C receiving
pegylated interferon alpha combined with ribavirin. We have also
tried to assess the efficiency of trazodone in treatment of symptoms
of anxiety in patients receiving pegylated interferon.
Method The total of 36 patients whose diagnosis of chronic
hepatitis C has been confirmed both serologically and patohisto-
logically, receiving interferon therapy, ages 22 to 60, participated
in this study. The control group consisted of 32 patients, all with
same diagnosis, corresponding with those in the study group
in terms of gender, age duration of the illness and the level of
education. All patients received pegylated interferon alpha 2a,
administered subcutaneously once per week, along with oral rib-
avirin. The research used the following instruments of clinical