European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S710–S771 S761
aripiprazole is approved for the acute management of manic and
mixed episodes and maintenance in BPD. It presents the advantage
of a low risk of metabolic side effects, sexual dysfunction, and seda-
tion, which can facilitate treatment adherence and help improve
clinical outcomes.
Objectives The authors present an illustrative case on which
aripiprazol long acting injection monotherapy was effective as
maintenance treatment in a patient with long history of BPD with
several hospital inpatient admissions and very poor therapeutic
adherence.
Methods Case report based on the patient’s file. Narrative review
of articles available in PubMed about the use of aripiprazol in BPD.
Results For this patient, aripiprazol long acting injection has
proved to be an excellent choice for long-term treatment of
BPD. The once-a-month injection promotes therapeutic adherence,
which in this casewas combinedwith involuntary outpatient treat-
ment, ensuring therapeutic compliance.
Conclusions Aripiprazol has been shown to be safe and effec-
tive in the maintenance treatment in BPD. It shows similar efficacy
and a superior tolerability profile when compared with other well-
established treatments. Further studies are needed, warranted by
its potential advantages, particularly on patients with poor insight
and adherence.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1098
Treating bipolar disorder in pregnancy
C. Solana∗, S. Nascimento , M. Mendes , M. Duarte
Centro Hospitalar Psiquiatrico de Lisboa, Psychiatry, Lisboa, Portugal
∗ Corresponding author.
Introduction Bipolar disorder is a chronic psychiatric illnesses
characterized by alternating episodes of mania/hypomania and
major depression, or with mixed features. Acute exacerbations
and maintenance treatment with appropriate pharmacotherapy
are mandatory. Long-term treatment with mood-stabilizing med-
ications is typically required. The incidence of bipolar disorders in
women during the primary reproductive years is very high, and
the episodes of mania or depression are thought to occur in an esti-
mated 25%–30% of women with bipolar disorder during pregnancy.
Objectives Provide a clinically focused review of the available
information on the effectiveness and safety of the different pharma-
cotherapies in the treatment of bipolar disorder during pregnancy.
Methods Abibliographic review ismade of the pregnancy inbipo-
lar disorder, based on the data published in PubMed.
Results Clinical decisionmaking about the use ofmood stabilizers
and atypical anti-psychotics by pregnant women can be conceptu-
alized as balancing the competing risks imposed by withholding or
stopping pharmacotherapeutic treatment against that of continu-
ing or initiating pharmacotherapy during pregnancy. Some of the
most effective pharmacotherapies have been associated with the
occurrence of congenital malformations or other adverse neonatal
effects in offspring. There is few information about the safety pro-
file and clinical effectiveness of atypical anti-psychotic drugs when
used to treat bipolar disorder during pregnancy.
Conclusions Treating women with bipolar disorders during preg-
nancy is a challenge. There are no uniformly effective or risk-free
treatment options. Fully informed decision-making requires the
review of the risks of both untreated maternal bipolar disorder and
risks associated with potentials interventions.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1099
A case report of an acute confusional
state related with perampanel
M. Solerdelcoll Arimany ∗, P. Bruguera , P. Guzmán ,
M. Balcells Oliveiró
1 Institute of Neuroscience, Hospital Clínic de Barcelona, Department
of Psychiatry and Psychology, Manlleu, Spain
2 IInstitute of Neuroscience, Hospital Clínic de Barcelona, Department
of Psychiatry and Psychology, Barcelona, Spain
∗ Corresponding author.
Introduction Perampanel (PER) is a new selective, non-
competitive AMPA glutamate receptor antagonist. PER is generally
well tolerated, with dizziness, somnolence, headache, and fatigue
as the most common treatment-emergent adverse events, how-
ever neuropsychiatric adverse reactions; particularly irritability
and aggressiveness can be expected.
Objective We describe a patient who developed and acute con-
fusional state presumably related to treatment with PER.
Aims At the conclusion, the participants should be able to
remember that PER is associated with psychiatric side effects.
Methods Collect the data of the clinical history of the patient, who
was admitted in the acute psychiatry ward of our hospital.
Results A 32-year-old woman diagnosed with pharmacoresis-
tant juvenile myoclonic epilepsy, was referred to the emergency
department because of severe behavioral disturbances, insomnia,
irritability and aggressivity after increasing the dose of PER from
6 to 12mg. Physical exploration, drug screen and blood tests were
all normal. No abnormalities were found in CT, EEG and MRI, and
then she was referred to psychiatric ward. At her admission, she
presented fluctuations of her mental state and level of conscious-
ness. She was diagnosed with acute confusional syndrome induced
by PER, and consequently PER was stopped and risperidone was
initiated. In the 4th week symptomatology remitted.
Conclusion Anti-epileptic drug’s (AEDs) are associated with psy-
chiatric side effects. Patients with epilepsy have higher risk
develop psychiatric symptoms and behavioral disturbances. There
is evidence to suggest that AMPA receptors are involved in the
pathogenesis of psychiatric conditions. Such mechanisms could be
responsible of the psychiatric symptoms observed. Neuropsycho-
logical profiles of AEDs are important considerations for treatment
selection, particularly in children and adolescents.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1100
A retrospective study of drug – drug
interactions in patients treated with
pharmacotherapy in the biggest
Slovenian correctional facility
M. Stuhec ∗, S. Brunec , V. Svab
1 Faculty of Pharmacy, Biopharmacy and Pharmacokinetics,
Ljubljana, Slovenia
2 Faculty of Medicine, Department for Psychiatry, Ljubljana, Slovenia
∗ Corresponding author.
Background Drug-drug interactions (DDIs) are known to lead to
treatment failure.
Objectives In most European countries there are no data on DDIs
in patients within correctional facilities.
Aim The main aim of this paper is to present the most frequent
DDIs in the biggest Slovenian male, Slovenian correctional facility
Dob to avoid serious DDIs in future.
Methods A retrospective study was carried between September
2015 and June 2016 on 141 patients on substitution treatment
(methadone, suboxone and buprenorphine) and 125 other prison-
ers with mental disorders in need for psychiatric treatment were