European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S772–S846 S837
sis. We started treatment with corticosteroids in spite of we did
not observe a decompensation of sarcoidosis. In a few days it was
remarked a clinical improvement and remission of the delusional
and affective clinic.
Conclusions It is needed to complete the study and continue the
monitoring of the patient to see the evolution and drug response.
The diagnosis of neurosarcoidosis should be kept in mind for
patients with both neurologic and psychiatric symptoms.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1318
Can drug interaction be useful?
Case report of a schizophrenic patient
treated with paliperidone long-acting
injection
M. Sarpe ∗, M. Bran , L. Maria
1 Senior MD. Psychiatrist, CMI Marcel Sarpe, Private Practice, Focsani,
Romania
2 Assistant Professor, University of Medicine and Pharmacy “Carol
Davila”, Bucharest, Romania
3 Associate Professor, University of Medicine and Pharmacy “Carol
Davila”, Bucharest, Romania
∗ Corresponding author.
Introduction Intramuscular paliperidone palmitate (PLAI) is a
long-acting atypical anti-psychotic approved in Romania for the
maintenance treatment of adults with schizophrenia.
Objectives To determine the efficacy and tolerability of PLAI in
a non-compliant patient with previously very low tolerability to
oral anti-psychotics. The patient had been on risperidone long act-
ing injection (RLAI) and had significant adverse events (i.e. tremor,
akatisia) which persisted even when treated with the lowest dose
of PLAI: 50mg.
Aims Since the efficacy of PLAI was good, and since a lower dose
(than 50mg of PLAI) is not available in Romania, we tried differ-
ent ways to lower plasma concentration (PC) of the anti-psychotic
because the patient presented clinically significant adverse effects
(AE).
Methods Initially the time between the injections was extended
at maximum recommended (35 days), with a slight effect, then an
off label treatment was associated in order to lower the PC of PLAI.
We used 300mg of carbamazepine long acting, that may lower the
PC of PLAI up to 30%. For the evaluation of the efficacy and tolera-
bility, we applied: the clinical evaluation, the positive and negative
syndrome scale, the Barnes Akathisia rating scale, the Simpson-
Angus Scale and the abnormal involuntary movement scale.
Results After using the above mentioned, strategies, the one that
had indeed good results on reducing AE, with no alteration of the
psychic status of the patient, was the association of carbamazepine.
Conclusions In clinical practice, some off label medication asso-
ciations may be salutary!
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV1319
Tracking referrals to early
intervention in psychosis team:
An audit
J. Sharma
Black Country Partnership Foundation NHS Trust, Early Intervention
Services, West Bromwich, United Kingdom
Aims To monitor if the early intervention services (EIS) in
Sandwell meet the standard of assessing all patients referred to
the team within the set target. To monitor factors that affects the
outcome including the source of referral, whether the patients,
are known to another team, and the demographic features of the
patient.
Background Providing timely, appropriate and coordinated care
for patients presenting with a first episode of psychosis has been
a focus for EIS teams to improve outcomes, experiences and in
reducing costs. In April 2016, new target times of 5–10 days for
referral-to-assessment and 14 days for referral-to-treatment were
introduced by the government.
Method All the referrals that were made since 01/04/2016
were followed up. A comparison was made with the referral-to-
assessment and referral-to-treatment target for referrals made
before the 01/04/16.
Results There has been an increase in referrals. Preliminary
evidence gathered suggests that there has been a marked
improvement in the referral-to-assessment pathway and referral-
to-management pathway. Patients referred to the EIS are offered
an earlier assessment. Majority of the referrals made are however
not appropriate to receive care from the EIS, and are not taken on by
the team. All the patients that are accepted by the team are offered
a NICE treatment package. Most of the referrals that come from
other EIS teams or wards, are accepted by the team, at least for an
extended assessment. Referrals from Children services are usually
at the point when they are due to turn 18, for a second opinion.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV1320
Antipsychotics in first-episode
psychosis: Patterns of prescription in
an inpatient unit
F. Monteiro∗ zevedo , L. Monteiro , C. Machado , G. Franc¸ a ,
A. Norton , A. Reis
Hospital de Magalhães Lemos, Inpatient Unit C, Porto, Portugal
∗ Corresponding author.
Introduction The treatment of first-episode psychosis patients
is different from those with multiple-episode schizophrenia: the
response to antipsychotics is better, the required doses are lower
and the sensitivity to side-effects is higher. As such, current guide-
lines recommend a “start slow, go slow” strategy and an active
avoidance of side-effects.
Objectives/aims To know the patterns of antipsychotic prescrip-
tion in first-episode psychosis patients of our inpatient unit.
Methods We retrospectively reviewed the clinical data of all non-
affective first-episode psychosis patients admitted to the Inpatient
Unit C of Hospital de Magalhães Lemos during 2015. The antipsy-
chotics prescribed at admission and discharge were recorded, as
well as the doses.
Results A total of 29 patients were identified. The mean age was
36.6 and 65.5%wereman. At admission, all patientsweremedicated
with second-generation antipsychotics: 62.1% with risperidone,
27.6% with olanzapine, 6.9% with paliperidone and 3.4% with arip-
iprazol. The mean dose of risperidone was 3.5mg/day. By the
time of discharge, 34.5% of patients were prescribed a depot
antipsychotic, half of them risperidone. Among those with oral
medication only, 55.5%were prescribed risperidone, 22.2%paliperi-
done and the remainder 22.3% other antipsychotics (aripiprazol,
olanzapine or quetiapine). The mean dose of risperidone was
3.7mg/day.
Conclusions Second-generation antipsychotics are clearly pre-
ferred. The mean dose by the time of discharge is similar to that
used in clinical trials. However, antipsychotics are initiated at doses
above theminimumeffective dose. On discharge, an important pro-
portion of patients are prescribed depot antipsychotics, which are
known to improve medication adherence.