Use of cariprazine as an impulsivity regulator in an adolescent with non suicidal self-injury and suicidal attempts. Case report

Introduction Adolescents with emotional dysregulation are at risk for self-injury. Antipsychotics are often used to manage these symptoms. Objectives The aim of the present case is to show the use of cariprazine as an effective drug for emotional dysregulation and impulsivity in a 17-year-old adolescent girl Methods Case report Results The patient was a 17-year-old female admitted to in patient psychiatric unit for a self-harm attempt due to sertraline overdose. She was being followed up for self-injury, anxiety and eating disorder symptoms. Her treatment was sertraline 200 mg, diazepam 20 mg per day and olanzapine 15 mg per day. With this medication she had gained up to 7 kgs in 4 months. A progressive change was made with cariprazine up to 3 mg and olanzapine was reduced to 2.5 mg at night. With this adjustment the patient did not present worsening in anxiety levels, with adequate impulse control and being able to perform emotional regulation strategies. Conclusions Although it has no indication in patients under 18 years of age, it shows a case of good tolerance and efficacy for the management of impulsivity by improving emotional regulation. Cariprazine is an atypical antipsychotic that works through partial agonism on dopaminergic receptors, serotonin 5-HT1A receptors and an antagonist at the 5-HT2B receptors, with moderate affinity for adrenergic, histaminergic, and cholinergic receptors reducing the likelihood of side effects Disclosure of Interest None Declared

Introduction: Impulsivity in adolescents has been largely studied as it is frequently observed in that phase.However, the relationship between impulsivity and emotion regulation has been rarely explored.
Objectives: Our study aimed to assess impulsivity and emotional regulation in medical students as well as to explore the link between them.Methods: This was a descriptive and analytical cross-sectional study conducted from September to December 2017, among first and second year students of the medical school of Sfax who were aged between 18 and 19 years.We collected sociodemographic as well as clinical data of the participants."Barratt Impulsivity Scale" (BIS) and "Difficulties in Emotion Regulation Scale" (DERS) were used to assess impulsivity and emotion regulation respectively.Results: One hundred students were included in our study, with a mean age of 18 years and a sex ratio of 0.81.Among them, 62% were smokers with an average consumption of 19.6 packets year.Alcohol and cannabis use was reported by 9% and 5% of the students respectively.The mean impulsivity score on the Barratt scale was 66.78 AE 9.44 with scores ranging from 40 to 112.Among our participants, 25% had a high level of impulsivity (score > 72).Unplanned impulsivity was the dimension with the highest mean score (23.74AE4.64).Our results showed that impulsivity was significantly associated with the male gender (p=0.002) and smoking (p<10-3).As for emotion regulation, the mean score on the DERS scale was 78.8 AE17.The majority of the students (64%) had a moderate difficulty in regulating emotions.Our results showed a positive correlation between impulsivity and emotional regulation with a moderate link (p=10-3; r= 0.57).The high emotion dysregulation group had a significantly higher score on the two dimensions of impulsivity: attentional impulsivity (p=10-3) and unplanned impulsivity (p=0.047).Conclusions: Our study highlights the relationship between emotion dysregulation and impulsivity, suggesting that emotion regulation may be an important factor to consider when assessing impulsive adolescents.

EPV0202
Use of cariprazine as an impulsivity regulator in an adolescent with non suicidal self-injury and suicidal attempts.Case report Introduction: Adolescents with emotional dysregulation are at risk for self-injury.Antipsychotics are often used to manage these symptoms.
Objectives: The aim of the present case is to show the use of cariprazine as an effective drug for emotional dysregulation and impulsivity in a 17-year-old adolescent girl Methods: Case report Results: The patient was a 17-year-old female admitted to in patient psychiatric unit for a self-harm attempt due to sertraline overdose.She was being followed up for self-injury, anxiety and eating disorder symptoms.Her treatment was sertraline 200 mg, diazepam 20 mg per day and olanzapine 15 mg per day.With this medication she had gained up to 7 kgs in 4 months.A progressive change was made with cariprazine up to 3 mg and olanzapine was reduced to 2.5 mg at night.With this adjustment the patient did not present worsening in anxiety levels, with adequate impulse control and being able to perform emotional regulation strategies.Conclusions: Although it has no indication in patients under 18 years of age, it shows a case of good tolerance and efficacy for the management of impulsivity by improving emotional regulation.Cariprazine is an atypical antipsychotic that works through partial agonism on dopaminergic receptors, serotonin 5-HT 1A receptors and an antagonist at the 5-HT 2B receptors, with moderate affinity for adrenergic, histaminergic, and cholinergic receptors reducing the likelihood of side effects Disclosure of Interest: None Declared

EPV0203
Lisdexamfetamine in combination with guanfacine as an effective treatment in the management of behavioral disturbances in patients with Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD).Case report