Use and experience with six-monthly paliperidone in the Campo de Gibraltar area. Descriptive study.

Introduction Long-acting injectable antipsychotics have demonstrated advantages over therapeutic adherence and can reduce the rates of relapses and due to treatment discontinuation. The novel presentation of paliperidone palmitate six-month (PP6M) can simplify the treatment to two injections per year. Objectives The purpose of the present research is to describe the profile of patients receiving this novel treatment in our area. For this, a descriptive study has been carried out. Methods We have collected and analyzed data from a total of 8 patients from the global long-acting injectable nursing registry in our area. The data collection was from May 2022 to October 2022. Results ID Patient Age Gender Medical comorbidities Social support Adherence to previous LAI EP001AGC 52 M No - Yes EP002EGA 53 M No Low No EP003ESL 45 F YesHIV, HCV, dyslipidemia, Enough Yes EP004ACG 60 M YesHypertension, dyslipidemia Good Yes EP005DCP 52 M YesCOPD Enough Yes EP006ATT 47 M No Enough / Low Yes EP007AH 40 F YesTension headache Enough Yes EP008IAR 66 F YesType 2 diabetes mellitus, hypertension, hyperuricemia Enough Yes ID Patient Diagnosis Refractory positive symptoms Last H. Polypharmacy Previous injection Injection date / Dose H. / Side Effects EP001AGC Paranoid schizophrenia - 08/03/2014 No PP3M525mg 17/05/221.000 mg No EP002EGA Schizoaffective disorder Yes 19/08/2022 YesValproic acid 1.000mg PP1M150mg(once) 13/09/221.000mg No EP003ESL Paranoid schizophrenia No 17/04/2019 YesOlanzapine 10mgBZD PP3M525mg 10/08/221.000mg Sedation (low) EP004ACG Paranoid schizophrenia No - YesQuetiapine 50mg PP3M525mg 16/09/221.000mg No EP005DCP Paranoid schizophrenia No 16/01/2004 YesOlanzapine 20mgBZD PP3M525mg 11/10/221.000mg No EP006ATT Persistent delusional disorder Yes - No PP3M525mg 19/09/221.000mg No EP007AH Paranoid schizophrenia No 2017 No PP3M525mg 03/08/221.000mg No EP008IAR Persistent delusional disorder Yes - YesBZD Paliperidone oral 9mg and laterPP3M350mg(twice) 18/10/221.000mg No Fig. 1: Sociodemographic characteristics and Fig. 2: Clinical characteristics. Conclusions None of the patients required hospitalization at the time of the study, although this work team considers that it is early to make conclusions in this regard. No serious or minor adverse effects were reported in any of the cases during the time of the investigation, apart from one case of mild sedation. The clinical characteristics of most patients were psychopathological stability and good adherence to previous treatment. Although this study shows that the drug was also used in patients who did not meet these characteristics, specially one case of poor social support. The data collected show that the profile of the patient in whom the drug has been prescribed can be varied and broad. Disclosure of Interest None Declared

Introduction: Risperidone is a benzisoxazole derivative and is an antipsychotic drug that is frequently used in psychiatric disorders with high binding to 5HT-2A, D2, α1-adrenergic and α2adrenergic receptors.It is a second generation antipsychotic and the most common side effects are known as extrapyramidal symptoms, weight gain, sedation, hyperprolactinemia, dizziness, insomnia, anxiety and nausea.Edema has been reported in a few cases as a side effect of risperidone in the literature.Objectives: In this case report, we aimed to present a case of peripheral edema developed in a patient using escitalopram combined with risperidone and to review the literature on this subject.Methods: A 48-year-old male presented to the outpatient psychiatry clinic with symptoms of difficulty in controlling his irritability and anger, damaging the things around him, depression, loss of interest and desire, sleep disturbance, fatigue, and feelings of worthlessness.The patient also applied to the psychiatry outpatient clinic with similar symptoms 5 months ago, and had been on sertraline 50 mg/day and quetiapine 25 mg/day since then.But it was learned that he did not benefit, so his treatment was adjusted as escitalopram 10 mg/day and risperidone 1 mg/day.The patient, who came to the outpatient clinic control after 1 month and did not describe a similar complaint before, described peripheral edema that developed approximately 2 weeks after he started using psychiatric medication.On examination, 3þ pretibial peripheral edema was detected.Since the patient had a previous history of escitalopram use, it was recommended to continue escitalopram 10 mg/day treatment, and risperidone 1 mg/day was discontinued and he was called for control.Results: It was observed that the edema completely resolved within 2 weeks following the discontinuation of risperidone treatment.Conclusions: In conclusion, risperidone is an antipsychotic frequently used in clinical practice, and edema is a rare but important side effect and can be encountered even at low doses.Despite the low incidence, this side effect should be considered by clinicians.There is a need for controlled studies that explain the relationship between risperidone and edema, elucidate the mechanism of edema and investigate its incidence.

EPV0831
Use and experience with six-monthly paliperidone in the Campo de Gibraltar area.Descriptive study.
Introduction: Long-acting injectable antipsychotics have demonstrated advantages over therapeutic adherence and can reduce the rates of relapses and due to treatment discontinuation.The novel presentation of paliperidone palmitate six-month (PP6M) can simplify the treatment to two injections per year.
Objectives: The purpose of the present research is to describe the profile of patients receiving this novel treatment in our area.For this, a descriptive study has been carried out.Methods: We have collected and analyzed data from a total of 8 patients from the global long-acting injectable nursing registry in our area.The data collection was from May 2022 to October 2022.
Conclusions: None of the patients required hospitalization at the time of the study, although this work team considers that it is early to make conclusions in this regard.No serious or minor adverse effects were reported in any of the cases during the time of the investigation, apart from one case of mild sedation.The clinical characteristics of most patients were psychopathological stability and good adherence to previous treatment.Although this study shows that the drug was also used in patients who did not meet these characteristics, specially one case of poor social support.The data collected show that the profile of the patient in whom the drug has been prescribed can be varied and broad.

EPV0832
Lithium neurotoxicitya case report and review of the literature C. Almeida Rodrigues1 *, A. Carvalho2 , F. Martins Costa 1 and V. Silva de Melo 1 Introduction: Lithium, a mood stabilizer, is a commonly prescribed and effective treatment for bipolar affective disorder.It´s excreted almost exclusively by the kidneys with a half-life primarily determined by renal function.Chronic intoxication results from an insidious accumulation of lithium in a chronically medicated patient (due to a reduction in renal function secondary to volume depletion, a new medication, et cetera).Patients often present with neurologic findings, including tremor, ataxia, dysarthria, confusion and neuromuscular excitability.Objectives: The objective of this report is to describe a clinical case of lithium neurotoxicity (myoclonus and encephalopathy), along with a review of the literature on the topic.Methods: We describe a case of lithium neurotoxicity, along with a brief non-systematic review of the literature on lithium toxicity.We conducted a PubMed bibliographic search using keywords such as "lithium intoxication", "lithium neurotoxicity", "lithium encephalopathy" and "lithium intoxication treatment".Results: A women aged 81 was brought to the emergency department by her daughter following 1 week of asthenia, diarrhoea, periods of confused speech and involuntary movements.In the previous week, the patient had been diagnosed with COVID-19.Her past medical history is significant for bipolar affective disorder, hypertension, diabetes mellitus, dyslipidemia and asthma.The patient has been treated with following drugs: lithium carbonate (no recent change of dose and previous serum levels around 1mmol/L), quetiapine, lisinopril, metformin, simvastatin, formoterol and budesonide.On the first examination, she had an exuberant multifocal myoclonus.Posteriorly, she became somnolent, with language impairment (verbal perseveration, echolalia) and dysarthria.Investigations revealed renal impairment (creatinine 1,5 mg/dL, blood urea nitrogen 42 mg/dL) and supratherapeutic lithium levels