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P.7.009 Ziprazidone among adolescents with overlapping OCD and Tourette's syndrome: pilot study
P7 Child and adolescent disorders
$596
analysed. Analytical procedure: we used the method described by WH Chang et al. (1983). Results: At admission anorexic patients had a significantly higher mean in pHVA (14.2±6.9) than controls (9.3±6.7) (p 0.002), but not at discharge after weight recovery. Between admission and discharge there was a statistically significant improvement in body mass index (p < 0.001), in nutritional parameters such as prealbumin (p < 0.001), Insulin-like growth factor I (p < 0.001), Insulin-like growth factor binding protein (p < 0.001), triiodothyronin (p < 0.001), in pHVA (p 0.036) and in different scales such as the EAT (p 0.006), the BDI (p 0.001) and the STAI (p 0.015). At admission, a subgroup of patients (N 14; 32%) had a very high pHVA level (mean of the control subjects plus standard deviation) and this subgroup obtain significantly higher scores on the BDI (p 0.009). Conclusion: While underweight, anorexic patients have a higher mean pHVA that tend to normalization after weight recovery and nutritional restoration. At admission, a subgroup of patients have very high levels of pHVA and higher scores on depressive symptomatology.
References [1] Wen-Ho Chang, M Scheinin, S Burns, M Linnoila. Rapid and simple determination of homovanilic acid in plasma using high performance liquid chromatography with electrochemical detection. Acta Pharmacol et Toxicol 1983; 53:275 79.
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Ziprazidone among adolescents with overlapping OCD and Tourette's syndrome: pilot study
Result" Despite the fact that the treatment began with 2 0 m g of Ziprazidone, no patient showed improvement, and even 40 mg of Geodon did not help. In 6 patients we observed improvement of OCD syndrome (CY-BOCS scores 28% mean degrease from baseline) with a dosage between 60 80 mg (60 + 20 mg capsule in bed time). Among 9 adolescents we observed much improvement of both symptoms after 4 week treatment with a dosage from 80 to 120 140mg. (CGI-TS Severity baseline 4.5±0.6 endpoint 2.6±1.2) Conclusion: Taking into consideration the fact that co-morbid OCD and Tourette's syndrome is influenced by medications of different pathway influence, the studies of athipical antipsychotics with both dopamine and serotonine properties are promising. Thus, the atypical antipsychotics with dopamine and serotonine properties can perhaps become the most useful medication. However, a new control study with a larger target group is needed.
References [1] Thomsen PH, Leckman J. [Obsessive-compulsive disorders in children. Subtypes of OCD and their relation to infection with group A streptococci] Ugeskr Laeger. 2002 Aug 5; 164(32): 3763 7. [2] Maruke Yeghiyan et al. [Tourette's spectrum disorders among adolescents and efficiency of combo therapy with Risperidon and Fluvoxamin.] Association of European Psychiatrists Congress. Geneva 14 18 April 2004 P-149: 239. [3] Floid R et al. [Ziprazidone treatment of Children and Adolescents with Turette's syndrome; A pilot Study.] J. Am. Acad. Child & Adol. Psych. 2000; 39(3): 299299.
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Changes in platelet monoamine oxidase activity, cholesterol levels and hyperactive behaviour over a period of three years in adolescents
M. Yeghiyan*, M. Tozalakyan, A. Veliciyan, G. Yeghiyan.
Association Child Psychiatty & Psychology, Child Adolescent Mental Health Centre, Yerevan, Armenia Background: OCD with an onset in childhood or early adolescents is usually presented as a specific subtype, with more boys affected and frequently co-morbid with tics and Tourette's syndrome [1]. Our observation in clinical practice indicates that during the pharmacotherapy the OCD and Tourette syndromes shift continuously. As a result for successful treatment medication should be changed from SSRI-s to Antipsychotic with Dopaminolitic properties or combination of both is needed [2]. We assume that medication with both serotoninergic and dopaminolitic properties may be useful for the treatment subtype of OCD spectrum mentioned above. Among the atypical antipsychotic Zyprazidone is the only drug with appropriate properties and this medication may act as ideal for treating OCD with Tourette's syndrome [3]. Objective: To investigate the Ziprazidone (Geodon) effectiveness among adolescents with co-morbid OCD and Tourette's syndrome. Method: In open studies we conducted 8 week trial of 14 adolescents (12 15 year old, 9 male and 5 female) with co-morbid OCD and Tourette's syndrome. All patients were pretreated for several years with a number ofpsychotropic medications including haloperidole, sulpiride, sertraline, fluvoxamine and clomipramine. Before starting the study all patients passed two week drug washout period. All patients were diagnosed according to DSM4 criteria of OCD and ICD-10 criteria of Tic disorders. Also patients held CY-BOCS and Zung tests for depression and CGITS-S. Dosage range of Geodon was from 20 to 80 140 mg./day depending on the effectiveness.
E. Kiive 1 *, L. Merenakk 2, M. Harro 3, J. Harro 1 . ]University of
Tartu, Psychology, Tartu, Estonia; 2University of Tartu, Public Health, Estonia; 3National Institute for Health Development, Health Behaviout; Estonia Platelet monoamine oxidase (MAO) activity is a peripheral marker of central serotonergic activity, and has been associated with aggressive, impulsive and hyperactive behaviour, alcohol and drug abuse. Central serotonergic activity has also been associated with plasma cholesterol levels. The purpose of the present longitudinal investigation in adolescents (described in more detail in [1]) was to study the changes in platelet MAO activity and plasma cholesterol levels over three years, and their possible association with changes in aggressive and hyperactive behaviour, smoking, alcohol and drug use. Data of 320 adolescents (132 boys, 188 girls) were used. The measures were taken at age 15 and 18 years. Psychological data were obtained from teachers by using the Hyperactivity Scale [2]. Adolescents reported alcohol, illicit drug use and their smoking habits in a questionnaire. Platelet MAO activity was measured by radioenzymatically with 14C-labelled b-phenyl-ethylamine as the substrate. Fasting basal cholesterol (total and HDL) was measured by standard methods. In most of the tested individuals, platelet MAO activity is a relatively stable measure, but the correlation between two MAO measurements with three years interval was 0.56 as there was a significant number of subjects with a noticeable change in MAO activity. An increase or a decrease in enzyme activity was found with similar frequency. There was a significant but weak negative correlation between changes in platelet MAO activity and smoking
$596
analysed. Analytical procedure: we used the method described by WH Chang et al. (1983). Results: At admission anorexic patients had a significantly higher mean in pHVA (14.2±6.9) than controls (9.3±6.7) (p 0.002), but not at discharge after weight recovery. Between admission and discharge there was a statistically significant improvement in body mass index (p < 0.001), in nutritional parameters such as prealbumin (p < 0.001), Insulin-like growth factor I (p < 0.001), Insulin-like growth factor binding protein (p < 0.001), triiodothyronin (p < 0.001), in pHVA (p 0.036) and in different scales such as the EAT (p 0.006), the BDI (p 0.001) and the STAI (p 0.015). At admission, a subgroup of patients (N 14; 32%) had a very high pHVA level (mean of the control subjects plus standard deviation) and this subgroup obtain significantly higher scores on the BDI (p 0.009). Conclusion: While underweight, anorexic patients have a higher mean pHVA that tend to normalization after weight recovery and nutritional restoration. At admission, a subgroup of patients have very high levels of pHVA and higher scores on depressive symptomatology.
References [1] Wen-Ho Chang, M Scheinin, S Burns, M Linnoila. Rapid and simple determination of homovanilic acid in plasma using high performance liquid chromatography with electrochemical detection. Acta Pharmacol et Toxicol 1983; 53:275 79.
•
Ziprazidone among adolescents with overlapping OCD and Tourette's syndrome: pilot study
Result" Despite the fact that the treatment began with 2 0 m g of Ziprazidone, no patient showed improvement, and even 40 mg of Geodon did not help. In 6 patients we observed improvement of OCD syndrome (CY-BOCS scores 28% mean degrease from baseline) with a dosage between 60 80 mg (60 + 20 mg capsule in bed time). Among 9 adolescents we observed much improvement of both symptoms after 4 week treatment with a dosage from 80 to 120 140mg. (CGI-TS Severity baseline 4.5±0.6 endpoint 2.6±1.2) Conclusion: Taking into consideration the fact that co-morbid OCD and Tourette's syndrome is influenced by medications of different pathway influence, the studies of athipical antipsychotics with both dopamine and serotonine properties are promising. Thus, the atypical antipsychotics with dopamine and serotonine properties can perhaps become the most useful medication. However, a new control study with a larger target group is needed.
References [1] Thomsen PH, Leckman J. [Obsessive-compulsive disorders in children. Subtypes of OCD and their relation to infection with group A streptococci] Ugeskr Laeger. 2002 Aug 5; 164(32): 3763 7. [2] Maruke Yeghiyan et al. [Tourette's spectrum disorders among adolescents and efficiency of combo therapy with Risperidon and Fluvoxamin.] Association of European Psychiatrists Congress. Geneva 14 18 April 2004 P-149: 239. [3] Floid R et al. [Ziprazidone treatment of Children and Adolescents with Turette's syndrome; A pilot Study.] J. Am. Acad. Child & Adol. Psych. 2000; 39(3): 299299.
•
Changes in platelet monoamine oxidase activity, cholesterol levels and hyperactive behaviour over a period of three years in adolescents
M. Yeghiyan*, M. Tozalakyan, A. Veliciyan, G. Yeghiyan.
Association Child Psychiatty & Psychology, Child Adolescent Mental Health Centre, Yerevan, Armenia Background: OCD with an onset in childhood or early adolescents is usually presented as a specific subtype, with more boys affected and frequently co-morbid with tics and Tourette's syndrome [1]. Our observation in clinical practice indicates that during the pharmacotherapy the OCD and Tourette syndromes shift continuously. As a result for successful treatment medication should be changed from SSRI-s to Antipsychotic with Dopaminolitic properties or combination of both is needed [2]. We assume that medication with both serotoninergic and dopaminolitic properties may be useful for the treatment subtype of OCD spectrum mentioned above. Among the atypical antipsychotic Zyprazidone is the only drug with appropriate properties and this medication may act as ideal for treating OCD with Tourette's syndrome [3]. Objective: To investigate the Ziprazidone (Geodon) effectiveness among adolescents with co-morbid OCD and Tourette's syndrome. Method: In open studies we conducted 8 week trial of 14 adolescents (12 15 year old, 9 male and 5 female) with co-morbid OCD and Tourette's syndrome. All patients were pretreated for several years with a number ofpsychotropic medications including haloperidole, sulpiride, sertraline, fluvoxamine and clomipramine. Before starting the study all patients passed two week drug washout period. All patients were diagnosed according to DSM4 criteria of OCD and ICD-10 criteria of Tic disorders. Also patients held CY-BOCS and Zung tests for depression and CGITS-S. Dosage range of Geodon was from 20 to 80 140 mg./day depending on the effectiveness.
E. Kiive 1 *, L. Merenakk 2, M. Harro 3, J. Harro 1 . ]University of
Tartu, Psychology, Tartu, Estonia; 2University of Tartu, Public Health, Estonia; 3National Institute for Health Development, Health Behaviout; Estonia Platelet monoamine oxidase (MAO) activity is a peripheral marker of central serotonergic activity, and has been associated with aggressive, impulsive and hyperactive behaviour, alcohol and drug abuse. Central serotonergic activity has also been associated with plasma cholesterol levels. The purpose of the present longitudinal investigation in adolescents (described in more detail in [1]) was to study the changes in platelet MAO activity and plasma cholesterol levels over three years, and their possible association with changes in aggressive and hyperactive behaviour, smoking, alcohol and drug use. Data of 320 adolescents (132 boys, 188 girls) were used. The measures were taken at age 15 and 18 years. Psychological data were obtained from teachers by using the Hyperactivity Scale [2]. Adolescents reported alcohol, illicit drug use and their smoking habits in a questionnaire. Platelet MAO activity was measured by radioenzymatically with 14C-labelled b-phenyl-ethylamine as the substrate. Fasting basal cholesterol (total and HDL) was measured by standard methods. In most of the tested individuals, platelet MAO activity is a relatively stable measure, but the correlation between two MAO measurements with three years interval was 0.56 as there was a significant number of subjects with a noticeable change in MAO activity. An increase or a decrease in enzyme activity was found with similar frequency. There was a significant but weak negative correlation between changes in platelet MAO activity and smoking