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P.2.006 Combined olanzapine-ECT therapy forresistant schizophrenia
Poster Sessions
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Circulatory levels of catecholamines and serotonin in neuroleptic malignant syndrome
D. Malin 1, B. Spivak2, Y. Vered 1, V. Kozyrev2, 1L Ravilov2, S. Mosolov 2. 1R, .Research Unit
Ness-Ziona Mental Health Center lsrael," 2Moscow Psychiatric Hospital No. 1, Moscow Research Institute of Psychiatry, Department for Therapy of Mental Disorders, 3, Poteshnaya, Moscow 107076, Russia Objective: Neuroleptic malignant syndrom (NMS) may be associated with a dysregulation of the catecholaminergic and serotonergic systems. The objective of the present study was to evaluate prospectively the circulatory levels of serotonin (5-HT), epinephrine (E) and Dopa in schizophrenic patients suffering from NMS. Material and Methods: The subjects were 8 schizophrenic patients (4 male and 4 female), aged 42.5±13.7 (meand:SD) years who developed persistent and severe muscle rigidity with hyperthermia accompanied by altered consciousness, tachycardia and abnormal (elevated or labile) blood pressure after exposure to classical neuroleptic agents. Platelet-poor plasma (PPP) levels of serotonin, epinephrine and Dopa were measured twice: in the acute state and in the state of remission. Results: PPP Dopa concentration was significantly lower in acute NMS state compared to the remission state (P = 0.023). In contrast, PPP, E level was significantly higher (P=0.019) in the acute NMS state and PPP 5-HT concentrations in the acute state tended to be higher than those at remission (P = 0.078). 5-HT/dopa ratio was significantly higher in the acute NMS (P = 0.015). Conclusion: The results may indicate a double alteration - low dopaminergic and high serotonergic activity as an important factor in NMS development. Therefore, it is possible that the potent antiserotonergic activity of the atypical antipsychotics is responsible for the low incidence of NMS associated with second-generation antipsychotics use.
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IP.2.0081 Combined olanzapine-ECT therapy for resistant schizophrenia E. Oleneva, E. Tsukarzi, S. Mosolov. Moscow Research Institute of Psychiatry, Department for Therapy of Mental Disorders, 3, Poteshnaya ul., Moscow 107076, Russia Objectives: to compare the efficacy of combined olanzapine-ECT therapy in resistant schizophrenic patients.
s131
Methods: 40 treatment-resistant schizophrenic patients aged from 18 to 60 years, according to diagnostic DSM-IV criteria were included. Patients were randomly assigned to treatment groups: olanzapine and olanzapine-ECT therapy for 10 weeks therapy. The doses of atypical antipsychotics were selected individually and remained constant. Bilateral ECT was provided 2 times a week, up to 18 sessions for 10 weeks treatment course, with 1.5-threshold intensity. Results: The response rate to the end of treatment course (patients with at least 20% reduction in total PANSS score) was: 67% in olanzapine group and 74% in olanzapine-ECT group (no significant differences). The therapeutic effect in combined group was marked just after the first few procedures and achieved a maximum to the 6-10th procedure (3-5 weeks). To the end of 4th week the response rate was 51.9% in olanzapine group and - 70% in group of the combined olanzapine-ECT therapy. Reduction in total PANSS score was 26.3-1-2.2% in olanzapine group and 37.6±2.9% in olanzapine-ECT group (p <0.01). Conclusion: Obtained results suggest that ECT adjunction to olanzapine treatment increase therapy efficacy in resistant schizophrenia, though no statistical differences were reached. But the therapeutic response obviously was more rapid. The data are preliminary and require confirmation in further studies.
IP.2.0071 Analysis of the action of antipsychoUcs in a 5-factor model of schizophrenia M.V. Kuzavkova, A.V. Eremin, S.N. Mosolov. Moscow
Research Institute of Psychiatry, Department for Therapy of Mental Disorders, Poteshnaya, 3, Moscow, 107076, Russia Objectives: to compare the action of atypical antipsychotic and haloperidol on 5-factor model of schizophrenia during 6-week therapy in patients with an exacerbation of paranoid schizophrenia. Materials and Methods: 180 patients with paranoid schizophrenia according to ICD-10 have been surveyed (87 men and 93 women, mean age 31.7-t-0.8 years, average duration of disease - 8.7±0.5 years). They were divided into 6 monotherapeutic groups, 30 persons each. The mean dose of risperidone was 4.1+0.2 mg per diem, the mean dose of olanzapine was l l + l . 5 m g per diem, quetiapine - 486.1-t-6.8 mg per diem, clozapine 307.37+10.8 mg per diem, amisulpride - 450+20.3 mg per diem, haloperidol - 27.5-t-6.1 mg per diem. Clinical efficacy of the antipsychotic therapy was estimated with the 5-factor model of schizophrenia (Lindenmayer et al., 1995) [1].
•
Circulatory levels of catecholamines and serotonin in neuroleptic malignant syndrome
D. Malin 1, B. Spivak2, Y. Vered 1, V. Kozyrev2, 1L Ravilov2, S. Mosolov 2. 1R, .Research Unit
Ness-Ziona Mental Health Center lsrael," 2Moscow Psychiatric Hospital No. 1, Moscow Research Institute of Psychiatry, Department for Therapy of Mental Disorders, 3, Poteshnaya, Moscow 107076, Russia Objective: Neuroleptic malignant syndrom (NMS) may be associated with a dysregulation of the catecholaminergic and serotonergic systems. The objective of the present study was to evaluate prospectively the circulatory levels of serotonin (5-HT), epinephrine (E) and Dopa in schizophrenic patients suffering from NMS. Material and Methods: The subjects were 8 schizophrenic patients (4 male and 4 female), aged 42.5±13.7 (meand:SD) years who developed persistent and severe muscle rigidity with hyperthermia accompanied by altered consciousness, tachycardia and abnormal (elevated or labile) blood pressure after exposure to classical neuroleptic agents. Platelet-poor plasma (PPP) levels of serotonin, epinephrine and Dopa were measured twice: in the acute state and in the state of remission. Results: PPP Dopa concentration was significantly lower in acute NMS state compared to the remission state (P = 0.023). In contrast, PPP, E level was significantly higher (P=0.019) in the acute NMS state and PPP 5-HT concentrations in the acute state tended to be higher than those at remission (P = 0.078). 5-HT/dopa ratio was significantly higher in the acute NMS (P = 0.015). Conclusion: The results may indicate a double alteration - low dopaminergic and high serotonergic activity as an important factor in NMS development. Therefore, it is possible that the potent antiserotonergic activity of the atypical antipsychotics is responsible for the low incidence of NMS associated with second-generation antipsychotics use.
F""""""--q
IP.2.0081 Combined olanzapine-ECT therapy for resistant schizophrenia E. Oleneva, E. Tsukarzi, S. Mosolov. Moscow Research Institute of Psychiatry, Department for Therapy of Mental Disorders, 3, Poteshnaya ul., Moscow 107076, Russia Objectives: to compare the efficacy of combined olanzapine-ECT therapy in resistant schizophrenic patients.
s131
Methods: 40 treatment-resistant schizophrenic patients aged from 18 to 60 years, according to diagnostic DSM-IV criteria were included. Patients were randomly assigned to treatment groups: olanzapine and olanzapine-ECT therapy for 10 weeks therapy. The doses of atypical antipsychotics were selected individually and remained constant. Bilateral ECT was provided 2 times a week, up to 18 sessions for 10 weeks treatment course, with 1.5-threshold intensity. Results: The response rate to the end of treatment course (patients with at least 20% reduction in total PANSS score) was: 67% in olanzapine group and 74% in olanzapine-ECT group (no significant differences). The therapeutic effect in combined group was marked just after the first few procedures and achieved a maximum to the 6-10th procedure (3-5 weeks). To the end of 4th week the response rate was 51.9% in olanzapine group and - 70% in group of the combined olanzapine-ECT therapy. Reduction in total PANSS score was 26.3-1-2.2% in olanzapine group and 37.6±2.9% in olanzapine-ECT group (p <0.01). Conclusion: Obtained results suggest that ECT adjunction to olanzapine treatment increase therapy efficacy in resistant schizophrenia, though no statistical differences were reached. But the therapeutic response obviously was more rapid. The data are preliminary and require confirmation in further studies.
IP.2.0071 Analysis of the action of antipsychoUcs in a 5-factor model of schizophrenia M.V. Kuzavkova, A.V. Eremin, S.N. Mosolov. Moscow
Research Institute of Psychiatry, Department for Therapy of Mental Disorders, Poteshnaya, 3, Moscow, 107076, Russia Objectives: to compare the action of atypical antipsychotic and haloperidol on 5-factor model of schizophrenia during 6-week therapy in patients with an exacerbation of paranoid schizophrenia. Materials and Methods: 180 patients with paranoid schizophrenia according to ICD-10 have been surveyed (87 men and 93 women, mean age 31.7-t-0.8 years, average duration of disease - 8.7±0.5 years). They were divided into 6 monotherapeutic groups, 30 persons each. The mean dose of risperidone was 4.1+0.2 mg per diem, the mean dose of olanzapine was l l + l . 5 m g per diem, quetiapine - 486.1-t-6.8 mg per diem, clozapine 307.37+10.8 mg per diem, amisulpride - 450+20.3 mg per diem, haloperidol - 27.5-t-6.1 mg per diem. Clinical efficacy of the antipsychotic therapy was estimated with the 5-factor model of schizophrenia (Lindenmayer et al., 1995) [1].