S252 Abstracts haveincreasedserotonergictone.Alternatively,orin
com-bination,directeffectsoflowcapacityfor5-HT4Ragonism mayalsobeimplicatedinthedepressedstate.Weare cur-rentlyinvestigatingif5-HT4Rbindingmayserveasa predic-torofantidepressantresponseto5-HT-acting pharmacologi-caltreatmentsorfacilitaterelevantsubtypingofdepressed patient groups whomay need individualized clinical care strategies.
VolumeofinterestCases(n=51) Controls(n=71) p-value Wholebrain 0.688±0.098 0.745±0.090 p=0.0003 Neocortex 0.618±0.095 0.691±0.090 p=0.000007 N.caudate 3.477±0.523 3.691±0.468 p=0.003 Pallidostriatum 3.262±0.455 3.529±0.417 p=0.0003 Hippocampus 1.029±0.455 1.090±0.165 p=0.02 References
[1]Madsen,K.,Torstensen,E.,Holst,K.K.,Haahr,M.E.,Knorr,U., Frokjaer, V.G., Brandt-Larsen, M., Iversen, P., Fisher, P.M., Knudsen,G.M.,2014.Familialriskformajordepressionis asso-ciatedwithlowerstriatal5-ht(4)receptorbinding.Int.J. Neu-ropsychopharmacol.18.
[2]Haahr, M.E., Fisher, P.M., Jensen, C.G., Frokjaer, V.G., Ma-hon,B.M.,Madsen,K.,Baaré,W.F.,Lehel,S.,Norremolle,A., Rabiner, E.A., Knudsen, G.M., 2014. Central 5-HT4 recep-tor binding asbiomarkerof serotonergictonus inhumans: a [11C]SB207145PETstudy.Mol.Psychiatry19,427–432. doi:10.1016/j.euroneuro.2019.09.370
P.353 Long-actinginjectable paliperidone as mainte-nancetreatmentforbipolardisorders
K.Altinbas∗,B.Akitan,E.Yavuz
Selçuk University Medical Faculty, Mazhar Osman Mood Clinic- Department of Psychiatry, Konya, Turkey
Introduction: Bipolar disorder is a chronic mood disorder withanepisodicillnesscourseand6thleadingcauseof dis-abilityin theworldaccordingtotheWorldHealth Organi-zation.Mostofthepatientswithbipolardisorderstakesat leasttwomedicationsformaintenancetreatment. Mainte-nance treatment of bipolar disorder is crucialfor general functioningandlifesatisfactionofpatientswithbipolar dis-orders. Treatment adherence is a significant problem for nearlyhalfofthebipolarpatientsandlong-actinginjectable drugscouldbeanoption toimprovetreatment adherence [1].Onlylong-actingformsofpaliperidoneandaripiprazole areavailableinTurkeyformaintenancetreatmentof bipo-larpatients.Withthisbackground,weaimedtoreviewthe demographicandclinical features ofbipolar patientswho wereonmonthlyinjectablepaliperidonetreatment. Methods:BipolartypeIpatients(n=13)whowerefollowed in MazharOsmanMood Clinicof SelcukUniversityMedical Faculty. All of the patients were in remission (Young Ma-niaRatingScalescore < 5,HamiltonDepressionRatingScale score < 5)atleastfortwomonthswithinjectable paliperi-donemonoorcombinationtherapyasamaintenance treat-ment. Clinical and demographic features of the patients wereevaluated.Descriptivestatisticalevaluationwasdone.
Results: Male/female ratio was 1.6, nearly half was not marriedand hada job(n=6,46.2%).More than twothird ofthepatientswerealsotakingamoodstabilizercombined withpaliperidonepalmitate(n=10,77%).8thdaydosewas notapplied to 61.5% of the patients considering previous historyof extrapyramidalsymptoms.Approximately 69.2% ofthepatientswereon100mgpaliperidonedepot.Median durationof remissionwas14weeks.There wasno signifi-cantdifferencebetweenpatientswhohadordidnothave 8thdaydoseinjectionintermsofnumberofpreviousmood episodes, prolactin levels and any adverse event related withthetreatment.
Conclusions: Long acting injectable antipsychotics are mostly recommended for patients with shciophrenia and other chronic psychotic disorders. However, long acting paliperidonepalmitatecouldbea goodoptionfor bipolar patientswhoarenon-adherenttothetreatmentorunstable illnesscourse[2].8thdaypaliperidonepalimitateis recom-mendedfor psychoticpatients tobeabletoreach appro-priateserumlevels.However,this8thdayinjectionmight causeextrapyramidalsymptomsinbipolarpatientswhoare reportedtobeliabletothesesideeffects.Therewasno sig-nificantdifferencesbetweenthebipolar patientswhohad ordidnothave8thdayinjectionintermsofprolactin lev-elsandadverseeffects.Thus,paliperidonepalmitate treat-mentregimencouldbeappliedwithoutthe8thday injec-tionfor bipolar patients. Duration of follow-up and num-berofthepatientsarethemainlimitationofthiscase se-ries.Prospectivelong-term studieswithlargersample size comparingdifferentlong-actingantipsychoticsamong bipo-larpatientsarerequired.
References
[1]Lingam,etal.,2002.ActaPsychiatr.Scand.105(3),164–172. [2]Boyce,etal.,2018.BipolarDisord.20(Suppl2),25–36. doi:10.1016/j.euroneuro.2019.09.371
P.354Elevatedceramideplasmalevelinmajor depres-sionandbipolardisorderindicateanincreasedriskfor metabolicdysregulation
N.Brunkhorst-Kanaan1,∗,K.Klatt-Schreiner2,K.Schröter3,
J.Hackel2,S.Trautmann2,L.Hahnefeld2,S.Wicker4,
A.Reif5,D.Thomas2,G.Geisslinger2,S.Kittel-Schneider1,
I.Tegeder2
1University hospital- Goethe University Frankfurt- Frank- furt, Department of Psychiatry- Psychotherapy and Psycho- somatic Medicine, Frankfurt am Main, Germany
2Institute of Clinical Pharmacology, Goethe-University Hos- pital Frankfurt, Frankfurt am Main, Germany
3University hospital- Goethe University Frankfurt- Frank- furt, Medical Student_Universitiy hospital- Goethe- Frank- furt am Main, Frankfurt am Main, Germany
4Goethe-University Hospital Frankfurt, Occupational Health Service, Frankfurt am Main, Germany
5University hospital- Goethe University Frankfurt, De- partment of Psychiatry- Psychotherapy and Psychosomatic Medicine, Frankfurt am Main, Germany
