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Abstracts / Schizophrenia Research 102/13, Supplement 2 (2008) 1279 261

610 COMPARISON OF REMISSION RATES ANDTOLERABILITY IN PATIENTS WITH EARLY-EPISODESCHIZOPHRENIA RECEIVING ARIPIPRAZOLE ORHALOPERIDOL

Sheila Assuno-Talbott 1 , David Crandall 1 , James M Eudicone 1 ,Andrei Pikalov 2 , Robert D McQuade 3 , John M Kane 41 Bristol-Myers Squibb, Plainsboro, NJ; 2 Otsuka America

Pharmaceutical Inc., Rockville, MD; 3

Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ; 4 The Zucker Hillside Hospital, Department of Psychiatry, Glen Oaks, NY, USAsheila.talbott@bms.com

Introduction: This analysis compared remission rates in patientswith early-diagnosed schizophrenia receiving either aripiprazole orhaloperidol.Methods: Pooled data from two 52-week, randomized, double-blind,multicenter trials of aripiprazole vs. haloperidol in acutely ill patientswith schizophrenia were analyzed. Symptomatic remission was cal-culated according to RSWG criteria in patients with early-episodeschizophrenia (patients mean = 40 years with mean duration of illness= 60 months).Results: Remission rates were signicantly higher for early-episodepatients treated with aripiprazole compared with haloperidol (38% vs.22%; p=0.003). Aripiprazole-treated patients achieved remission in ashorter time than haloperidol-treated patients; however, this differencewas not statistically signicant between the two groups (log rank p=0.1, HR=1.4, 95% CI: 0.9- 2.1). All remitters received signicantlylower global clinical ratings than non-remitters (p < 0.0001 for bothtreatments). Aripiprazole was associated with a signicantly lower rateof discontinuations due to AEs than haloperidol (10.6% vs. 29.3%;p< 0.001) and lower concomitant medication use for EPS (26% vs.60%; p < 0.0001).Conclusions: Acutely ill patients with early-episode schizophreniatreated with aripiprazole demonstrated a signicantly higher rate of symptomatic remission compared with haloperidol-treated patientsbased on RSWG criteria. Aripiprazole was better tolerated, as shownby its lower discontinuation rates due to AEs and lower use of anticholinergics. Although more data are needed, this preliminary

post-hoc analysis shows the efcacy and tolerability of aripiprazole inpatients with early-episode schizophrenia.Acknowledgements: Supported by Bristol-Myers Squibb and Otsuka.References[1] Lieberman JA et al. CNS Spectr 2007; 12(3 Suppl 4):113.[2] Wyatt RJ. Biol Psychiatry 1995;38:13.

611 CONCOMITANT USE OF ANTICHOLINERGIC AGENTSWITH ATYPICAL ANTIPSYCHOTICS IN SCHIZOPHRENIA

Won-Myong Bahk 1 , Young Sup Woo 1 , Ho-Jun Seo 1 ,Bo-Hyun Yoon 2 , Jeong-Ho Chae 11 Department of Psychiatry, College of Medicine, The CatholicUniversity of Korea, Seoul; 2 Naju National Hospital, Naju, Koreawmbahk@caholic.ac.kr

Introduction: Antipsychotic drugs induce extrapyramidal symptomssuch as dystonia, akathesia and parkinsonian symptoms early inthe treatment. With the advent of atypical antipsychotic drugs, theincidence of extrapyramidal symptoms has decreased, but dangerstill exists. Hence, in treatment of schizophrenia with antipsychotics,anticholinergic agents are often indicated.Methods: In this observational, retrospective study, we examinedwhether the initiation of risperidone, olanzapine, or quetiapine, thethree most widely prescribed atypical antipsychotics, is related to theconcomitant use of anticholinergic agents. We identied patients withschizophrenia from outpatient clinics in the St. Marys hospital anddened initiation of risperidone, olanzapine, or quetiapine as patientswho initiated on the target drug after January 1 2004 and continuouslyuse the antipsychotics for 6 months. The data were analyzed using on

way ANOVA, Mann-Whitney U test or Fishers exact tests.

Results: The study yield two major ndings. First, compared withrisperidone initiators, there were signicantly fewer olanzapine ini-tiators who used anticholinergic agent concomitantly. Secondly, therewere signicantly fewer olanzapine or quetiapine initiators thanrisperidone initiators who prescribed anticholinergic agent on thesame day when antipsychotics were initiated.Conclusions: As the use of anticholinergic agent is a proxy forthe presence of extrapyramidal symptom, these ndings suggest thatrisperidone may be more associated with extrapyramidal symptomsthan olanzapine or quetiapine. Controlled studies comparing them toone another should be of particular interest.References[1] Ren XS, Huang YH, Lee AF, Miller DR, Qian S, Kazis L. Ad-

junctive use of atypical antipsychotics and anticholinergic drugsamong patients with schizophrenia. J Clin Pharm Ther. 2005 Feb;30(1):65-71.

612 THE EFFECT OF HEPATOPROTECTORS ONINCREASED SERUM TRANSAMINASE INDUCED BYATYPICAL ANTIPSYCHOTICS

Won-Myong Bahk 1 , Young Sup Woo 1 , Ho-Jun Seo 1 ,

Bo-Hyun Yoon2

, Jeong-Ho Chae1

1 Department of Psychiatry, College of Medicine, The CatholicUniversity of Korea, Seoul; 2 Naju National Hospital, Naju, Koreawmbahk@caholic.ac.kr

Introduction: Atypical antipsychotics are reported to induce serumtransaminase increase frequently in Korea, although most cases arebenign. Thus, some hepatoprotectors are commonly prescribed tomanage rapid transaminase increase in patients with schizophrenia.We performed a retrospective chart review to investigate the effectof two hepatoprotectors [a biphenyldimethyldicarboxylate+garlic oilcombination (BDD) and a silymarin+silybin combination (SMR)] ontransaminase (AST/ALT) increase induced by atypical antipsychotics.Methods: The records of 53 schizophrenic patients who experienceserum AST/ALT increase after treatment with atypical antipsychoticswere reviewed. We obtain the level of serum AST/ALT at the time

of hepatoprotectors administration, 1 week, 2 weeks, 3 weeks, and 4weeks after administration.Results: Among all patients, 36 patients were treated with BDD and17 patients were treated with SMR. After administration of hepato-protectors, both serum AST and ALT level were signicantly reducedafter 4 weeks. Further, both AST and ALT levels were signicantlyreduced in only one week. BDD was superior to SMR in number of patients whose ALT level was reduced below in-house, upper limita-tion after 4 weeks. However, there was no difference between BDDand SMR in aspect to AST level.Conclusions: Both hepatoprotectors, BDD and SMR, were effectivein reducing serum AST/ALT level increased by atypical antipsy-chotics, especially within only one week. Increased liver enzymeswere normalized in most patients within 4 weeks. BDD was superiorto SMR in normalizing serum ALT level.

References[1] Dumortier G, Cabaret W, Stamatiadis L, Saba G, Benadhira R,Rocamora JF, et al. Hepatic tolerance of atypical antipsychoticdrugs. Encephale 2002;28:542-551.

613 COMBINED CLOZAPINE AND ELECTROCONVULSIVETHERAPY IN CLOZAPINE-RESISTANTSCHIZOPHRENIA:IMPACT ON CLINICALAND COGNITIVE OUTCOME

Falko Biedermann 1 , Nicole Pfaffenberger 2 , Georg Kemmler 2 ,W.Wolfgang Fleischhacker 2 , Alex Hofer 21 Medical University for Psychiatry of Innsbruck, Innsbruck;2 Medical University, Innsbruck, AustriaFalko.Biedermann@uki.at

Introduction: Clozapine (CLZ) has been shown to have unique ef-