Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 63

Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 63
POSTERS / 27TH NORDIC PSYCHIATRIC CONGRESS I Our aim was to determine the effect of zolpidem in a group of women diagnosed with monosymptomatic sleep disturbances during the premenstrual period. We studied 26 women (age 28-43 years, mean age: 35.6 years) who showed insomnia throughout 3 menstrual cycles (between 10 days before and 1-2 days after the start of the menses). During this period the patients received zolpidem in 5 or 10 mg dose for an average of 8.4 days. Seven patients (27%) and 19 patients (73%) re- sponded to 5 and 10 mg daily dose of zolpidem, respectively. Ad- verse side effects have not been reported. All patients reported significantly improved subjective sleep status. We conclude that daily zolpidem treatment during the niid and late luteal phase effectively normalizes sleep disturbances in recur- rent luteal phase insomnia. P - 15 Thursday 14/8, 14:00-15:00 Maintenance clozapine therapy of schizophrenia Peter Gaszner, Professor of Psychiatry. National Institute of Psychiatry and Neuro- logy, H-1021 Budapest, Hiivösvölgyi u. 116, Hungary. Zoltán Makkos. hl2890gas@ella.hu During the last seventeen years at the Department of Clinical Psycho-pharmacology, National Institute of Psychiatry and Neuro- logy (Budapest) 1071 inpatients were treated with clozapine and in this material 778 were schizophrenic. The diagnosis was made by the DSM-IV criteria (with the modification of the time). The effi- cacy of clozapine was 76%; 23% of the schizophrenic inpatients be- come symptom-free. The maintenance therapy of these 175 in- patients was examined: because the compliance of the patients, 144 continued clozapine treatmenl after one year, (31 schizophrenics discontinued treatment). Some of the patients continued clozapine treatment during seventeen years and they were also symptoms- free. From the 31 patients, who discontinued the treatment, 29 had symptoms of schizophrenia after one month; most of them had the previous serious problems. In these two groups, 79 inpatients had clozapine as first antipsychotic, 96 were nonresponders to the clas- sical (or atypical) antipsychotics. Tlie patients had no serious side effects with clozapine. In the control group, 152 schizophrenic inpatients received halo- peridol treatment during more than one year and were symptom- free. Only 48 inpatients had good compliance and were symptoms- free, after one year 104 discontinued haloperidol treatment and 101 had previous symptoms after one month, only 3 were symptom-free after six months. Two patients (58 and 49 years old males) are selected for case re- Port. Tliey received clozapine during 25 years and are symptom-free. During the antipsychotic treatmenl most of the schizophrenics become symptom-free. The compliance of clozapine is much better íhan at the classical antipsychotics. If the responders are taking the dozapine most of them are symptom-free after several years. References * Gaszner P, Makkos Z. Clozapine in the treatment of schizophrenia. Neuro- psychopharmac Hung 1999; 1: 28-30. * Meltzer HY. Treatment-resistant schizophrenia - the role of clozapine. Curr Med Res Clin 1997; 14:1-20. P - 16 Thursday 14/8, 14:00-15:00 Suboptimal pharmacotherapy and partial compliance: Barriers to continued improvement Robert Lasser. MD>, CNS Medical Affairs. Janssen Pharmaceutica Products. Tren- ton-Harbourton Road, 08560 Titusville, NJ, USA. Cyndi Bossie, PhDl, Young Zhu. PhD1, Georges Gharabawi, MDi. Uanssen Pharmaceutica Products, Titusville, NJ, USA. sdbuyssc@psmbe.jnj.com Background and Aims: Stepwise improvements in schizophrenia management were realized with the introduction of oral conven- tional antipsychotics, followed by long-acting conventionals, and more recently, oral atypicals. A long-acting atypical agent, offering more stable blood levels and assured medication delivery - the foundation of symptom improvement, remission, and functional gains - could provide further benefits. This analysis examined the effect of long-acting risperidone, the first long-acting atypical, in stable patients. Method: Data were derived from an open-label 50-week study of long-acting risperidone (25, 50, or 75 mg every 2 weeks) in 725 stable patients with schizophrenia or schizoaffective disorder. Tlie effect of treatment was examined in clinically stable patients at study entry on oral risperidone, conventional depot antipsychotics, or conventional oral antipsychotics. Results: At study entry, 336 patients were receiving oral risperidone, 188 conventional depots, and 46 conventional oral antipsychotics. After receiving long-acting risperidone, mean PANSS total scores improved significantly throughoul the 50 weeks and at end point in all groups (p<0.001). The greatest numeric improvement was ob- served in the latter group. Condusions: Results show significant symptom improvement with long-acling risperidone in stable patients wilh schizophrenia. They support the concept that improved pharmacotherapy and more assured delivery contribute to the benefits of a long-acting atypical. P - 17 Thursday 14/8, 14:00-15:00 Clinical improvement with long-acting risperidone in patients previously receiving oral olanzapine P Jones, C Bossie, R Lasser, CNS Medical Affairs, Janssen Pharmaceutica Products, Trenton-Harbourton Road, 08560 Titusville, NJ, USA. sdbuyssc@psmbe.jnj. com Background and Aims: Although atypical antipsychotics have ad- vanced the management of schizophrenia, currently available agents require daily dosing - commonly associated with limitations on adherence, response, and functional outcomes. This analysis examined long-acting risperidone for symptom control and quality of life in patients previously receiving the oral atypical, olanzapine. Method: A 12-week, placebo-controlled, multicenter, double-blind study assessed patients receiving long-acting risperidone (25,50, or 75 mg) every 2 weeks (n=370). Patients receiving prior therapy with oral olanzapine were analyzed (n=16, placebo; n=42 long-acting risperidone). Results: Baseline PANSS-Total scores and mean prior olanzapine doses were comparable between placebo and long-acting risperi- Læknablaðið / FYLGIRIT 48 2003/89 63
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