Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 64

■ POSTERS / 27TH NORDIC PSYCHIATRIC CONGRESS
done groups (83.3±9.7, 83.1± 2.4; 15.3±1.9 mg/d, 16.0±0.83 mg/day,
respectively). At endpoint, PANSS-Total scores worsened in
placebo group, while improving significantly from prior olanzapine
treatment (p=0.027) in the long-acting risperidone group (+4.4 and
-6.9, respectively; p=0.05 between groups). Significant improve-
ment (p<0.05) from prior olanzapine treatment was present in the
long-acting risperidone group across Positive, Negative and Mood/
Anxiety domains. Improvement from prior olanzapine treatment
was present in the SF-36 domain social functioning (p=0.053) and
the mental health index (p=0.041) following treatment with long-
acting risperidone.
Conclusions: These data support potential improvements in symp-
toms and quality of life with long-acting risperidone in patients
previously receiving oral olanzapine.
P - 18 Thursday 15/8,14:00-15:00
Effect of a novel long-acting antipsychotic in stable
patients with schizoaffective disorder
Vieta Eduardi Gharabawi Georges2, Bossie Cynthia A2, Zhu Young2, Lasser Ro-
bert A2.
'Hospital Clinic, University of Barcelona, Barcelona Spain; 2CNS Medical Affairs,
Janssen Pharmaceutica Products, LP, Titusville, NJ, USA.
sdbuyssc@psmbe.jnj. com
Background and Ainis: Evaluate efficacy and safety of long-acting
injectable risperidone in stable patients with schizoaffective dis-
order.
Methods: After a 2-week run-in period during which patients re-
ceived flexible doses of oral risperidone 1-6 mg, palients received
intramuscular injections of 25, 50, or 75 mg of long-acting risperi-
done every 2 weeks for 50 weeks. Efficacy and safety measures in-
cluded the Positive and Negative Syndrome Scale (PANSS) and
Extrapyramidal Symptom Rating Scale (ESRS).
Results: Of the 725 patients receiving treatment in the study (RIS-
INT-57), 110 had schizoaffective disorder: the latter are the subjects
of this analysis. Mean age was 43.5 years; 52.7% were women;
67.3% completed the trial. The baseline mean (SE) PANSS total
score was 62.3 (1.73). Mean PANSS total scores improved signifi-
cantly (P < .001) from baseline at weeks 12 (-7.4), 24 (-10.0), 36
(-8.4), 50 (-10.2), and endpoint (-7.9). Significant reductions were
observed at endpoint in mean PANSS scores for positive symptoms
(-1.7, P < .01), negative symptoms (-2.9, P < .001), anxiety/depres-
sion (-1.2, P < .01), and disorganized thoughts (-1.5, P < .001). A
>20% reduction in PANSS lotal scores was seen in 56.2% of
patients at endpoint. According to Clinical Global Impressions
scores, the proportion of patients rated not ill or with very mild or
mild symptoms increased from 54.6% at baseline to 76.6% at
endpoint. Significant improvements (P<0.001) from baseline ESRS
scores were noted on the overall subjective rating and the Parkin-
sonism exam. The most common adverse events were insomnia in
36.4%, anxiety in 30.0%, depression in 25.5%, and psychosis in
24.6%. The incidence of adverse events was reduced substantially
from months 1-3 to months 10-12.
Condusions: Stable patients with schizoaffective disorder can
safely and effectively be switched from current treatment to long-
acting risperidone.
P - 19 Thursday 14/8,14:00-15:00
Management options of treatment-resistant panic
disorder
Marc Zicgcnbein, MD, Social Psychiatry and Psychotherapy, Medical School
Hannover, Carl-Neuberg-Str.l, 30625 Hannover, Germany. Petra Garlipp, MD.
mziege999@yahoo. com
Treatment resistance is a common problem in severe panic disorder.
First line agents are selective serotonin reuptake inhibitors (SSRIs)
and cognitive behavioural therapy (CBT). Well known factors
contributing to medication treatment resistance include inadequate
dosage, non-compliance, poor tolerability and psychiatric or medical
comorbidity. Combination treatment with a benzodiazepine or
tricyclic antidepressant (TCA) is a possible option for those patients
who have not responded to one or more adequate trials of SSRIs.
Augmentation with the presynaptic 5-HTl A-antagonist pindolol or
switching to to a different class of medication is beneficial for the
refractory patients as well. The newer antidepressants like reboxe-
tine might be useful for patients with a comorbid mood disorder. For
patients with hypomania, irritability and insomnia Carbamazepine
and olanzapine might be particularly beneficial. Fortunately a num-
ber of promising pharmacological approaches have been introduced
during the last years, but so far there is no clinical data on the
usefulness and safety of such drugs. Ongoing research is needed to
further elucidate the role of corticotrophin releasing factor, gluta-
mate systems and GABA systems in refractory panic disorder.
P - 20 Thursday 14/8, 14:00-15:00
Reboxetine versus citalopram in major depressive
disorder: Antidepressive effect and sexual side-effects
Owe Bodlund, MD, PhD, Dept of Clinical Science, Division of Psychiatry. Umeá
University, S-901 85 Umeá, Sweden. Torbjörn Ohrt, Hans Ágren.
owe.bodliind@psychiat.umu.se
Aims and methods: The objective of the study was to compare the
efficacy and tolerability of reboxetine (selective NRI) with the
SSRI citalopram, in treatment of MDD. In total, 357 outpatients
with MDD were randomized to treatment with reboxetine 8 -10 mg
or citalopram 20-40 mg per day during 24 weeks. Primary end-point
was change from baseline in the Hamilton Depression Rating Scale
(HAMD, 21 items). Sexual function/dysfunction was measured by
the Sexual Function scale.
Results: Observed case analysis showed tliat both treatments
yielded a gradual reduction of H AMD scores: reboxetine with -21.4
and citalopram with -22.1 points (NS). The response rate was 90.3%
for reboxetine and 92.7% for citalopram (NS).
The most common side-effect in the reboxetine group was dry
mouth, and in the citalopram group sexual dysfunction. At week 24,
anorgasmia was reported by 5.9% of the sexually active women in
the reboxetine group vs 39% in the citalopram group (p<0.001). In
sexually active men, delayed ejaculation was reported by 11.8% in
the reboxetine group vs 44.8% in the citalopram group (p<0.05).
The dropout number was 91 in the reboxetine group, and 54 in the
citalopram group.
Conclusions: To summarize, both treatments yielded a satisfactory
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