Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 77

POSTERS / 27TH NORDIC PSYCHIATRIC CONGRESS I
to potential functional disturbances in the cortico-subcortical cir-
cuit in patients with depressive disorder.
Methods: A 99m-Tc-ethyl cysteine dimer (ECD) brain SPECT was
acquired in 63 inpatients (39F, 24M, mean age 43.0 years) within the
acute phase of a rnajor depressive disorder (MDD, DSM-IV). Sixty-
three healthy volunteers (39F, 24 M, mean age 43.4 years) were used
as a control group. All subjects showed a normal CT scan of the
brain. The group of patients with MDD was compared with the
group of healthy volunteers, using volume-of-interest (VOI) analysis.
Results: Compared to the group of healthy volunteers, the group of
patients with MDD showed significant (p<0.001) hypoperfusion in
the bilateral prefrontal regions and the head of the right caudate;
and a significant (p<0.001) hyperperfusion in the left medial tempo-
ral lobe, the left thalamus and, bilaterally, in the cerebellar regions.
Condusion: Our results indicate cortical and subcortical involve-
ment in MDD. The increased perfusion in limbic system related
structures together with the hypoperfusion in frontal and subcorti-
cal structures provides further support for cortico-subcortical cir-
cuit involvement in MDD.
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Reduced serum prolactin levels following treatment with
long-acting risperidone
C Canuso, C Bossie, G Gharabawi, R Lasser, CNS Medical Affairs, Janssen Pharma-
ceutica Products, Trenton-Harbourton Road, 08560 Titusville, NJ, USA.
sdbuyssc@psmbe.jnj. com
Buckground and Aims: Prolactin elevation observed with antipsy-
chotic medication use results from pituitary dopamine D2 receptor
antagonism. The magnitude and duration of such elevations may
vary due to dosing regimens, patient characteristics, and collection
bias. Moreover, the relationship and relevance of prolactin levels to
presumed clinical sequelae is being increasingly challenged, with
less robust relationships being reported than previously believed.
Long-acling risperidone, with its reduced peak-trough fluctuations
of active drug, may offer insight into some factors contributing to
the reported variance of prolactin levels.
Method: Data were derived from a randomized double-blind study
of patients with schizophrenia receiving long-acting or oral daily
risperidone, examined prolactin levels over the course of 12 weeks.
Rcsults: Prolactin levels reflecting oral risperidone treatment at
baseline (n=276; 38.0 ng/ml, 2-6 mg/day) decreased at endpoint (-
0.90 ng/ml; -2.3%). By both mean values and percent mean change,
pharmacokinetically matched dosing for long-acting risperidone
was associated with greater significant reductions in prolactin levels
at endpoint (n=257; -4.83 ng/ml, P<0.001 versus baseline; -12.9%).
Conclusions: In this analysis, long-acting risperidone, with its re-
duced peak-trough fluctuations of active drug, was associated with
significantly decreased prolactin levels.
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Core symptom remission in patients with schizophrenia
receiving long-acting risperidone
R Lasser, CNS Mcdical Affairs, Janssen Pharmaceutica Products, Trenton-Harbour-
ton Road, 08560 Titusville, NJ, USA. Rodriguez, C Bossie, G Gharabawi, J Kane.
sdbuyssc@psmbe.jnj. com
Background and Ainis: DSM-IV defines the essential features of
schizophrenia as the presence and persistence of characteristic signs
and symptoms. These include delusions, hallucinations, disorga-
nized speech, grossly disorganized or catatonic behavior, and nega-
tive symptoms. Tlie objective of this analysis was to assess the effect
long-acting risperidone on these core disease features, exploring
the concept of disease remission.
Method: Expert-defined essential disease features (via Positive and
Negative Syndrome Scale) defined remission: delusions (Pl), con-
ceptual disorganization (P2), hallucinations (P3), suspiciousness
(P6), blunted affect (Nl), emotional withdrawal (N2), and concep-
tual disorganization (G9). Remission was defined as a score of <3
(mild or less) on each item for >2 consecutive visits. Data were de-
rived from an open-label 50-week study of long-acting risperidone
in stable patients with schizophrenia or schizoaffective disorder.
Rcsults: Although patients were clinically stable at sludy entry, 397
did not meet remission criteria at baseline (<3, each item). PANSS
total scores decreased significantly for these patients (baseline 74.7,
endpoint 64.1; p<0.0001). Of these patients, 144 (36.3%) met remis-
sion criteria during the study.
Condusions: A substantial number of patients treated with long-
acting risperidone reached the defined level of remission, suppor-
ting the need for further attention to the symptomatic and func-
tional definition of remission in schizophrenia.
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Tic reduction with olanzapine in Tourette's disorder (TD)
Naudts KH, MD, Department of Psychiatry, Ghent University, 9000 Ghent,
Belgium. Van den Eynde F, Sieben A, Dhondt K, Audenaert K, Van Heeringen C.
kris. naudts@hotmail. com
Background: Until recently, only haloperidol and pimozide were
approved by the FDA for treatment of TD. To our knowledge there
are no double-blind, placebo controlled trials on the use of atypical
neuroleptics in TD.
Aims: To report on a case of TD, treated with Olanzapine.
Methods: We report on the use of Olanzapine in a 25-year-old male
patient, diagnosed with TD since 13 years of age and unsuccessfully
treated with pipamperon, haloperidol, pimozide, and risperidone
Results: On admission, the patient scored 90 on the Yale Global Tic
Severily Scale YGTSS (max 100) and 22 on the Yale-Brown Obses-
sive Compulsive Scale Y-BOCS (max. 40). One week later, Olanza-
pine (ZyprexaR Velotabs) 10 mg daily was started. Another week
later, we increased the dose to 20 mg daily. After 2 weeks on this
dose, we noted a serious improvement in number of tics, frequency,
and intensity. After 4 weeks, he obtained a score of 19 on the
YGTSS and of 14 on the Y-BOCS.
Conclusions: Olanzapine 20 mg during 4 weeks yielded a spectacular
and fast improvement of tics in this patient. This case report suggests
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