SYMPOSIA

Poster Presentations
schizophrenia patients.
Methods: Ninety one schizophrenic patients (38 female, 53 male) receiving antipsychotics for at least one year were included in the study.
The parameters associated with MS were as follows: Body mass index, body weight, waist circumference, systolic and diastolic blood
pressure, fasting blood glucose, insulin, serum triglycerides, HDL cholesterol levels, and the insulin resistance as calculated by using the
value HOMA (homeostasis model assessment). The criteria were based on ATP-III criteria for metabolic syndrome (Adult Treatment Panel
III). Statistical analysis was performed by using SPSS 17.0 (for Windows).
Results: Serum triglyceride levels were inversely correlated with serum direct bilirubin (p=.006) and positively correlated with indirect/
direct bilirubin ratio (p =. 002). Serum HDL levels (p=.018) showed a significant positive correlation with indirect/direct bilirubin ratio.
Waist circumference (p=.048) showed a significant negative correlation with serum total bilirubin. The levels of insulin (p =.038) and value
of HOMA (p =.015) were inversely correlated with serum direct bilirubin.
The rate of metabolic syndrome was significantly lower in the patients with highest quartile (75-100) of the serum direct bilirubin levels
than the other quartiles (p=.022).
In these patients, the ratio of the patients that meet criteria for metabolic syndrome according to levels of the fasting triglyceride (p=.013)
and HDL (p=.040) was significantly lower than others. Additionally, the means of body weight (p=.026), waist circumference (p=.022), and
serum triglyceride levels (p=.039) of these patients were found significantly lower.
Conclusions: In this study we found that bilirubin levels are associated with metabolic syndrome and its parameters and high levels of
serum direct bilirubin may be associated with the lower risk for MS in schizophrenia patients; similar to the healthy individuals (1,2,4).
Our study is the first study investigating this issue. Our results may be important for the following aspects: High serum direct bilirubin
levels may serve as an easily applicable, inexpensive marker indicating lower MS risk for schizophrenic patients. Additionally, it may be
possible to prevent antipsychotics induced metabolic side effects by avoiding the drugs with higher risk for MS, in the patients with low
levels of direct bilirubin. Due to the relatively limited number of patients and cross-sectional nature, our results required to be confirmed
by longitidunal studies with larger samples.
Key words: Schizophrenia, metabolic syndrome, bilirubin, antipsycotic drug
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S179-80
[PP-096] Ref. No: 293
Olanzapine abuse: A case report
Neslihan Akkişi Kumsar, Atila Erol
Sakarya Training and Research Hospital, Sakarya, Turkey
E-mail: drneslihanakkisi@yahoo.com
Introduction: Olanzapine is a thienobenzodiazepine which specifically blocks 5-HT2A and D2 receptors and additionally blocks
muscarinic (M1), H1, 5-HT2C, 5-HT3.5-HT6, a l, and D4 receptors. It has greater affinity for 5-HT2 receptors than for D2 receptors (Kelly,
Conley & Carpenter 2005). Olanzapine has consistently been found to be significantly superior to placebo and comparable with, or
superior to, haloperidol for the treatment of overall, positive, and negative symptoms of schizophrenia. In this case, we want to report a
case of olanzapine abuse.
Case Report: A 48-year old, primary school graduate, married, female patient was admitted to our psychiatry clinic with tachycardia,
insomnia, and anxiety. In psychiatric assessment, she mentioned that her symptoms have been similar for 15 years and in the last 3 years
she has used citalopram 40 mg/d and olanzapine 10 mg/d and after this treatment her symptoms decreased. During psychiatric treatment
when her consequent doctor wanted to stop the olanzapine treatment, she did not succeed and the patient had anxiety, insomnia, and
anger and reported decreased symptoms after using the drug again
Discussion: Besides medications with obvious abuse potential such as benzodiazepines and methyphenidate and other stimulants, abuse
of a number of commonly prescribed psychiatric medications has been reported. The abuse of anticholinergic drugs was first reported
in 1960 with the description of a patient, who increased her trihexyphenidyl to achieve antidepressant and euphoriant effects. Recently,
abuse of quetiapine for its sedative and anxiolytic effects has been reported. The abuse risk of quetiapine has been also reported in our
country and Kaya et al. studied the abuse risk of quetiapine with prisoners. In the literature there are only two cases of olanzapine abuse.
Key words: Abuse, olanzapine
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S180
S180 Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org