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XI Congresso della Società Italiana di Psicopatologia Psichiatria ...

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Fig. 1.<br />

Fig. 2.<br />

tanza <strong>della</strong> psichiatria <strong>di</strong> Consultazione e Collegamento nella<br />

gestione <strong>di</strong> casi <strong>di</strong>fficili, in cui compaiano importanti variabili<br />

emozionali. Tali considerazioni chiariscono come siano<br />

in<strong>di</strong>spensabili la creazione ed il buon funzionamento <strong>di</strong><br />

un’attività <strong>di</strong> <strong>Psichiatria</strong> <strong>di</strong> Liaison.<br />

Bibliografia<br />

Rundell JR, Wise MG. La <strong>Psichiatria</strong> nella pratica me<strong>di</strong>ca. Torino:<br />

Centro Scientifico E<strong>di</strong>tore 1998.<br />

Gala C, et al. A Multicenter Investigation of Consultation-Liaison<br />

Psychiatry in Italy. Gen Hosp Psychiatry 1999;21.<br />

179. Utilizzo <strong>di</strong> quetiapina in setting acuto:<br />

decision-making da aloperidolo fiale<br />

a quetiapina compresse<br />

S. Masuzzo, R. Intorella, M. Sittinieri<br />

SPDC Ospedale Maria Paternò, Arezzi <strong>di</strong> Ragusa<br />

POSTER<br />

Introduzione: l’identificazione <strong>di</strong> schemi <strong>di</strong> switching da<br />

formulazioni iniettive <strong>di</strong> antipsicotici tipici ad atipici (in<br />

questo lavoro quetiapina), che tengano conto dell’acuzie dei<br />

pazienti e dei tempi <strong>di</strong> degenza, facilita l’impostazione <strong>di</strong><br />

trattamenti efficaci e tollerati che possano essere agevolmente<br />

continuati.<br />

Obiettivo: valutare efficacia, sicurezza e tollerabilità <strong>di</strong> uno<br />

schema <strong>di</strong> switch da aloperidolo fl. a quetiapina cpr in pz.<br />

psicotici ospedalizzati in fase <strong>di</strong> acuzie.<br />

Metodologia: pz (n. 10) con <strong>di</strong>agnosi <strong>di</strong> Disturbo Schizofrenico<br />

o Bipolare I più recente episo<strong>di</strong>o maniacale, (DSM<br />

IV TR), CGI 5, ricovero minimo 7 giorni, trattati il 1 giorno<br />

con aloperidolo fl., il 2 giorno introduzione <strong>di</strong> quetiapina, titolata<br />

a 900 mg/<strong>di</strong>e in 5 giorni, con sospensione <strong>di</strong> aloperidolo<br />

fl al 5 giorno (al 3 giorno 50% dose iniziale, 4 giorno<br />

il 25%). Efficacia valutata con BPRS, CGI, PANSS, YMRS<br />

(basale T0, 7 giorno T1 e alla <strong>di</strong>missione TD); sicurezza tol-<br />

lerabilità me<strong>di</strong>ante la rilevazione <strong>di</strong> eventi avversi e monitoraggio<br />

dei segni vitali.<br />

Risultati: miglioramento psicopatologico generale (TD vs.<br />

T0) con percentuale <strong>di</strong> miglioramento del 31,9% alla BPRS,<br />

65,4 alla CGI, 68,8% alla YMRS. Nessuna variazione dei<br />

parametri vitali, né comparsa <strong>di</strong> eventi avversi.<br />

Conclusioni: i dati in<strong>di</strong>cano che lo schema rapido <strong>di</strong> switching<br />

utilizzato (in 5 giorni, monoterapia con quetiapina<br />

900 mg/<strong>di</strong>e e sospensione <strong>di</strong> aloperidolo fiale) consente <strong>di</strong><br />

impostare già durante le prime fasi del ricovero, una terapia<br />

efficace, maneggevole e sicura.<br />

Bibliografia<br />

Chengappa. CNS Spectr 2004.<br />

180. Group II metabotropic glutamate<br />

receptor ligands-induce neurogenesis<br />

in cerebellar granular cell cultures<br />

F. Matrisciano * ** , I. Panaccione ** , B. Turriziani ** ,<br />

M. Zusso *** , P. Giusti *** , P. Girar<strong>di</strong> * , R. Tatarelli * ,<br />

D. Melchiorri ** , F.B. Nicoletti *<br />

* Department of Psychiatry and Psychological Me<strong>di</strong>cine,<br />

Sant’Andrea Hospital, University of Rome “La Sapienza”;<br />

** Department of Human Physiology and Pharmacology,<br />

University of Rome “La Sapienza”; *** Department of Pharmacology<br />

and Anesthesiology, University of Padova<br />

Introduction: metabotropic glutamate (mGlu) receptors<br />

have been recently shown to be involved in the pathophysioloy<br />

of depression. Group I and II mGlu receptors are upregulated<br />

by chronic antidepressant treatment, and exert<br />

antidepressant-like activity in several preclinical and some<br />

clinical stu<strong>di</strong>es. Antidepressant drugs induce proliferation<br />

and <strong>di</strong>fferentiation of progenitor cells in the hippocampal<br />

dentate gyrus of the adult brain. The generation of new<br />

neurons is thought to be involved in the antidepressant activity.<br />

Recently, the selective serotonin reuptake inhibitor,<br />

fluoxetine was reported to up-regulate proliferation of<br />

progenitor cells in cerebellar granular cell cultures. This<br />

fin<strong>di</strong>ng is of interest as granule cell cultures are a unique in<br />

vitro model of post-natal <strong>di</strong>fferentiating neurons. We thus<br />

examined whether treatment with selective ligands of<br />

mGlu receptors mimics the neurogenic effect of fluoxetine<br />

in mixed cultures of both progenitor and mature cerebellar<br />

granule cells.<br />

Material and Methods: primary cultures of rat cerebellar<br />

granule cells prepared from 7-day-old rat pups contain<br />

both <strong>di</strong>fferentiated granule cells and un<strong>di</strong>fferentiated precursors,<br />

the latter termed round cells. The expression of in<strong>di</strong>vidual<br />

mGlu receptor subtypes was assessed in round<br />

cells by Western Blot analyses. Ten days after plating,<br />

mixed granule cell cultures were exposed either to fluoxetine<br />

(1 µM), or to the selective group II mGlu receptor ligands<br />

LY379268 (1 µM) and LY341495 (1 µM) for 72<br />

hours. Cell proliferation was assessed following incorporation<br />

of 5-bromo-2’-deoxyuri<strong>di</strong>ne (BrdU) (10 µM) by<br />

round cells.<br />

Results: round cells, at 6-10 days in vitro (DIV) expressed<br />

mGlu2/3 and -5 receptors. Fluoxetine, the selective group<br />

II mGlu receptor agonist, LY379268, and the group II<br />

304

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