PS86. Kleptomania - a side-effect induced by venlafaxine

s | 29 Abstract Objectives: To compare the risk for subsequent development of mania or hypomania between venlafaxine monotherapy group and Olanzapine augmentation group, the authors conducted a preliminary retrospective medical record review for patients originally diagnosed as unipolar major depression during 7-year follow-up period. Methods: we selected samples from the patients who visited psychiatric outpatient clinic of Bongseng memorial hospital from August 1st 2006 to August 31st 2008. All patients were diagnosed as originally unipolar depressive disorder and prescribed venlafaxine alone (VLF) or olanzapine augmentation (OLZ+) from the first visit according to clinician’s decision. We included consecutively 35 patients in each group and reviewed the development of mania or hypomania according to the DSM-IV-TR diagnostic criteria for 7-year follow up (F/U) period. Results: In VLF group, symptom severity (CGI-S 3.9 ± 0.7 vs 4.5 ± 0.6) was lower, F/U duration (36.0 ± 33.8 vs 62.6 ± 41.0 months) was shorter and age at first visit (45.0 ± 16.7 vs 57.2 ± 12.4 years) was younger (p < 0.01) than OZP+ group. In VLF group, manic (2.9 vs 0.0 %) and hypomanic (8.6 vs 2.9 %) switch rate were higher than OZP+ group, but those were not statistically significant. Almost all cases were switched to manic or hypomanic in the early phase of F/U period (3 cases within 1 month and 1 case within 3 months) and revealed previous early onset or multiple non-treated brief mood episodes according to post-hoc meticulous history taking. Conclusion: OLZ augmentation could be preventive option for manic or hypomanic switching in treatment of depressive disorder. We should be careful to detect manic or hypomanic switch in the early treatment phase of younger and non-treatment history patients with uncovered early onset or multiple brief mood episodes. Limitations of our study were small sample size, shorter duration of F/U period, no active periodic F/U check, older age of sample and unstructured design.