$286 P.6 Other topics Discussion: Discharges of DH into a full time hospital are very fre- quent: 40% of them were considered probably linked to a drug-related problem. 54.6% of these discharges were sent to the somatic hospital: the main causes of these hospitalisations were falls and delirium. This last condition was frequently related to drug abuse or drug interactions. Psychiatric hospitalisations were frequently related to problems of com- pliance and to insufficient drug efficacy linked to the difficult management of treatment in a out-patient facility. Conclusion: drug-related problems in geriatric psychiatry are a well stablished problem. In fact, it's very difficult to psychiatrists to manage drug treatments for this category of patients: they have to balance all the time the relationship between the benefit expected and the risk of side effects. Each facility for elderly patients mentally ill should have systematic data concerning the frequence of these drug-related problems: these data may increase the quality of drug treatments. References [1] Cooper JW (1989) Geriatrics 44, 79-86. • Electroconvulsive therapy in clinical practice: Procedure and therapeutic response R. Frey, D. Schreinzer, J. Scharfetter, A. Heiden, T. Blasbichler, J. Tauscher, O. Presslich, S. Kasper. Department of General Psychiatry, Un&ersity of Vienna, Vienna, Austria The paper refers to the electroconvulsive therapy (ECT) with Thymatron DG (Somatics, INC) at the Department of General Psychiatry in Vienna, between 09/1994 and 12/1996. Different questions concerning treatment procedures and therapeutic response were supposed to retrospective data analysis. In total, 64 patients were treated with ECT according to the Task Force Report of the APA (1). Severe depression (ICD 10:F31-F33) was diagnozed in 48 patients, schizophrenia (F 20) in 9 patients and schizoaffective disorder (F 25) in 7 patients. The sample consisted of 47 females (mean age: 51.1a) and 17 males (49.5a). Informed written consent was given by themselves or by jurisdiction (N = 4). Even if medication resistance was obvious, antidepressants and neuroleptics were mostly continued under steady state conditions. Benzodiazepines were reduced to minimal dosages, lithium and anticonvulsants were omitted. As anesthetic agent propofol was used at first in 11 patients, lateron methohexital was used. ECT was administered at three times per week unilaterally over the right hemisphere for at least five treatments, with the option to provide bifrontotemporal electrode placement afterwards. In 1994/95 stimulus intensity was fixed according to the "age = dose" protocol as suggested in the manual of Thymatron DG. Thus, a 50 years old patient received 50% of the maximal charge (504 mC). Since 01/1996 "stimulus titration method" was performed in 34 patients. They needed a mean charge of 100 mC to elicit a seizure at the first treatment. In sub- sequent treatments, stimulus dosing was adjusted to be 2-3 times above seizure threshold. The ECT course consisted of 10.0 (SD 3.2) treatments. At the fifth treatment, a mean charge of 255 (SD 130) mC led to an ictal EEG of 39.7 (SD 15.7) sec and an fetal EMG of 27.7 (10.9) sec. There was no correlation between charge and EEG - EMG difference. Seizure duration was equal in females and males (matched pairs analysis, N = 2 x 13, considering age and charge). Clinical Global Impression (CGI) was 7.1 (SD 0.7) at baseline, 5.7 (0.8) at treatment 5 and 4.9 (0.8) at the end of therapy. The latter score differed significantly as compared to baseline and treatment 5 (p < 0.001, t-Test for paired samples). Moreover, treatment 5 differed significantly from baseline (p < 0.001). CGI improved to one degree in 23.4% (N = 15), two degrees in 43.8% (N -- 28), three or better in 32.8% (N = 21), respectively. The clinical improvement did not depend significantly on age, sex or diagnostic entity. 53.1% (N = 34) showed an improvement of at least two degrees until the fifth treatment. 19 patients were switched to bilateral technique. Their mean CGI at treatment 6 was 6.2 (0.8) and further improvement was only 1.0 (0.9). There were neither incidents during anesthesia nor severe cognitive impairment, suggesting premature limitation of ECT in any individual. In conclusion, ECT was administered to 64 patients in a severe episode of a mental disorder (mean CGI: 7.1), predominantly medication resistent depression. ECT course consisted of ten treatments in the average. De- tection of seizure threshold at the first unilateral treatment proved to be useful. At the fifth treatment, a mean charge of 255 mC caused a mean seizure duration of 39.6 sec in EEG. CGI score improved significantly (p < 0.001) over the treatment course. Beginning from the sixth treat- ment, 30% (N = 19) received ECT bilaterally with only minor further improvement. There were no severe adverse effects. R~rencea [1] American PsychiaWicAssociation. (1990) The practice of ECT: recommenda- tion for treatment, training and privileging. Washington, D.C. ~ Inositol treatment of bulemia Diana Ghelber, Joseph Levine, R.H. Belmaker. Ministry of Health Mental Health Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheva, Israel Inositol is a simple isomer of glucose that is a precursor for the second messenger system for numerous neurotransmitters, including serotonin 5HT-2. Inositol 12 gm per day has been reported in double-blind controlled trials to be effective in depression, panic disorder, obsessive- compulsive disorder but not schizophrenia. Serotonin specific reuptake inhibitors (SSRI) are effective in the treatment of bulimia. Since the clinical spectrum of therapeutic efficacy of inositol seemed to parallel that of SSRI's, we decided to study inositol in bulimia in a double-blind con- trolled design. Patients age 18-50 meeting DMS-IV criteria for bulimia nervosa, Bulimia Investigatory Test (BITE) > 10, excluding anorexia nervosa, who had not responded to previous therapy, had side effects with previous therapy, or refused standard therapy, were offered 18 gm inositol per day for 6 weeks or crossover to 18 gm glucose for 6 weeks. Texture, appearance, and taste of the compounds were similar. Patients were instructed to dissolve two teaspoons in juice or coffee three times per day. The study was proceeded by a one week placebo run-in. Assessment was done with Eating Diary (EDI), HAM-D, HAM-A, analogue visual scale, Eating Attitude Test (EAT), and a side effect scale. All scales were completed by a psychiatrist blind to the medication phase. Preliminary results suggest efficacy for inositol treatment in bulimia, another SSRI responsive syndrome. References Levine J, Barak Y, Gonsalves M, Szor H, Eliznr A, Kofman O and Belrnaker RH (1995). A double-blind controlled trial of inositol treatment of depression. American Journal of Psychiatry 152: 792-794. Benjamin J, Levine J, Fux M, Aviv A, Levy D and Belmaker RH (1995). Inositol treatment for panic disorder: a double-blind placebo-controlled crossover trial. American Journal of Psychiatry 152: 1084-1086. Fux M, Levine J, Aviv A, Belmaker RH (1996). Inositol treatment of obsessive- compulsive disorder. American Journal of Psychiatry 153: 1219-1221. • Photons, CNS, and the possible role of absorbing and fluorescent substances; Is our brain an "Optocybernetic system"? F. Grass 1, D. Oren 2, H. Klima 3, S. Kasper 1.1Department.of General Psychiatry University of Vienna," 3Atomic Institute of the University of Vienna, Austria, 2Department of Psychiatry Yale University, USA Photon emission from unicellular and multicellular organisms has been studied for decades, the phenomenon is referred to by a variety of names, such as mitogenic radiation, dark-luminescence, low-level chemilumines- cence and biophotons. If these photons have a biocommunicative role, or are just a side product of radical formation, has been a long discussion. Gurvich, Dicke and later Popp have developed concepts that photons play a role in cell to cell communication and metabolic regulation at the subcellular level. Shen's experiments could actually show degranulation of pig neutrophils being mediated by photons. According to Jibu and Hameroff's hypothesis cytoskeletal microtubules are capable of guiding photons, thus forming as "microtubular networks" the ultrastructural basis of memory, cognition and conciousness. They even raise the possibility that our cells, and subsequently also our brain acts as a "holographic computer" or "optocybemetic system". Oren in 1995 presented his humoral phototransduction hypothesis as complementary explanation for the action of light regulating biological