The following abstracts were presented as posters at the 2016 NEI Psychopharmacology Congress Congratulations to the scientific poster winners of the 2016 NEI Psychopharmacology Congress! 1 st Place: A Case Report and Literature Review of Clozapine Re-challenge Titration Schedules (page 26) 2 nd Place: Mental Health Statistics and Suicide Prevention at St. Tammany Parish Jail-2015 (page 41) 3 rd Place: Lithium-Induced Neurotoxicity at Therapeutic Range: Illustrative Cases and Literature Review (page 43) 101 Sertraline-induced chemosensory dysfunction Ahmed Elazzab 1 ; Alan R. Hirsch, MD 2 ; and Wannapak Richter, MD 3 1 Mansoura-Manchester Medical Programme, Mansoura University, Mansoura, Egypt 2 Smell and Taste Treatment and Research Foundation 3 Ramathibodi Hospital, Thailand ABSTRACT: Introduction: Myriad medications can cause chemosensory dysfunction including the antidepressant, citalopram (Okeke et al 2016). Sertraline has not hereto- fore been reported to cause smell and taste loss. METHODS: Case study: A 52 year old right handed female was nasute until five years prior to presentation, when she began on citalopram for treatment of depression. Shortly thereafter, she lost her smell and taste, which recovered after discontinuing this antidepressant. A similar situation occurred with sertraline treatment, causing her smell and taste to diminish. On discontinu- ing sertraline, her smell and taste partially returned which again attenuated after sertraline rechallenge. Specifically before sertraline taste was 80% of normal, but 2 weeks after 50 mg/day sertraline, taste dropped to 20%. Before sertraline, chocolate taste was 60% of normal, and then dropped to 10% of normal on sertraline. Eggroll and fried rice possessed 100% of normal taste when off sertraline then dropped to 50 and 0% respectively on sertraline. Coffee was at 75% taste when off sertraline and 50% on sertraline, whereas, blue raspberry sucker was 150% off and 75% on sertraline. Before sertraline she would experience 5 olfactory windows a day, whereas, on sertraline, she had none. RESULTS: Name of the test Off sertraline On sertraline Quick Smell Identification test 3 (normal) 1 (anosmia) Alcohol Sniff Test 3 (anosmia) 0 (anosmia) Retronasal Smell Index 2 (abnormal) 1 (abnormal) DISCUSSION: In this patient impairment of smell and taste occurred on sertraline. There was an improvement when it was discontinued. This temporal relationship suggests that sertraline is the pathologic factor for smell and taste impairment in this individual. Serotonin (5-HT) fibers are prominent in olfactory bulb (Brunert et al 2016). Serotonergic neurons that innervate the olfactory bulb modulate the initial representation and processing of olfactory information between sensory neurons and cortex (Brunert et al 2016). 5-HT receptor agonists reduce odor evoked responses in the olfactory bulb (Baumgarten Von et al 1963; Bloom et al 1964; Petzold et al 2009). Increasing 5-HT attenuates odor-evoked synaptic input to glomeruli through 5-HT 2C receptors, which are intensi- fied with decreased serotonergic activity (Petzold et al 2009). This supports the finding in this patient that 5-HT suppresses olfactory input. This occurs because sertraline causes inhibition of neuronal uptake of 5-HT (FDA, 2012) inducing relative 5-HT excess, thus inducing smell loss in this patient. The taste loss may similarly be due to increase in 5-HT. This is because taste is a physiological synesthe- sia, as retronasal smell. Retronasal smell is linked directly to about 90% of taste (Wahlstrom et al 2015). Thus, smell loss would also be perceived as taste loss. Query and assessment of olfactory and gustatory abilities in patients taking medications which enhance 5-HT are warranted. 102 Mixed effects modeling of placebo response across 8 placebo-controlled aripiprazole trials spanning 20 years in acutely relapsed schizophrenia patients Alejandro Ochoa, PhD 1 ; John D. Storey, PhD 1 ; Srikanth Gottipati, PhD 2 ; Shashank Rohatagi, PhD 2 ; Andy Forbes, PhD 2 ; Debbie Profit, PhD 2 ; Raymond Sanchez, MD 2 ; Margaretta Nyilas, MD 2 ; and William Carson, MD 2 1 Lewis-Sigler Institute for Integrative Genomics & Center for Statistics and Machine Learning, Princeton University, Princeton, NJ, USA CNS Spectrums (2017), 22, 62–109. © Cambridge University Press 2017 doi:10.1017/S1092852916000900 ABSTRACTS https://www.cambridge.org/core/terms. https://doi.org/10.1017/S1092852916000900 Downloaded from https://www.cambridge.org/core. IP address: 54.163.42.124, on 27 May 2020 at 06:27:32, subject to the Cambridge Core terms of use, available at