Introduction Acute mania can have behavioral effects such as agitation, being a frequent cause of presentation in the emergency department. Pharmacological treatments include mood stabilizers and atypical antipsychotics. Valproate is an effective drug. However, the intravenous formulation is relegated to other pathologies, such as epilepsy. Objectives The objective was to review the use of intravenous valproate in acute mania in the literature and present its use through a clinical case. Methods A clinical case using intravenous valproate to treat an episode of acute mania is described and the scientific literature of the last 5 years is reviewed. Results A 43-year-old patient attended the emergency department with a diagnosis of bipolar disorder type I in manic episode with agitation, rejection of oral medication, brought in by the police due to risk of aggression against family members, who reported that the patient had stopped taking her usual medication with valproate 500 mg / 24h and quetiapine 200 mg / 24h threemonths ago. Due to the possibility of having intravenous valproate, it was decided to administer 300 mg intravenously, as well as haloperidol 5 mg intravenously, and hospitalization was decided. The patient had a favorable evolution, with no side effects to the medication, and oral treatment was started after 8 hours, with a good response. In the literature there are few studies in this regard, although the most of them approved the use of valproate as a loading dose in acute mania. Conclusions Intravenous valproate is an effective, safe, and tolerated treatment in acute mania. More studies are needed to collect precise information. Disclosure No significant relationships.

IntroductionIt is knowed the relationship between psychological problems and cardiovascular disease. Pychological alterations can cause cardiovascular diseases, and a cardiovascular event can trigger psychological alterations.ObjectivesThe aim was to present a clinical case about a young man with cardiovascular alterations and depressive symptoms and to analyze the role played by cardiovascular drugs, psychoactive drugs, and their interactions.MethodsWe present the clinical case and search the relation between cardiovascular disease and depressive symptoms and treatment at scientific literature of last five years.ResultsA 38-year-old man comes to the emergency room with symptoms of palpitations, fatigue and shortness of breath for 2 weeks. An electrocardiogram is performed showing premature ventricular beats. The patient reports that he is sadder recently due to the loss of work, for which he is prescribed sertraline 50 mg daily and is referred to cardiology. No medical history or consumption of alcohol, tobacco or other toxins. The cardiologist requests ergometry, echocardiography, and Holter monitoring, resulting in all normal tests, with no evidence of ischemia. Bisoprolol 2.5 mg daily is prescribed and sertraline 50 mg daily is maintained. After two months, the patient reports feeling better in spirit. The control electrocardiogram is normal and the patient reports disappearance of palpitations. You are referred to your family doctor.ConclusionsElevation of cortisol, platelet hyperactivity, and alteration in heart rate variability were found in depressives. The SSRIs would be the ones of choice. Dual serotonin and noraderaline reuptake inhibitors should be avoided. Other atypical drugs such as bupropion or trazodone should be considered.DisclosureNo significant relationships.

IntroductionAttention Deficit and Hiperactivity Disorder (ADHD) is a neurobiological disorder, affecting executive functions and defined by hyperactivity, attention deficit and/or impulsivity symptoms. This neurodevelopmental disorder affect up to 7% of children. It is observed as a chronic pathology appearing on childhood with other comorbid diseases. Often, remarkable symptoms use to change with the age, however a real improvement is also related with other -external- factors, as social environment.Objectives-To highlight variability of ADHD symptoms and complexity of available treatments in childhood. -To analize influence of personal and familiar factors, which affect to evolution of ADHD and the response to treatment.Methods Comparative-study. Retrospective selection of 8 patients with treatment for ADHD and currently stable. A 12-months ADHD confirmed diagnosis in Child and Adolescent Mental Health Unit and follow-up after diagnosis. They are compared by aged-pairs (females and males) at the different development school-stages (preschool 3-6 years, primary school 7-12 years and adolescence 13-16 years). *Pairs of study: male-5 years/female-6 years; male-7 years/female-8 years; female-10 years/male-11 years; female-13 years/male-15 yearsResults-Evolution of ADHD highlights the influence of age-factor about remarkable symptoms mainly (from hiperactivity to inattentiveness). -Comorbid disorders seems related with sex-factor (impulsivity-eating disorders on females and irritability-mood disorders on males). -Children social environment, specially family support, is an important external factor for all these patients (low self-steem or somatization disorders).Conclusions 1. ADHD as a chronic disorder whose evolution depends on the age, sex and social factors 2. Genetic component or familiar support are also considered as influencers factors 3.Multidisciplinary approach to objectives: motivation, organization and maturity 4. Treatment is consider according to side effects and comorbidity

Introduction Postpartum depression is a common psychiatric complication after pregnancy, so it is necessary to know the depressive symptoms to be able to carry out early prevention and treatment interventions. It is a health problem with a prevalence that ranges between 10–15% according to the world literature. Behavioral and psychosocial factors favoring postpartum depression are recognized. Objectives -To emphasize multidisciplinary treatment in the combined attention to the mother-baby. -To demostrate decreased risk for baby if early use of antidepressants. -To evaluate of the impact of desvenlafaxine during breastfeeding. Methods Descriptive-study. Clinical Case. Evolution of postpartum depression. Follow-up of a patient based on coordination with the midwife attending a successful breastfeeding while treatment with desvenlafaxine. Use of Edinburgh Postnatal Depression Scale. Results -Use of Desvenlafaxine 50-100mg being compatible with breastfeeding, in adittion to depressive illness improvement *Obstetrics and psychiatry guidelines and safety considerations for lactation and antidepressants). Conclusions -Postpartum-depression could be the first episode of depression in a healthy woman. Sometimes there are unnoticed symptoms during pregnancy. -Health-care for puerperal women should be focused on both, biomedical and psychosocial issues, with a coordinated multidisciplinar team. -Due to important early treatment during the puerperium, it is recommended a close medical control of the mother´s psychological state after the birth. -If depression appears, a psychiatric follow-up is kept even after the episode remission. Besides, the role of the midwife is essential during lactation. -Some antidepressants like desvenlafaxine have demonstrated benefits over the risk of the baby´s complications without treatment. Disclosure No significant relationships.

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