1. PRESENTACIÓ CORPORATIVA BACKGROUND In order to deinstitutionalize patients with severe mental illness, in 1980 Stein described in USA the model of Assertive Community Treatment (ACT), characterized as an individualized, intensive and multidisciplinary treatment. This model has been successfully replicated in many countries. The antipsychotic drugs are the mainstream of medical treatment of these disorders. Nevertheless, despite recommendations from different clinical guidelines about not exceeding recommended doses, the clinical practice suggests that the use of high dose increases the risk of adverse effects: extrapiramidal side-effects, metabolic syndrome and sudden cardiac death. The aim of this study is to analyse the changes in treatment of antipsychotic therapy dose and number of concomitant antipsychotic, before and after the time of inclusion in an ACT program. CONCLUSION The ACT program multidisciplinary approach allows reducing the dose of antipsychotic drugs, by decreasing the number of patients with high and very high antipsychotic dose and also the polypharmacy, representing an increase of therapeutic safety and reducing pharmacological costs. METHODOLOGY A retrospective study was designed to include schizophrenic spectrum disorder patients (schizophrenia, schizoaffective disorder or schizotypal personality disorder) from an ACT program, with functional impairment and a course of disease for more than two years. The program was scheduled in a Catalonia midlands county mental health centre. Data on antipsychotics total daily dose prescribed and number of patients with high dose (HDA) or very high dose (VHDA) of antipsychotic converted to equivalent dose of Olanzapine and the number of antipsychotic for patient were obtained from medical records. HDA was defined by a total daily dose which exceeds to 20mg Olanzapine, upper limit stated in the summary of product characteristics, and VHDA, when daily dose exceeds to 30mg Olanzapine. Age, gender, diagnostic and relapse were also registered. Percentages and frequencies are shown for qualitative variables and average, standard deviation or percentiles are shown for quantitative ones. Bivariate analysis was conducted under parametric or non-parametric assumptions and differences between entrance and discharge were conducted under paired tests. IMPACT OF ASSERTIVE COMMUNITY TREATMENT IN THE HIGH DOSE AND POLIPHARMACY ANTIPSYCHOTIC VI Annual meeting on therapeutics in psychiatry, 5-6 May 2016 Barcelona, Spain Ana Martín, Clara Blanch, Núria Riera, Pere Roura-Poch, María-José Alvarez Vic Hospital Consortium & Mental Health and Social Innovation Research Vic University Group. Vic, Barcelona, Spain RESULTS Average daily dose of antipsychotic (mg of olanzapine) Number of patient s on HDA/VHDA treatment 81 entrances of 73 patients to ACT program, 45 (61.6 %) were males. The age average was 39.3 years (Confidence interval 0.95: 36.3-42.4) and no differences were observed between age and gender. The total reduction in the dose of olanzapine was from 30.6 mg to 25.5 mg (Fig. 1). The number of patients with HDA was decreased 4 patients, from 48 to 44, and for the patients with VHDA, was decreased 8 patients, from 34 to 26 (Fig. 2). The number of patients on treatment with 2 or more antipsychotic agents (Fig. 3) was reduced from 43 to 40, and patients on three or more drugs was decreased from 10 to 5. All these results have shown statistic significant differences (Chi Squared test). Number of patient s on polytherapy Fig. 1 Fig. 3 Fig. 2 REFERENCES Satake N, Hazama K, Sono T, Takahashi M, Ito J. Changes in antipsychotic medication in clients of assertive community treatment in Japan: a one-year follow up. Clin Pract Epidemiol Ment Health 2011 Jan 19;7:1-3) High dose antipsychotic therapy (HDAT) guideline. NHS. November 2012 [Referenced 09.05.2016] Disponible in: http://www.humber.nhs.uk/Downloads/Services/Pharmacy/Guidelines/High%20dose%20antipsychotic%20therapy.pdf http://www.humber.nhs.uk/Downloads/Services/Pharmacy/Guidelines/High%20dose%20antipsychotic%20therapy.pdf