Older adults in social setting


Optimising pharmacological treatments

Prescribing safely and effectively is more challenging as people age. We research ways to optimise existing drug treatments for mental health conditions in older people and test alternatives.

Clinical trials evaluating the safety and effectiveness of drug treatments for mental health conditions including psychosis and depression are typically carried out in young people, and exclude people aged over 65 years or with physical health conditions. When extrapolating from these studies to older people, dose estimates are imprecise and the treatment outcome less predictable, as the risks and benefits may differ considerably. 

Our research has helped to understand the mechanisms of antipsychotic drug side effects in older people with psychosis with onset after 60 years, both in the context of schizophrenia and Alzheimer’s type dementia. We have also produced guidance on antipsychotic (risperidone) dose adjustments, which take into account age and dementia severity. Our search for alternative  and potentially safer treatments led to the repurposing of an anti-sickness medication, ondansetron, as a treatment for hallucinations in people with Parkinson’s and dementia with Lewy bodies. Future research will focus on depression in older people and will evaluate the impact of remaining on or discontinuing antidepressant treatment.