Professor Rob Howard

Teacher and Psychiatrist at UCL Institute of Mental Health

Speaker

I work to develop and evaluate better treatments for people with dementiaand for psychosis in older people by investigating the mechanisms ofsymptoms and through the conduct of independent clinical trials. For example, our trials have shown the cognitive, functional and independentliving benefits of continuing dementia drugs until the late stages of Alzheimer's disease (DOMINO) and of antipsychotic treatment in people with very late-onset schizophrenia-like psychosis (ATLAS). Currently, I am trialling the effectiveness of problem-adaptation therapy in people with dementia who are depressed (PATHFINDER).

I work with Suzanne Reeves to identify ways in which psychosis in olderpeople can be treated most effectively and safely through optimising the use ofexisting antipsychotics and investigating the potential of novel and repurposed agents (e.g. ondansetron in the TOP HAT trial). We're working with Emma McLachlan and Neil Burgess at theICN to understand how dysfunction of thehippocampus and associated structures might underpin confabulation and delusionformation in AD.

With Kathy Liu we are investigating the structure and function of central noradrenergic pathways whose dysfunction might underlie the common and hard-to-treat agitation syndrome seen in people with AD.

Anxiety disorders are the most difficult mental health problems to treat successfully in older people. With Becky Gould and colleagues, we are looking at Acceptance and Commitment Therapy for this and have just completed a feasibility trial in older people with treatment resistant generalised anxiety disorder (FACTOID trial).