Drug treatment of elderly presents special challenges because of changing physiological parameters, comorbidities, concomitant medications, and occasional frailty. These challenges which are part of drug development, are mostly addressed in phases IIIB and IV as well as in daily clinical practice. For example the low propensity of novel antipsychotics to produce EPS or the lack the of drug-drug interaction of some of the antidepressants isomers are particularly relevant to elderly who are more sensitive to AE. However, the main change in terms of drug development for elderly is to develop drugs to treat the most age dependent condition i.e., dementia.
Since most dementias are caused by brain neuronal degeneration no therapeutic intervention can have a major impact once dementia is fully manifested. Only treatment of impending but asymptomatic or of very early manifestations, aimed at preventing or delaying neuronal degeneration, can significantly impact on dementia. This leaves theoretically the possibility of general prevention or targeted prevention. General prevention would require that the intervention has non or minimal AE, is easy to administer, and inexpensive hence, it can be made available to all elderly above a certain age. Vitamin E, hormones and unsaturated fatty acids have been suggested in this context but were not found to benefit dementia in a significant manner. Targeted prevention for individuals at high and/or at imminent risk, appears a more realistic strategy. However this strategy requires accurate markers of impending disease and of disease progression. Developments of markers has recently moved from putative neuropsychological markers to imagery markers, in the form of fMRI, PET, and computerized EEG. Moreover the imagery technology appears to be useful to understand CNS drug’s pharmaco-kinetic and hopefully shade light of the drugs mechanism of actions. The symposium will focus on markers as it pertains to new drug development.
Back to S019 New Drug Development in Psychogeriatrics
Back to The Eleventh International Congress