Clinical Psychopharmacology

+44 (0)1865 226394 (fax +44 (0)1865 251075)
phil.cowen@psych.ox.ac.uk

Brain imaging Depression Drug treatment Evidence Based Medicine Magnetic Resonance Imaging (MRI) Mental illness Neuroimaging Pharmacology

Founded by Dr Bertram Mandelbrote in the 1970’s.

The group focuses on understanding psychotrophic drug treatments in psychiatry.

Our primary funding is from the Medical Research Council (MRC).

Our research aims to understand how psychotropic drugs work at molecular level. By exploring this through clinical research in patients we contribute to the development of new evidence-based pharmacological treatments for severe mental illness.

Two PET images of the brain showing 5-HT2A receptor binding as measured by [11C]MDL100907. The first image shows the brain after placebo, and the second image shows the brain after Mirtazapine (30mg orally). — Our group's PET imaging study showed the effect of the antidepressant drug mirtazapine on brain 5-HT2A receptors.

The chance discovery of psychotropic drugs in the middle of the last century transformed the practice of psychiatry. However in recent years, with dwindling industry investment, the development of new psychotropic drugs has been relatively slow. It is therefore crucial for academia to stimulate the process of drug discovery.

The Clinical Psychopharmacology group comprises of collaborations between basic scientists and clinicians, using techniques such as pharmacological challenge, neuroimaging, neuropsychological testing and drug repurposing to explore the mechanisms of new and existing psychopharmacological treatments in psychiatry.

On order to inform a ‘precision medicine’ approach to treatment, we explore the different mechanistic pathways that can lead to severe mental illness. For example, there is increasing evidence that inflammation may play a role in the symptoms of depression. Our group is currently investigating if the anti-inflammatory properties of a type of drug commonly prescribed to lower cholesterol, called statins, has antidepressant effects. By exploring the influence of statins on emotional processing, in collaboration with the Oxford Psychopharmacology and Emotion Laboratory (PERL), we can gain insight into potential inflammatory mechanisms of depression.

Brain imaging is an important part of understanding how psychotropic drugs work and we have collaborations with the IMANOVA PET Institute at the Hammersmith Hospital and with the Oxford Centre for Functional Imaging of the Brain (FMRIB). Our current work focuses on the clinical application of magnetic resonance imaging (MRS). We are using MRS to measure levels of certain neurometabolites that are important for energy production; this has enabled us to study the brain chemistry of chronic fatigue syndrome, as well as the symptoms of fatigue experienced by some patients recovering from COVID-19.

Lithium is still the best mood stabiliser for patients with bipolar disorder. However, it has some problematic long-term side effects and is not well-tolerated. In collaboration with colleagues in the University Department of Pharmacology we are exploring the potential of a safe antioxidant drug called ebselen as a lithium mimetic. Our initial studies suggest some efficacy of ebselen in the treatment of mania and we are currently assessing its effects in patients with depression.