Medway school of pharmacy

I joined the team at the Medway School of Pharmacy in August 2006.  I am a Neuropharmacologist, and I have held a number of academic and industrial research positions in the UK, USA, France and Germany.  My research focuses on understanding the nature of neurobiological processes underlying motivation, learning, affect, drug abuse and abnormal psychopathology.

I have held scientist positions at Syntex Pharmaceuticals, Scotland, Centaur Pharmaceuticals, California & most recently at Organon Laboratories, Scotland,.(2002-2005);  where I managed a team working toward pre-clinical drug discovery of novel anti-depressant and anti-psychotic drugs.  I have also held a senior lecturer post, teaching pharmacology within the MPharm degree course at the University of Brighton (2000-2002).  I have a broad interest in mental health and drug use in psychiatry.

Specialist area

Lecturer in pharmacology. I deliver lectures / seminars / labs / workshops in the areas of biology, physiology, pharmacology, neuropharmacology. I am the disabilities co-ordinator for the school.

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I am interested in studying interventions to improve functioning in children with neurodisabilities, particularly the neurodevelopmental disorders autistic spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD), and to improve quality of life of the family units supporting these children.

Autism Overview

Autism is a highly complex neurological condition affecting approximately 1% of all children and exists on a spectrum of severity and symptom mix (technically called behavioural endophenotypes). Children with autism have difficulties in social functioning and social communication, and typically display restricted and repetitive interests, with strong reactions to change or being deflected from a chosen activity. Quite often children with autism also have motoric and balance problems and also changes in sensory processing (being either hypo- or hyper-reactive to all modalities of sensory stimuli, light, sound or touch/pain).  As a result primarily of deficits in social functioning, a significant number of autistic children show challenging behaviour, and this can be apparent in children either with or without communication or learning impairments.  Often many other conditions can occur superimposed upon the autism (so called comorbid disorders), including epilepsy, attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), oppositional defiant disorder (ODD), affective disorders, (anxiety and depression), and many others.  It is important therefore that accurate diagnosis is performed as early as possible so that individualised early intervention strategies may be put in place to increase effective functioning and to allow the children to develop and to build upon coping strategies which will take them through life in a social world.  With an adequate amount of specialist educational, and social support children and the families of children with autism can lead incredibly fulfilling lives and surmount the challenges facing them.

Specific Projects

1). Use of stimulant medication to treat children with a primary diagnosis of ASD: A systematic analysis of clinical benefit .

Although the current diagnostic criteria of the DSM IV (Diagnostic & Statistical Manual of mental Disorders) does not allow for the comorbid diagnosis of autistic spectrum disorder (ASD) + attention deficit hyperactivity disorder (ADHD), it is accepted in clinical practice that many autistic children do additionally display symptoms of hyperactivity, impulsivity, and oppositionality.  The mainstay of pharmacological treatment of children with attention deficit is with the stimulant drugs, namely methylphenidate (Ritalin) and atomoxetine.   It is of interest therefore to study prescribing practices in relation to stimulant usage in ASD, and also to assess level of efficacy (benefit) along with   frequency of adverse drug reactions in this vulnerable population.

2). An analysis of sleep hygiene and treatment of sleep disorders in children with neurodevlopmental disorders: ASD & ADHD.

The incidence of sleep disorders in children with developmental disorders such as attention deficit hyperactivity (ADHD) and autistic spectrum disorder (ASD) appears to be higher than in neurotypical children.  However, it is not clear exactly what proportion of children with ASD do suffer poor quality sleep or what the precise nature of their sleep problems may be.  Considering just how important sleep is for its restorative, and immune boosting properties and for facilitating condensation of learning experiences into memories, it is important to understand how far reaching and damaging effects of insomnia may have on the functioning of the child with ASD as well as family members who also suffer diminished rest.  Adequate sleep may be facilitated by the implementation of good sleep hygiene measures such as constant routine, the use of very solid visual cues surrounding bedtime (visual schedules, sand timers), relaxing practices such as bathing, massage and social bonding time such as story-telling and cuddling.  Despite good sleep hygiene, often children with ASD do struggle to get to sleep and show bedtime resistance, they may also wake often and for long periods during the night, and they can also display higher frequencies of nocturnal parasomnias (night terrors).  This study sets out to investigate the prevalence of sleep disorders in children with neurodisabilities and also how they may be treated, either by non-pharmacological means (ie: behavioural  modification), or pharmacological means (use of antihistamine or melatonin based hypnotic agents).  Many pharmacological therapies utilised to treat problematic behaviours in children with ASD’s, such as stimulant drugs, (methylphenidate), or selective serotonin reuptake inhibitors (SSRI’s),  can unfortunately have a disruptive effect on sleep architecture, to worsen  already poor sleep.  It is important that this fact be highlighted in order to inform clinician’s choice of individualised treatment interventions.

3).  Parents perspectives on living with autism:

It can be a devastating diagnosis to receive that your child is autistic, and it may take substantial time to understand and accept this life changing event.  I am interested in gathering data on how parents cope following diagnosis, and how effective coping may be affected by such factors as A). Level of social support: extent of extended family or social services  / respite in its various forms, etc. B). Severity of autistic symptoms, including challenging behaviour, C). Membership to charity organisations / autism support groups.

The National Autistic Society has recently produced a helpful document “After diagnosis”.
(Print copies are available from http://www.autism.org.uk/products/leaflets/after-diagnosis.aspx).

National Autism Organizations:
http://www.autism.org.uk/
http://www.researchautism.net

Local Support Groups:
http://www.medway-magic.org/
http://www.kentautistic.com

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• Hodge CW, Bratt AM, Kelley SP. (2008). Deletion of the 5HT (3A)-receptor subunit blunts the induction of cocaine sensitization. Genes Brain Behav. 7(1): 96-102.
• Hodge CW, Kelley SP, Bratt AM, Iller K, Schroeder JP, Besheer J. (2004). 5HT(3A) receptor subunit is required for 5HT3 antagonist induced reductions in alcohol drinking.  Neuropsychopharmacology 10: 1807-1813
• Bratt AM.  (2003) A large group hybrid lecture and problem-based learning approach to teach central nervous system pharmacology within the third year of an integrated masters level pharmacy degree course.  Pharmacy Education 3(1): 35-52.
• Sosabowski, MH.,  Bratt, AM,  Herson, K,  Olivier, GWJ, Sawers, R,  Taylor, S,  Zahoui, AM,  Denyer, SP. (2003). Enhancing Quality in the M.Pharm Degree Programme: Optimisation of the Personal Tutor System.
• Pharmacy Education. Volume 3, pp. 103-108

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