Antydepresant w sprayu – esketamina podawana donosowo jako nowa perspektywa walki z depresją oporną na leczenie

Autorzy

Martyna Szlenk
1. Studenckie Koło Naukowe przy Katedrze i Zakładzie Biofizyki im. prof. Zbigniewa Religii, Wydział Nauk Medycznych w Zabrzu, Śląski, Uniwersytet Medyczny w Katowicach
Patryk Walocha
Julia Stachowiak
Michał Wilk

Słowa kluczowe:

esketamina, ketamina, depresja oporna na leczenie, skuteczność, bezpieczeństwo

Streszczenie

Depresja oporna na leczenie (ang. treatment-resistant depression, TRD), stanowi jedno z największych wyzwań współczesnej psychiatrii ze względu na trudność jej zdefiniowania, ograniczone i mało efektowne możliwości leczenia, brak dokładnego poznania patomechanizmu oraz złe rokowania dla pacjenta. Obecnie przyjmuje się, że TRD klasyfikujemy, gdy u pacjenta nie dojdzie do redukcji nasilenia większej niż 25% po zastosowaniu dwóch różnych terapii lekowych. Zalecenia dotyczące dalszego postępowania nie są spójne, rekomendując modyfikacje terapii lekami przeciwdepresyjnymi, terapie neurostymulujące oraz psychoterapie, jednakże skuteczność opisanych metod jest niska lub krótkotrwała, a powikłania, zwłaszcza w modyfikowanej farmakoterapii, są liczne. W 2019 roku pojawiła się nowa obiecująca perspektywa leczenia TRD, którą okazał się enancjomer powszechnie używanej w anestezjologii ketaminy. Esketamina firmy SpruvatoTM podawana donosowo, okazała się zaskakującym rozwiązaniem, zarówno z powodu komfortowej dla pacjenta formy podaży, jak również wysokiej skuteczności, przy względnie wysokim bezpieczeństwie. Przewaga omawianego preparatu kryje się w jego niecałkowicie poznanym mechanizmie wpływającym na układu glutaminergicznego, GABA-ergiczne oraz układ receptorów opioidowych, pozwalający zadziałać na zupełnie innego neurofizjologiczne struktury mózgu, niż standardowe leki przeciwdepresyjne wpływające głównie na układ monoaminergiczny. Celem niniejszej pracy jest przybliżenie problematyki TRD wraz z dokładnym omówieniem skuteczności i bezpieczeństwa terapii z wykorzystaniem esketaminy.

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Zapowiedzi

16 września 2024
Prawa autorskie (c) 2024 Martyna Szlenk, Patryk Walocha, Julia Stachowiak, Michał Wilk

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