Esketamin u liječenju terapijske rezistentne depresije

postgraduate specialist thesis

• Author: Margareta Vudrić
• Mentor: Miroslav Herceg (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Miroslav Herceg (član povjerenstva)
• Committee member: Iva Mucalo (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2024-09-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

CILJ ISTRAŽIVANJA
Cilj ovog preglednog rada je opisati i istražiti mehanizam djelovanja, učinak i razinu sigurnosti
upotrebe esketamina u liječenju rezistentne depresije.
MATERIJALI I METODE
U izradi ovog preglednog rada korištena je stručna i znanstvena literatura na temu antidepresiva,
s posebnim naglaskom na upotrebi esketamina u liječenju terapijski rezistentne depresije.
Literatura je pretraživana prema temi i predmetu istraživanja, od općih do specijaliziranih
članaka, pri čemu su odabrani članci relevantni za problematiku ovog specijalističkog rada.
Ciljana pretraga je provedena putem akreditiranih baza podataka kao što su PubMed,
ScienceDirect i Cochrane Library, kao i baza sažetaka opisa svojstava lijekova Agencije za
lijekove i medicinske proizvode (HALMED) i Europske agencije za lijekove (EMA).
REZULTATI
Depresivni poremećaj pogađa oko 4,7 % svjetske populacije. Unatoč širokom spektru
terapijskih opcija razvijenih za liječenje, samo 60-70 % pacijenata postiže zadovoljavajući
odgovor na standardnu terapiju. Trećina pacijenata ne odgovara na standardne terapijske
pristupe. Ovakvi oblici bolesti nazivaju se depresijom otpornom na liječenje te predstavljaju
složen izazov u dijagnostici i planiranju liječenja. Istraživanja pokazuju da intranazalni
esketamin smanjuje rizik od suicida i simptome depresije. Nuspojave kao što su povećan krvni
tlak i disocijacija su prolazne.
ZAKLJUČAK
Tradicionalne opcije liječenja terapijski rezistentne depresije imaju spor početak djelovanja
što ograničava njihovu korist kod najteže pogođenih pacijenata koji mogu biti pod visokim
rizikom od samoubojstva. Stoga je brzodjelujuća terapija bitna. Nazalni esketamin se ističe
kao obećavajući brzodjelujući antidepresiv koji ima potencijal poboljšati simptome teške
depresije već unutar 24 sata od primjene. Ova brza reakcija može biti ključna za pacijente,
pružajući im brzo olakšanje od simptoma i poboljšavajući njihovu kvalitetu života.

Abstract (english)

OBJECTIVES
The goal of this review paper is to describe and explore the mechanism of action, efficacy and
safety level of using esketamine in the treatment of treatment-resistant depression.
MATERIAL AND METHODS
The literature search was done by the subject of research from general to specialized articles
relevant to the questions discussed in this paper. The targeted search was carried out via online
databases such as PubMed, ScienceDirect, and Cochrane Library, summaries of product
characteristics (SmPC) in the database Agency for Medicinal Products and Medical Devices,
and European Medicines Agency.
RESULTS
Depressive disorder affects approximately 4,7 % of the world’s population. Despite a wide
spectrum of therapeutic options developed for treatment, only 60-70 % of patients achieve a
satisfactory response to standard therapy. One-third of patients do not respond to standard
therapeutic approaches. Such forms of the disease are called treatment-resistant depression and
represent a complex challenge in diagnosis and treatment planning. Research shows that
intranasal esketamine reduces the risk of suicide and depressive symptoms. Side effects such
as increased blood pressure and dissociation are transient.
CONCLUSION
Traditional treatment options for treatment-resistant depression often have a slow onset of
action, which limits their effectiveness, especially for severely affected patients who may be at
high risk of suicide. Therefore, the need for rapid-acting therapies is crucial. One promising
rapid-acting antidepressant is intranasal esketamine. It has the potential to improve symptoms
of severe depression within 24 hours of administration. This rapid response can be a key factor
for patients, providing quick relief from symptoms and enhancing their quality of life.. In
summary, while traditional treatments may have limitations, newer approaches like intranasal
esketamine offer hope for more effective and timely relief for those struggling with treatment resistant depression.

• Keywords: esketamin; depresija; antidepresivi; rezistentna depresija
• Keywords (english): esketamine; depression; antidepressants; resistant depression
• Language: croatian
• URN:NBN: urn:nbn:hr:163:867116
• Study programme: Title: Clinical pharmacy - specialistic study - university study; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni specijalist kliničke farmacije (sveučilišni specijalist kliničke farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2025-02-11 11:21:38