Abstract | Depresija je jedan od najčešćih mentalnih poremećaja i predstavlja vodeći uzrok invaliditeta u svijetu. Karakteriziraju ju intenzivna tuga, gubitak interesa za uobičajene aktivnosti, osjećaj bespomoćnosti i bezvrijednosti, umanjen apetit, gubitak energije i drugi simptomi. Procjenjuje se da preko 300 milijuna ljudi u svijetu pati od depresije. Neki od faktora koji doprinose razvoju depresije su genetički faktori, stres i traumatski događaji, te neravnoteža neurotransmitera u mozgu (adrenalin, noradrenalin, dopamin, glutamat, GABA, acetilkolin). Neurotransmiteri imaju ulogu posrednika u prijenosu signala između neurona vežući se za specifične receptore.
NMDA (N-metil-D-aspartat) ekscitatorni je receptor glutamata. Kada se glutamat veže za NMDA receptor dolazi do prijenosa živčanih signala. NMDA receptor otkrili su Richard Morris i Jeff Watkins, a njegovo otkriće bilo je ključno je za razumijevanje neurotransmisije i funkcioniranje mozga.
Istraživanja su pokazala da je disfunkcija NMDA receptora povezana s razvojem i manifestacijom depresije zbog nedovoljne neurotransmisije glutamata. Zbog toga neki antidepresivi za metu imaju NMDA receptor. Najpoznatiji takav lijek je ketamin koji djeluje kao antagonist NMDA. Nedavno su razvijene i druge vrste antagonista NMDA receptora kao što esketamin (S-ketamin) koji je enantiomer ketamina. Imaju izrazito brz antidepresivan učinak, ali privremen. Vrlo su dobra alternativa za rezistentnu terapiju, ali se javlja problem toksičnosti i ovisnosti. |
Abstract (english) | Depression is one of the most common mental disorders and is a leading cause of disability worldwide. It is characterized by intense sadness, loss of interest in usual activities, feelings of helplessness and worthlessness, decreased appetite, loss of energy, and more. It is estimated that over 264 million people worldwide suffer from depression. Some factors contributing to the development of depression include genetic factors, stress, traumatic events, and imbalance of neurotransmitters in the brain (such as adrenaline, noradrenaline, dopamine, glutamate, GABA, and acetylcholine). Neurotransmitters play a role as mediators in signal transmission between neurons by binding to specific receptors.
NMDA (N-methyl-d-aspartate) is an excitatory receptor for glutamate. When glutamate binds to the NMDA receptor, nerve signals are transmitted. Richard Morris and John Watkins discovered it, and its discovery was crucial for understanding neurotransmission processes and brain functioning.
Research has shown that dysfunction of NMDA receptors is associated with the development and manifestation of depression due to insufficient glutamate neurotransmission. Therefore, some antidepressants target NMDA receptors. The most well-known medication is ketamine, which acts as an NMDA antagonist. Other types of NMDA receptor antagonists have been developed, such as esketamine (S-ketamine), which is the enantiomer of ketamine. They have a rapid and pronounced antidepressant effect but are temporary. They serve as a good alternative for treatment-resistant depression, but toxicity and addiction issues may arise. |