NMDA-receptorantagonister vid depression : En litteraturstudie om klinisk profil, prediktorer och neuroplasticitet hos ketamin, esketamin och dextrometorfan (AXS-05)

Sammanfattning

Major Depressive Disorder (MDD) is a severe mental illness, and a significant numberof patients experience treatment-resistant depression (TRD) where conventionalantidepressants fail to achieve significant or rapid results. This study aims to evaluatethe clinical efficacy, safety, and impact on neuroplasticity of the NMDA receptorantagonists racemic ketamine and esketamine for TRD as well as dextromethorphan (inthe combination drug AXS-05) for MDD. Through a literature review where six clinicalstudies were analyzed that evaluated these fast-acting treatment methods. The resultsshowed that all three substances contributed to a rapid and significant improvement indepressive symptoms. Racemic ketamine and esketamine provided comparable reliefwithin 24 hours which correlates with increased neuroplasticity but were associatedwith severe dissociative side effects. AXS-05 on the other hand showed promisingresults as highly effective and was a well-tolerated alternative for MDD, completelylacking dissociative side effects. However, the analyzed studies were limited by the lackof direct head-to-head comparisons between AXS-05 and ketamine/esketamine anddifferences in patient populations. Further comparative research in specific TRDpopulations is recommended to confirm the relative clinical superiority and potential ofthese treatments.