Učinci vortioksetina i escitaloprama na razinu moždanoga neurotrofnoga čimbenika u plazmi i aktivnost trombocitne onoaminooksidaze tipa B u ispitanika s depresivnim poremećajem

doctoral thesis

• Title (english): Effects of vortioxetine and escitalopram on plasma brain derived neurotrophic factor level and platelet monoamine oxidase B activity in subjects with depressive disorder
• Author: Anja Dvojković
• Mentor: Marina Šagud (mentor)
• Mentor: Nela Pivac (komentor)
• Committee member: Dražen Begić (predsjednik povjerenstva)
• Committee member: Dubravka Švob Štrac (član povjerenstva)
• Committee member: Miroslav Herceg (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2022-10-20, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Antidepresivi nemaju učinak u svih bolesnika na simptome depresije, uključujući i kognitivne simptome. Za sada ne postoje pouzdani predskazatelji učinka antidepresiva, a jedan od kandidata je moždani neurotrofni čimbenik (BDNF). Njegova je koncentracija snižena u depresivnih bolesnika, dok neki antidepresivi povisuju koncentraciju BDNF-a. Ovo prospektivno, randomizirano, longitudinalno istraživanje uključilo je 121 depresivnog bolesnika, među kojima je 61 bolesnik liječen vortioksetinom, a 60 escitalopramom. Nakon 4 tjedna terapije, unatoč podjednakom poboljšanju simptoma depresije, vortioksetin je izazvao porast koncentracije BDNF-a u plazmi, dok uz terapiju escitalopramom nije zapažena promjena. Oba antidepresiva podjednako su ublažila kognitivnu disfunkciju, osim što escitalopram nije pokazao učinak na testu pažnje. Nadalje, escitalopram je izazvao veći pad koncentracije trombocitnog serotonina u usporedbi s vortioksetinom, pri čemu je veći pad koncentracije serotonina predvidio dobar odgovor na escitalopram. Oba lijeka nisu značajno utjecala na aktivnost trombocitne MAO-B. Rezultati istraživanja upućuju na razlike u biološkom učinku escitaloprama i vortioksetina, koje mogu biti povezane i s kliničkim učinkom. Istraživanje predstavlja doprinos razumijevanju mehanizma djelovanja antidepresiva i naglašava potrebu individualnog pristupa u liječenju.

Abstract (english)

Antidepressants are not effective in all patients in treating depressive symptoms, as well as cognitive dysfunction. So far, there are no established predictors of treatment response, and brain derived neurotrophic factor (BDNF) is potential biomarker candidate. While its concentration has been decreased in depressed patients, some antidepressants increase BDNF levels. This prospective, randomized, longitudinal study included 121 patients with depression: 61 patients were treated with vortioxetine and 60 with escitalopram. After 4 weeks of treatment, despite similar improvement in depressive symptoms, vortioxetine increased plasma BDNF concentration, while escitalopram had no effects. Escitalopram induced larger reduction in platelet serotonin concentration than vortioxetine, whereas greater decrease in serotonin concentration predicted better response to escitalopram. Both antidepressants produced similar improvement of cognitive symptoms, although escitalopram has not affected attention. Both antidepressants have not changed platelet MAO-B activity. Our findings suggest different biological effects of escitalopram and vortioxetine, which may be associated with clinical outcome. This research contributes to better understanding of antidepressant mechanism of action and emphasizes the need for personalized treatment approach.

• Keywords: escitalopram; vortioksetin; BDNF; trombocitni serotonin; aktivnost trombocitne MAO-B
• Keywords (english): escitalopram; vortioxetine; BDNF; platelet serotonin; platelet MAO-B activity
• Language: croatian
• URN:NBN: urn:nbn:hr:105:239046
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 131 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-11-22 09:20:45