![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Peter S on June 11, 2001, at 18:32:48
HI all,
A while back there were people recounting experiences with Mirapex for depression. I would be interested in hearing people's experiences with it: whether it is effective and at what dose. My pdoc just gave me a prescription for it, but I'd like to hear a bit more about it before I go out fill it.
Thanks!
Peter
Posted by SalArmy4me on June 12, 2001, at 2:37:14
In reply to Mirapex experiences?, posted by Peter S on June 11, 2001, at 18:32:48
The American Journal of Psychiatry
Copyright © 1999 American Psychiatric Association.
Volume 156(5) May 1999
Pramipexole in Refractory Bipolar Depression
[Letters To The Editor]
GOLDBERG, JOSEPH F. MD; FRYE, MARK A. MD; DUNN, ROBERT T. MD, PHD
New York, N.Y.TO THE EDITOR: Pramipexole, a direct dopamine agonist with D3 receptor selectivity, recently approved by the FDA for the treatment of Parkinson's disease [1], has been reported to be as effective as fluoxetine in the treatment of major depression (unpublished 1997 study by Corrigan and Evans) and an effective neuroleptic adjunct for the negative symptoms of schizophrenia [2]. We report two cases of treatment-resistant bipolar depression where improvement followed augmentation with pramipexole.
"Mr. A, a 50-year-old man with a 23-year history of bipolar I disorder and over 15 hospitalizations, had recurrent dysphoric manias and major depressions with reversed vegetative signs. There was a remote period of cocaine abuse and a dense family history of bipolar illness. Past manias had responded poorly to lithium, carbamazepine, and valproate monotherapies or combinations. Incidents of depression persisted despite regimens of bupropion; however, low doses of sertraline triggered mania. Depressions previously responded to ECT but resisted a course of 40 bilateral treatments. Mr. A's condition was stable for over 1 year on a high-dose regimen of lamotrigine and clonazepam, until he was rehospitalized for anergic depression that was unresponsive to lithium augmentation. Pramipexole was begun at a dose of 0.25 mg/day and increased over 10 days to 0.75 mg/day. Within 1 week, marked improvement was noted in mood and activity. Euthymia was achieved, and Mr. A remained without side effects at his 8-week follow-up."
"Mr. B, a 33-year-old artist with a 15-year history of bipolar I illness and alcohol abuse (in remission), had 14 hospitalizations for both psychotic depressions and manias. His episodes improved minimally with lithium, carbamazepine, valproate, verapamil, and gabapentin alone and in combination with adjunctive typical neuroleptics and benzodiazepines. Sertraline, tricyclics, and one course of ECT were ineffective for his depressions. Nortriptyline and venlafaxine each induced dysphoric mania and cycling. Bupropion plus lithium and lamotrigine provided substantial improvement until he developed a tolerance after 2 months."
"Olanzapine, topiramate, and lamotrigine controlled mania and cycling until severe depression recurred, with reversed vegetative signs, prompting a trial of pramipexole. Mr. B was given a 1-mg/day dose of pramipexole; after 6 weeks, a marked antidepressant response occurred, and the drug was well tolerated except for transient, dose-related nausea. Subsequently, a brief depressive exacerbation resolved itself without medication changes. Mr. B's functional improvement, with only low-grade depression and no cycling, continued through his 6-month follow-up."
The greater density of D3 receptors in the mesolimbic areas [3] involved in mood regulation may relate to pramipexole's efficacy in psychomotor-retarded conditions (i.e., negative symptoms, Parkinson's disease, depression). Controlled studies of pramipexole, in doses of 0.25-10.25 mg/day over 4-8 weeks (2, unpublished 1997 study by Corrigan and Evans), are encouraged to clarify dose-related acute and long-term efficacy in bipolar depression, possible side effects (e.g., insomnia, fatigue, dyskinesias, orthostatic hypotension, hallucinations), potential induction of mania/psychosis, and preferential response in atypical versus melancholic depression.
JOSEPH F. GOLDBERG, M.D.
MARK A. FRYE, M.D.
ROBERT T. DUNN, M.D., PH.D.
Posted by ChrisK on June 12, 2001, at 4:57:25
In reply to Mirapex experiences?, posted by Peter S on June 11, 2001, at 18:32:48
I've been taking Mirapex since the first of the year and it has worked out great for me. I feel like I've got the majority of my life back. Before Mirapex I sufferred with anhedonia and apathy that left me just sitting around not wanting to do anything. Within 2 weeks I began to notice a difference as the anhedonia started to lift. My scores on depression questionaires have been cut in half this year.
I also take Nortiptyline (100mg) and Geodon (80mg) along with the 4mg/day of Mirapex. Most doctors will start out with very low doses and titrate up to around 3 - 1mg tablets/day. Thisi s mostly because the studies have shown that one of the biggest side effects is nausea which can be worse if you start out with too high of a dose. I generally don't get side effects badly from any med so I was up to 3 mg/day within one week.
Try here for a good study:
http://www.parkinson.org/mxdepress.htm
The two meds that have helped me the most in the past 2years have been Mirapex and Zyprexa (I just recently switched from Zyprexa to Geodon). I feel that each med has addresssed different symptoms in my depression. Nortriptyline helped with by baseline mood, Zyprexa and Geodon helped with the ruminating thoughts and the strong suicidal tendencies and Mirapex has lifted my anhedonia so I now have some joy in my life. I even went back to work part time.
I hope this helps with your question and you give it a try.
Chris
> HI all,
>
> A while back there were people recounting experiences with Mirapex for depression. I would be interested in hearing people's experiences with it: whether it is effective and at what dose. My pdoc just gave me a prescription for it, but I'd like to hear a bit more about it before I go out fill it.
>
> Thanks!
>
> Peter
Posted by Peter S on June 12, 2001, at 14:52:55
In reply to Re: Mirapex experiences?, posted by ChrisK on June 12, 2001, at 4:57:25
Thanks for the info Chris!
I'm going to give it a try.
Peter
> I've been taking Mirapex since the first of the year and it has worked out great for me. I feel like I've got the majority of my life back. Before Mirapex I sufferred with anhedonia and apathy that left me just sitting around not wanting to do anything. Within 2 weeks I began to notice a difference as the anhedonia started to lift. My scores on depression questionaires have been cut in half this year.
>
> I also take Nortiptyline (100mg) and Geodon (80mg) along with the 4mg/day of Mirapex. Most doctors will start out with very low doses and titrate up to around 3 - 1mg tablets/day. Thisi s mostly because the studies have shown that one of the biggest side effects is nausea which can be worse if you start out with too high of a dose. I generally don't get side effects badly from any med so I was up to 3 mg/day within one week.
>
> Try here for a good study:
>
> http://www.parkinson.org/mxdepress.htm
>
> The two meds that have helped me the most in the past 2years have been Mirapex and Zyprexa (I just recently switched from Zyprexa to Geodon). I feel that each med has addresssed different symptoms in my depression. Nortriptyline helped with by baseline mood, Zyprexa and Geodon helped with the ruminating thoughts and the strong suicidal tendencies and Mirapex has lifted my anhedonia so I now have some joy in my life. I even went back to work part time.
>
> I hope this helps with your question and you give it a try.
>
> Chris
>
>
> > HI all,
> >
> > A while back there were people recounting experiences with Mirapex for depression. I would be interested in hearing people's experiences with it: whether it is effective and at what dose. My pdoc just gave me a prescription for it, but I'd like to hear a bit more about it before I go out fill it.
> >
> > Thanks!
> >
> > Peter
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.