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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by uncouth on August 18, 2009, at 16:14:34
What's the consensus on Mirapex for unipolar and bipolar depression, especially the anhedonia and motivation factors. REad a few studies done a few years ago but nothing new. I've been on the MAOIs, trying bupropion now, but wondering if anyone has seen success with mirapex or another dop agonist (say amantadine)
-uncouth
Posted by Brain Damage on August 19, 2009, at 5:16:16
In reply to Consensus on Mirapex (pramipexole), posted by uncouth on August 18, 2009, at 16:14:34
Firstly I should say I've never taken Mirapex
My impresion is that it work ok for a few days then stops working.
Also can cause "sudden sleep attacks".Maybe it works for some people.....
I personaly think Piribedil is a better bet
Posted by SLS on August 19, 2009, at 5:47:34
In reply to Re: Consensus on Mirapex (pramipexole), posted by Brain Damage on August 19, 2009, at 5:16:16
> Firstly I should say I've never taken Mirapex
>
> My impresion is that it work ok for a few days then stops working.
> Also can cause "sudden sleep attacks".
>
> Maybe it works for some people.....
> I personaly think Piribedil is a better betI agree with all of this.
Thanks, Brain Damage.
I do know someone who received mild benefit from Mirapex (pramipexole) for almost six months, but this seems to be the exception.
The NIH had run an investigation into the use of Mirapex in the treatment of mood disorders. Nothing seems to have come of it.
http://clinicaltrials.gov/ct2/show/NCT00025792
Then you come upon studies like these:
http://www.ncbi.nlm.nih.gov/pubmed/15219473
http://www.ncbi.nlm.nih.gov/pubmed/10984002
http://biopsychiatry.com/pramipexoledep.htm
There are a bunch more. It is difficult to reconcile the conclusions of these studies with what I have seen personally. I think the bottom line is that if you are running out of options, giving Mirapex or Requip a quick trial might be justified.
http://clinicaltrials.gov/ct2/show/NCT00086307
Having found this ongoing clinical trial, and in consideration of the previous NIH study, I guess they have found some utility in using Mirapex.
I once tried bromocriptine (Parlodel), another DA receptor agonsist. It helped for 3 days and then quit on me. However, this is also my pattern of response to standard antidepressants.
I guess I raised more questions than I answered.
- Scott
Posted by Bob on August 19, 2009, at 16:31:56
In reply to Re: Consensus on Mirapex (pramipexole), posted by Brain Damage on August 19, 2009, at 5:16:16
> Firstly I should say I've never taken Mirapex
>
> My impresion is that it work ok for a few days then stops working.
> Also can cause "sudden sleep attacks".
>
> Maybe it works for some people.....
> I personaly think Piribedil is a better betWhy exactly do you think Piribedil would be a better bet? Is that drug available in the US?
Posted by Brain Damage on August 20, 2009, at 2:50:16
In reply to Re: Consensus on Mirapex (pramipexole) » Brain Damage, posted by Bob on August 19, 2009, at 16:31:56
I doubt Piribedil would be any less likely to stop working than Miripex
However it is more stimulating & less likely to cause sleepines.
I'm afraid Piribedil is not available in the US or the UK :(
Posted by SLS on August 20, 2009, at 5:51:13
In reply to Re: Consensus on Mirapex (pramipexole)-Bob, posted by Brain Damage on August 20, 2009, at 2:50:16
> I doubt Piribedil would be any less likely to stop working than Miripex
>
> However it is more stimulating & less likely to cause sleepines.
> I'm afraid Piribedil is not available in the US or the UK :(Formily known as ET-495, piribedil (Trivastal) was used investigationally in the 1980s in the US. My doctor at the time would have liked to combine it with Parnate. Piribedil stimulates D2 receptors and blocks D3 receptors. That there are D3 autorecptors is a significant finding. Blocking these receptors likely produces an increase in the synthesis and release of dopamine. Unlike piribedil, pramipexole (Mirapex) and ropinerole (Requip) stimulate D3 receptors. What I am unsure of is where these neurons are located. My guess is that they are present in the limbic system in areas like the nucleus accumbens (reward, motivation). D2 autoreceptor stimulation is the probably the cause of sleep attacks with piribedil, pramipexole, and ropinerole.
- Scott
Posted by Bob on August 21, 2009, at 1:14:13
In reply to Consensus on Mirapex (pramipexole), posted by uncouth on August 18, 2009, at 16:14:34
> What's the consensus on Mirapex for unipolar and bipolar depression, especially the anhedonia and motivation factors. REad a few studies done a few years ago but nothing new. I've been on the MAOIs, trying bupropion now, but wondering if anyone has seen success with mirapex or another dop agonist (say amantadine)
> -uncouthI have indeed had sleep attacks with this med and also seem to have a lessened effect over time. However, decreased effectiveness over time has not at all been uncommon with me for many different psych drugs.
I am augmenting Nortriptyline and a small amount of Citalopram with 0.5mg of Mirapex.
This is the end of the thread.
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