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Re: pramipexole » jodsteroo

Posted by SalArmy4me on May 31, 2001, at 21:45:54

In reply to PRAMIPEXOLE?? MANERIX?? ANY INFO?, posted by jodsteroo on May 31, 2001, at 20:47:25

Mirapex (pramipexole) is used for Parkinson's Disease. But, it has been shown in two studies to have antidepressant properties in non-Parkinson's patients.
First, the background: I have treatment-resistant depression with many drugs.
It started working for me in a little less than a week (possibly because I got up to 6 mg per day in two days' time)! I found out that it needs to be taken about every 5 hours, otherwise I relapse. I have no side-effects from it (thank God).

Though I start to feel a relapse after 5 hours on Mirapex, that is because I have a fast metabolism. Mirapex actually has greater than 90% bioavailability with a long elimination half-life of 8 to 12 hours. So, some people can take it two times a day without relapsing; others take it three-times a day (so they don't feel bad again).

But when I wake up in the morning--8 hours after my last dose), I still feel okay. However, if I wait two hours after I get up to take the Mirapex, then I will relapse and not want to go to work.

Here are some advantages of Mirapex:

--It has a benign side-effect profile, with most patients reporting nausea as the main side-effect. But that side-effect may have been from the levodopa that the Parkinsons' patients were also taking during the clinical trials.
--Mirapex is definitely less expensive than Prozac or Wellbutrin. 100 of the 1.5 mg Mirapex tablets costs $80 on insurance at the largest HMO in the US. Prozac and Paxil are definitely more costly.
--It has few anticholinergic effects.
--It is not known to cause sexual dysfunction.
--Though it probably has to be taken three times a day, so does Neurontin, Wellbutrin IR, Effexor IR, and Visken.
--Mirapex has two studies done on it in non-Parkinsons' patients--one for unipolar depression and the other for bipolar disorder.
--It has minimal drug interactions as compared to Tricylcic Antidepressants or MAOI's (& RIMA's).

Thus, if it works for you, its a good deal.

-Studies on Medline:
2. Pramipexole augmentation in the treatment of unipolar and bipolar depression: a retrospective chart review Ann Clin Psychiatry. 2000 Sep;12(3):137-40.
3:
Maj J, Rogoz Z.
Synergistic effect of pramipexole and sertraline in the forced swimming test. Pol J Pharmacol. 1999 Nov-Dec;51(6):471-5.
PMID: 10817524
4: Corrigan MH, Denahan AQ, Wright CE, Ragual RJ, Evans DL. Related Articles Comparison of pramipexole, fluoxetine, and placebo in patients with major depression. Depress Anxiety. 2000;11(2):58-65.
5: DeBattista C, Solvason HB, Breen JA, Schatzberg AF. Related Articles Pramipexole augmentation of a selective serotonin reuptake inhibitor in the treatment of depression. J Clin Psychopharmacol. 2000 Apr;20(2):274-5. No abstract available.
6:
Goldberg JF, Frye MA, Dunn RT.
Pramipexole in refractory bipolar depression.
Am J Psychiatry. 1999 May;156(5):798.
7:
Bennett JP, Piercey MF.
Pramipexole--a new dopamine agonist for the treatment of Parkinson's disease. J Neurol Sci. 1999 Feb 1;163(1):25-31. Review.
8: Piercey MF. Related Articles Pharmacology of pramipexole, a dopamine D3-preferring agonist useful in treating Parkinson's disease. Clin Neuropharmacol. 1998 May-Jun;21(3):141-51. Review.
9:
Willner P.
The mesolimbic dopamine system as a target for rapid antidepressant action. Int Clin Psychopharmacol. 1997 Jul;12 Suppl 3:S7-14. Review.


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