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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Alex J on May 14, 2001, at 21:30:18
Greetings,
I am looking for input (both positive and negative) on your experiences with Mirapex. I am considering Mirapex but it is not yet approved in Canada so my doctor would have to apply for special permission in order for me to obtain it. I would like to know if Mirapex is worth all of this work.
TIA,
AJ
Posted by SalArmy4me on May 14, 2001, at 22:12:04
In reply to More Mirapex..., posted by Alex J on May 14, 2001, at 21:30:18
I know that ChrisK and AndrewB on this board have had some success with the dopamine-agonist Mirapex in depression. I tried it briefly, too. I didn't have any side-effects on it.
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 Tricylcics 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):471-5.4: Corrigan MH, Denahan AQ, Wright CE, Ragual RJ, Evans DL. 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. Pramipexole augmentation of a selective serotonin reuptake inhibitor in the treatment of depression. J Clin Psychopharmacol. 2000 Apr;20(2):274-5.
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. 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.
Posted by Alex J on May 14, 2001, at 22:18:34
In reply to Re: More Mirapex... » Alex J, posted by SalArmy4me on May 14, 2001, at 22:12:04
Why did you only try it briefly?
>I tried it briefly, too. I didn't have any side- >effects on it.
Posted by ChrisK on May 15, 2001, at 5:20:15
In reply to More Mirapex..., posted by Alex J on May 14, 2001, at 21:30:18
I have had very good success with Mirapex in relieving my anhedonia/apathy. I wouldn't say that it should be used by itself but rather to augment an AD that might be working a little bit for you. There is a 5/13 post of mine that has links to a couple of studies of Mirapex as an AD. If anhedonia is a problem I would say that it is worth a try but it is expensive if you don't have insurance to cover it. Not sure how Canada treats meds that aren't approved.
Chris
> Greetings,
>
> I am looking for input (both positive and negative) on your experiences with Mirapex. I am considering Mirapex but it is not yet approved in Canada so my doctor would have to apply for special permission in order for me to obtain it. I would like to know if Mirapex is worth all of this work.
>
> TIA,
>
> AJ
Posted by Alex J on May 18, 2001, at 21:42:43
In reply to Re: More Mirapex... » Alex J, posted by SalArmy4me on May 14, 2001, at 22:12:04
Can you please tell me why you only tried Mirapex briefly? What caused you to stop taking it, if you don't mind me asking?
TIA,
AJ
> I know that ChrisK and AndrewB on this board have had some success with the dopamine-agonist Mirapex in depression. I tried it briefly, too. I didn't have any side-effects on it.
>
> 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 Tricylcics 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.
>
> 4: Corrigan MH, Denahan AQ, Wright CE, Ragual RJ, Evans DL. 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. Pramipexole augmentation of a selective serotonin reuptake inhibitor in the treatment of depression. J Clin Psychopharmacol. 2000 Apr;20(2):274-5.
>
> 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. 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.
Posted by Alex J on May 18, 2001, at 21:49:15
In reply to Re: More Mirapex... » Alex J, posted by ChrisK on May 15, 2001, at 5:20:15
Chris,
My pdoc has applied to the Canadian government for permission to allow me to take Mirapex. The downside is it will take 3-4 weeks before I will be able to get my hands on it.
Thanks for your reply,
AJ
Posted by SalArmy4me on May 18, 2001, at 23:29:55
In reply to Re: More Mirapex... » SalArmy4me, posted by Alex J on May 18, 2001, at 21:42:43
I was taking the Mirapex for depression. It was putting me to sleep, so I stopped taking it after a week. But most people I talked to said that it doesn't cause sedation. So I must have been the 'lucky' one who got a bad side-effect.
Posted by Mitch on May 19, 2001, at 10:24:58
In reply to Re: More Mirapex... » Alex J, posted by SalArmy4me on May 18, 2001, at 23:29:55
Try some Permax (pergolide). It is also a DA agonist like Mirapex. Mirapex also made me very very sleepy. Permax was a little stimulating in comparison-but it made me too nauseous. Maybe it won't make you nauseous,who knows?
Mitch
> I was taking the Mirapex for depression. It was putting me to sleep, so I stopped taking it after a week. But most people I talked to said that it doesn't cause sedation. So I must have been the 'lucky' one who got a bad side-effect.
Posted by Lorraine on May 19, 2001, at 11:47:20
In reply to Re: More Mirapex... » SalArmy4me, posted by Alex J on May 18, 2001, at 21:42:43
> Can you please tell me why you only tried Mirapex briefly?
This wasn't directed to me, but I was also on Mirapex "briefly". Mirapex decreased my "edginess" from Selegiline (like skin picking behaviour) and increased sexual desire. The bad thing was it also knocked me on my but so that I couldn't function and I think caused significant rebound depression. I had the lowest dose tablet and cut it into quarters. Taking one quarter knocked me on my butt.
Posted by Alex J on May 19, 2001, at 11:59:59
In reply to Re: More Mirapex..., posted by Lorraine on May 19, 2001, at 11:47:20
Lorraine,
Have you experienced this reaction with other meds that act via dopamine? I ask because Dexedrine can make me very sleepy and I am now wondering if Mirapex will have the same effect.
Thanks,
AJ
> This wasn't directed to me, but I was also on Mirapex "briefly". Mirapex decreased my "edginess" from Selegiline (like skin picking behaviour) and increased sexual desire. The bad thing was it also knocked me on my but so that I couldn't function and I think caused significant rebound depression. I had the lowest dose tablet and cut it into quarters. Taking one quarter knocked me on my butt.
Posted by Alex J on May 19, 2001, at 12:03:28
In reply to Re: More Mirapex... » Alex J, posted by SalArmy4me on May 18, 2001, at 23:29:55
Have you experienced this sedation on other dopaminergic meds?
AJ
> I was taking the Mirapex for depression. It was putting me to sleep, so I stopped taking it after a week. But most people I talked to said that it doesn't cause sedation. So I must have been the 'lucky' one who got a bad side-effect.
Posted by SalArmy4me on May 19, 2001, at 13:48:39
In reply to Re: More Mirapex... » SalArmy4me, posted by Alex J on May 19, 2001, at 12:03:28
> Have you experienced this sedation on other dopaminergic meds?
Not on Wellbutrin or Requip. I don't know if I should try Permax or not, because I haven't found much evidence of its use in unipolar depression.
Posted by Alex J on May 19, 2001, at 14:01:07
In reply to Re: More Mirapex... » Alex J, posted by SalArmy4me on May 19, 2001, at 13:48:39
Interesting. I experienced sedation on Wellbutrin. Maybe Mirapex will help me. I guess I won't know for sure until I give it a try. Thank you for your reply.
AJ
> Not on Wellbutrin or Requip. I don't know if I should try Permax or not, because I haven't found much evidence of its use in unipolar depression.
Posted by AndrewB on May 20, 2001, at 16:07:29
In reply to Re: More Mirapex... » Alex J, posted by SalArmy4me on May 19, 2001, at 13:48:39
Sal,
Nice post up top on Mirapex. Interesting you experienced sedation on Mirapex but not Requip. They are supposedly quite similar drugs. I am aware that small doses of Mirapex can have an opposite effect of a larger (therapeutic dose, i.e. up to 5mg.or 6mg./day). What was your dosage?
Can you please describe your experience with Requip?
AndrewB
Posted by Lorraine on May 21, 2001, at 10:37:01
In reply to Re: More Mirapex... » Lorraine, posted by Alex J on May 19, 2001, at 11:59:59
Dexedrine does not make me sleepy. It energizes me. Same with Adderal.
This is the end of the thread.
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