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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by SDW on December 22, 2004, at 15:42:08
Today is my 7th day taking MIRAPEX...I am taking .25 mg 3 times daily (.75mg/day). TARGET DOSE: 1.5 mg to 3.0 mg daily.
SIDE EFFECTS: Some drowsiness/grogginess for an hour or so after each dose; no nausea except after the very first dose.
I have not noticed any real effects because the dose is still sub-therapeutic. This is a tough drug if you're impatient, because it takes so long to titrate.
I'm interested in hearing at what point/dose others had a positive response.
I am also tapering off Parnate to start another AD as of January 1. Considering Wellbutrin or Cymbalta.
Posted by Optimist on December 22, 2004, at 16:32:43
In reply to MIRAPEX Update: 1 Week, posted by SDW on December 22, 2004, at 15:42:08
> Today is my 7th day taking MIRAPEX...I am taking .25 mg 3 times daily (.75mg/day). TARGET DOSE: 1.5 mg to 3.0 mg daily.
>
> SIDE EFFECTS: Some drowsiness/grogginess for an hour or so after each dose; no nausea except after the very first dose.
>
> I have not noticed any real effects because the dose is still sub-therapeutic. This is a tough drug if you're impatient, because it takes so long to titrate.
>
> I'm interested in hearing at what point/dose others had a positive response.
>
> I am also tapering off Parnate to start another AD as of January 1. Considering Wellbutrin or Cymbalta.
>
>May I ask why you are tapering off the Parnate? I was thinking of switching over to is from my wellbutrin, prozac, adderall combo.
Posted by blanding on December 22, 2004, at 20:20:46
In reply to MIRAPEX Update: 1 Week, posted by SDW on December 22, 2004, at 15:42:08
SDW, are you using pramipexole as an antidepressant?
I read a study about its antidepressant effects and thought about augmenting my current ADs with this dopaminergic agent but my pdoc advised against it because it may induce psychosis.
Posted by SDW on December 23, 2004, at 1:45:43
In reply to Re: MIRAPEX Update: 1 Week » SDW, posted by Optimist on December 22, 2004, at 16:32:43
<< May I ask why you are tapering off the Parnate? I was thinking of switching over to is from my wellbutrin, prozac, adderall combo. >>
Parnate has been very helpful to me in the past for Major Depression, but for the last 2 years it has not effectively controlled my Dysthymia, even at a high dose (90mg). I seem to have become tolerant to its effects. I recommend it in general—it can be a great medication. I hope I can find something that works that well. I am curious about why you are going off Wellbutrin…That’s one I’m considering.
<< SDW, are you using pramipexole as an antidepressant? I read a study about its antidepressant effects and thought about augmenting my current ADs with this dopaminergic agent but my pdoc advised against it because it may induce psychosis. >>
Fort the moment I guess I am using pramipexole as an antidepressant, but only while I taper off one AD and go on another.
From what I have read, Pramipexole could cause Psychosis if you push the dose too high too fast, or if you have ever had a Dopamine-related disorder like Schizophrenia. This med is gaining attention as an augmenting agent because it activates Dopamine, which I believe is a major factor in my Anhedonia/Apathy.I am now in the process of deciding which AD to start next, and holding out high hopes for MIRAPEX in the meantime…
I will post any new developments…
Posted by Optimist on December 23, 2004, at 8:21:51
In reply to Re: MIRAPEX Update: 1 Week, posted by SDW on December 23, 2004, at 1:45:43
>I am curious about why you are going off Wellbutrin…That’s one I’m considering.
>
I think I've decided to stay with the Wellbutrin after all. After adding 3g of tyrosine each morning it seems to have definitely kicked it up a notch. It's hard to say what augmentation created the big improvement that I've been experiencing. About 3 weeks ago I added the tyrosine as well as Vitex(weak dopamine agonist) to my regimand and it ended up with a major breakthrough. I'm still deciding whether my improvements are from the tyrosine, the Vitex or being on the Prozac for an extended period of time. I'll have to play around a little with discontinuation and continuation of the Vitex and tyrosine to get a better indication. I know from the past that the Vitex has created a robust mood improvement but it tended to poop out after a month or so. Hopefully the addition of the tyrosine will prevent that.I'm just happy that I'm experiencing a 100% remission for the first time in my life I believe. My personality has undergone a distinct change in the last 3 weeks which is both a welcome change but also a little disconcerting as it will take me a little getting used to. I'm not used to being assertive, socially confident, energetic, motivated, humourous, and the added stability that has seemed to have come with my moods. It's a welcome change that's for sure. I'm just crossing my fingers that it stays.
Parnate will most likely be the alternative if this combo ever poops out, or perhaps adding lithium. I'll have to talk with my pdoc concerning that.
Good luck whatever you choose.
Posted by iris2 on December 23, 2004, at 15:00:57
In reply to MIRAPEX Update: 1 Week, posted by SDW on December 22, 2004, at 15:42:08
I tried Mirapex and had terrible side effects. I am wondering if I had so much trouble because I didnot taper up slowly enough. I did not realise I needed to do this. What information do you have about it?
Thanks,
irene
Posted by jerrympls on December 23, 2004, at 17:41:03
In reply to MIRAPEX Update: 1 Week, posted by SDW on December 22, 2004, at 15:42:08
I've been on Mirapex for about 3 months at .5mg. I've only been taking it for restless legs but am going to bump up the dosage if my doctor approves. He too has read the studies using Mirapex as an augmentor to antidepressant therapy. I've read that it can help tremendously for those with severe apathy -which is a huge part of my depression. However, the side effects are not to be taken lightly and the dosage must be increased very slowly - .25mg a week until anywhere between 1mg - 4mg daily.
I haven't experienced any side effects from it at all. One alarming side effect is sudden uncontrollable sleep attacks - which apparently only happen at higher dosages.
Thanks for keeping us posted!
Jerry
Posted by blanding on December 23, 2004, at 17:50:32
In reply to Re: MIRAPEX Update: 1 Week, posted by iris2 on December 23, 2004, at 15:00:57
Hi Iris2,
What kind of side effects did you experience and at what dosages?
Did you eventually notice any antidepressant effect?
Posted by blanding on December 23, 2004, at 17:53:35
In reply to Re: MIRAPEX Update: 1 Week » SDW, posted by jerrympls on December 23, 2004, at 17:41:03
Jerry, have you noticed any antidepressant effect or less apathy with Mirapex yet?
Posted by jerrympls on December 23, 2004, at 17:57:44
In reply to Re: MIRAPEX Update: 1 Week, posted by blanding on December 23, 2004, at 17:53:35
> Jerry, have you noticed any antidepressant effect or less apathy with Mirapex yet?
No...however, remember I'm only at .5mg. It has helped my restless legs tho....
Jerry
Posted by SDW on December 23, 2004, at 22:04:05
In reply to Re: MIRAPEX Update: 1 Week » blanding, posted by jerrympls on December 23, 2004, at 17:57:44
The slow dosage increase is very important with Mirapex, and I think increasing too fast is how people are likely to run into side effects that cause them to discontinue before they know if the med will be effective.
The therapeutic Range is 1.5 mg to 4mg daily, taken in three divided doses.
However, Pfizer recommends starting with .125 - .5 mg 3 times a day (tid) for one whole week, then adding .25 - .5mg (tid) per week until there is a response (up to a total of 6 - 7 weeks). This will help minimize the two most common problems: nausea and sleepiness/fatigue.
I have had some fatigue but no nausea – I take it with food.
I plan to go up a little faster than is recommended, but I don’t expect a response for 1-2 more weeks, when I reach 1.5 – 2.0 mg total per day.
MIRAPEX Full prescribing information is here:
http://www.bidocs.com/renetnt:/Prescribing%20Information/PIs/Mirapex/Mirapex.pdf?DMW_FORMAT=pdf
Posted by jerrympls on December 24, 2004, at 0:27:54
In reply to MIRAPEX Dosage Info and Link, posted by SDW on December 23, 2004, at 22:04:05
> The slow dosage increase is very important with Mirapex, and I think increasing too fast is how people are likely to run into side effects that cause them to discontinue before they know if the med will be effective.
>
> The therapeutic Range is 1.5 mg to 4mg daily, taken in three divided doses.
>
> However, Pfizer recommends starting with .125 - .5 mg 3 times a day (tid) for one whole week, then adding .25 - .5mg (tid) per week until there is a response (up to a total of 6 - 7 weeks). This will help minimize the two most common problems: nausea and sleepiness/fatigue.
>
> I have had some fatigue but no nausea – I take it with food.
>
> I plan to go up a little faster than is recommended, but I don’t expect a response for 1-2 more weeks, when I reach 1.5 – 2.0 mg total per day.
>
> MIRAPEX Full prescribing information is here:
>
> http://www.bidocs.com/renetnt:/Prescribing%20Information/PIs/Mirapex/Mirapex.pdf?DMW_FORMAT=pdf
>Please keep us updated! I'd love to hear that it works!!
Posted by iris2 on December 24, 2004, at 11:39:44
In reply to Re: MIRAPEX Update: 1 Week, posted by blanding on December 23, 2004, at 17:50:32
I think I started feeling side effects at .25 three times a day but much more at .5 three times a day. I had rhinitus(sp) my head and nose were all clogged up and runny nose and it was painful. I was feverish. A very bad headache and something else I cannot remember now. I think it was a stomach ache and nausia.
I waited about a week after things got intollerable and they never gjot any better enven when I decreased the dose. I never took it long enough to see andy antidepressant effect.
I hope you have better luch than I.
Irene
Posted by iris2 on December 24, 2004, at 11:43:04
In reply to MIRAPEX Dosage Info and Link, posted by SDW on December 23, 2004, at 22:04:05
I'm sorry I messed up with my response and remembered wrong. It was .125 three times a day and up to .5 that I go t to but never could get to .4 three times a day.
irene
This is the end of the thread.
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