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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Maxime on March 3, 2006, at 12:19:14
Hi
My doctor gave me a script for Mirapex. How long before I feel an effect from it? It's funny, the pharmacist was very concerned that I was taking this med. She had never heard being used for depression.
God, I hope it helps.
Maxime
Posted by ed_uk on March 3, 2006, at 17:42:53
In reply to How long before the Mirapex works?, posted by Maxime on March 3, 2006, at 12:19:14
Hi Maxie
What dose are you starting at?
Ed x
Posted by Maxime on March 3, 2006, at 18:12:56
In reply to Re: How long before the Mirapex works? » Maxime, posted by ed_uk on March 3, 2006, at 17:42:53
> Hi Maxie
>
> What dose are you starting at?
>
> Ed x2 mg. I am so nauseous!
Maxime xx
Posted by Phillipa on March 3, 2006, at 21:36:09
In reply to Re: How long before the Mirapex works? » ed_uk, posted by Maxime on March 3, 2006, at 18:12:56
Maxie what is it? finger crossed. Love Phillipa
Posted by Maxime on March 4, 2006, at 11:45:34
In reply to Re: How long before the Mirapex works? » Maxime, posted by Phillipa on March 3, 2006, at 21:36:09
Phillipa, it's used for people with Parkinsons disease. But it's also used for depression as it's a dopamine agonist.
Maxime
Posted by Phillipa on March 4, 2006, at 12:14:10
In reply to Re: How long before the Mirapex works? » Phillipa, posted by Maxime on March 4, 2006, at 11:45:34
Thanks Maxie I wish you the very best of luck. Keep us informed Love Jan/Phillipa
Posted by ed_uk on March 4, 2006, at 13:51:13
In reply to Re: How long before the Mirapex works? » ed_uk, posted by Maxime on March 3, 2006, at 18:12:56
2mg per day!?
In the UK, the recommended starting dose is 0.125mg three times a day ie. 0.375mg per day. The dose is gradually increased to minimise side effects.
Nausea is a very common side effect of Mirapex, particularly if the starting dose is too high. The nausea usually decreases with time :)
Ed xx
Posted by Maxime on March 4, 2006, at 16:59:31
In reply to Re: How long before the Mirapex works? » Maxime, posted by ed_uk on March 4, 2006, at 13:51:13
I think I will cut it down to .5 a day. You have no idea how sick I am from this stuff. My pdoc has never presribed it before. Sigh. I'm as white as a ghost and I feel like I am going to throw up.
Thanks ED.
Maxime xxx
> 2mg per day!?
>
> In the UK, the recommended starting dose is 0.125mg three times a day ie. 0.375mg per day. The dose is gradually increased to minimise side effects.
>
> Nausea is a very common side effect of Mirapex, particularly if the starting dose is too high. The nausea usually decreases with time :)
>
> Ed xx
Posted by ed_uk on March 4, 2006, at 18:15:41
In reply to Re: How long before the Mirapex works? » ed_uk, posted by Maxime on March 4, 2006, at 16:59:31
Hi Maxie
>You have no idea how sick I am from this stuff.
I have a pretty good idea! I imagine that most people would vomit *badly* in response to 2mg. 2mg is a very high starting dose! Dopamine agonists are emetic.
>I think I will cut it down to .5 a day.
Or even less: 0.25mg per day in two divided doses might be best.
>My pdoc has never presribed it before.
I can tell ;-)
Love
Ed xx
Posted by Maxime on March 4, 2006, at 19:27:41
In reply to Re: How long before the Mirapex works? » Maxime, posted by ed_uk on March 4, 2006, at 18:15:41
Oh yes, the vomiting was very bad yesterday. I didn't take any today. It will be hard for me to take 1/2 of .25 but if I can split the pill I will do it. Why do I have to go through this?
Maxie xx
> Hi Maxie
>
> >You have no idea how sick I am from this stuff.
>
> I have a pretty good idea! I imagine that most people would vomit *badly* in response to 2mg. 2mg is a very high starting dose! Dopamine agonists are emetic.
>
> >I think I will cut it down to .5 a day.
>
> Or even less: 0.25mg per day in two divided doses might be best.
>
> >My pdoc has never presribed it before.
>
> I can tell ;-)
>
> Love
>
> Ed xx
>
>
Posted by ed_uk on March 5, 2006, at 14:12:28
In reply to Re: How long before the Mirapex works? » ed_uk, posted by Maxime on March 4, 2006, at 19:27:41
Dear Maxie
If you don't have a pill splitter, get those nail scissors out! Wait until the nausea subsides and then restart the Mirapex at 0.125mg twice a day. Certain sedating antihistamines can be useful for nausea, perhaps you could buy something from the pharmacy.
>Why do I have to go through this?
Because your doctor was silly and started you on a inappropriate dose!
HUGS
Ed xxx
Posted by Maxime on March 5, 2006, at 16:13:20
In reply to Re: How long before the Mirapex works?, posted by ed_uk on March 5, 2006, at 14:12:28
Ed, yup I know the nail splitter trick. I was able to cut them into .125 mg and will restart tomorrow. I am not throwing up anymore, but I am still very nauseous.
Do you know how high a dosage one can go up to for depression? I am just curious to know when we can call it quits. Optimistic, aren't I.
Love,
Maxie> Dear Maxie
>
> If you don't have a pill splitter, get those nail scissors out! Wait until the nausea subsides and then restart the Mirapex at 0.125mg twice a day. Certain sedating antihistamines can be useful for nausea, perhaps you could buy something from the pharmacy.
>
> >Why do I have to go through this?
>
> Because your doctor was silly and started you on a inappropriate dose!
>
> HUGS
>
> Ed xxx
Posted by ed_uk on March 5, 2006, at 16:37:00
In reply to Re: How long before the Mirapex works? » ed_uk, posted by Maxime on March 5, 2006, at 16:13:20
Hi Maxie
>I am not throwing up anymore, but I am still very nauseous.....will restart tomorrow.....
Perhaps you should wait until the nausea passes before restarting. Did you have any other side effects apart from nausea/vomiting? (as if that wasn't enough!)
>Do you know how high a dosage one can go up to for depression?
Not sure - but wouldn't exceed the maximum dose recommended for Parkinson's disease.
Are you still taking desipramine? Has the lactation stopped?
Ed xxx
Posted by Maxime on March 5, 2006, at 21:44:07
In reply to Re: How long before the Mirapex works? » Maxime, posted by ed_uk on March 5, 2006, at 16:37:00
Hi, no I just had serious vomiting and then nausea which is just about gone.
I am not taking the Desipramine because I lactated. I figured I would see if the mirapex worked and the I could try Nortrip. If the mirapex doesn't help I am going 5 weeks without Prozac and tapering of the Trileptal and then re-starting the Parnate. Sigh. I hope I can make it through all this. I feel worse now than I did in the hospital.
Love, Maxie
> Hi Maxie
>
> >I am not throwing up anymore, but I am still very nauseous.....will restart tomorrow.....
>
> Perhaps you should wait until the nausea passes before restarting. Did you have any other side effects apart from nausea/vomiting? (as if that wasn't enough!)
>
> >Do you know how high a dosage one can go up to for depression?
>
> Not sure - but wouldn't exceed the maximum dose recommended for Parkinson's disease.
>
> Are you still taking desipramine? Has the lactation stopped?
>
> Ed xxx
>
Posted by Maxime on March 6, 2006, at 11:43:30
In reply to Re: How long before the Mirapex works? » ed_uk, posted by Maxime on March 5, 2006, at 21:44:07
I took .125 of the Mirapex last night, along with some Benedryl and I am fine. I took my morning dose as well, and I don't feel sick. Amen.
Maxie
Posted by ed_uk on March 6, 2006, at 13:41:42
In reply to Re: How long before the Mirapex works?, posted by Maxime on March 6, 2006, at 11:43:30
Hi Maxie
>I am not taking the Desipramine because I lactated.
Desipramine did seem to be helping. Now you're on Mirapex, you could probably take desipramine without lactating.
>I took .125 of the Mirapex last night, along with some Benedryl and I am fine. I took my morning dose as well, and I don't feel sick. Amen.
:) I thought it would work out :)
Love
Ed xx
Posted by sukarno on March 8, 2006, at 7:32:57
In reply to Re: How long before the Mirapex works? » Maxime, posted by ed_uk on March 6, 2006, at 13:41:42
I've been interested in trying Mirapex. I read some interesting articles about it causing some people to become compulsive gamblers. Is this the one?
Dopamine agonists, if they are anything like Survector was (a dopamine reuptake inhibitor), should cause more rapid relief of depression relative to serotonergic antidepressants. Survector would take only 7 days to feel the antidepressant effect whereas SSRIs can take weeks.
I am really interested in trying this one. By the way, have you felt unusually sleepy on Mirapex?
Take care and I hope you get some relief soon. :-)
Paul
Posted by Maxime on March 8, 2006, at 16:59:38
In reply to Re: How long before the Mirapex works?, posted by sukarno on March 8, 2006, at 7:32:57
I don't know about the gambling! I hope not.
I am on a small starting dosage right now and have no side effects yet. But I have also heard that it makes people really sleepy.
I'll keep you posted.
Maxime
> I've been interested in trying Mirapex. I read some interesting articles about it causing some people to become compulsive gamblers. Is this the one?
>
> Dopamine agonists, if they are anything like Survector was (a dopamine reuptake inhibitor), should cause more rapid relief of depression relative to serotonergic antidepressants. Survector would take only 7 days to feel the antidepressant effect whereas SSRIs can take weeks.
>
> I am really interested in trying this one. By the way, have you felt unusually sleepy on Mirapex?
>
> Take care and I hope you get some relief soon. :-)
>
> Paul
Posted by kingcolon on March 19, 2006, at 11:27:13
In reply to Re: How long before the Mirapex works? » sukarno, posted by Maxime on March 8, 2006, at 16:59:38
The debate about Mirapex goes on. I have posted about Requip, which I have been on for four months with excellent results. It works similarly to Mirapex with the same side effects. Noone should start these drugs on high doses. The nausea generally subsides with small doses increases. Requip is used at a mean dose of 1.5 mg a day, titrated up, very gradually, starting with 0.25 mg a day; the doses are split into two or three divided doses a day.
All the information you need is available from Entrez Pub Med by searching for "ropinirole augmentation for depression" or "pramipexole for depression". There is only one study to date on Requip, and a few on Mirapex.
I think these are very exciting for treatment of resistant depression and anhedonic/amotivational depression, particularly as augmenting agents. In my case, there has been no poop out or signficant sedation. Sedation occurs in high doses used for Parkinsons, or even at doses used for restless leg syndrome, which are not necessary for depression.
In the US where there is virtually no choice of dopaminergic agents except Wellbutrin, which is weak, or Parnate, which is loaded with side effect concerns, or amphetamines, with obvious concerns, I think more docs should be using (or trying) Requip or Mirapex. As far as Provigil, it is not dopaminergic, and there are also few studies to support its efficacy in depression or anhedonic states. I tried it and experienced a hyped up state that was unpleasant.Good luck.
This is the end of the thread.
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