Long-Term Use of Pramipexole in Bipolar Depression: A Naturalistic Retrospective Chart Review

El‐Mallakh, Rif S.; Penagaluri, Praveen; Kantamneni, Arun; Gao, Yonglin; Roberts, R. Jeannie

doi:10.1007/s11126-010-9130-6

Cited by 15 publications

(5 citation statements)

References 27 publications

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“…119, 120, 121, 122, 123, 124, 125, 126, 127 Although there have not been any RCTs investigating the efficacy of methylphenidate or amphetamines in bipolar depression, the available open-label and naturalistic studies point towards a benefit of stimulants in a selected group of patients with drowsiness and fatigue. 128, 129, 130, 131 Randomised controlled studies and open-label reports with other stimulant like agents such as modafinil and its R-enantiomer, armodafinil also indicate efficacy in bipolar depression although the development programme for armodafinil failed.…”

Section: Modulation Of the Dopamine System And Treatment Of Bipolar Dmentioning

confidence: 99%

The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment

et al. 2017

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Bipolar affective disorder is a common neuropsychiatric disorder. Although its neurobiological underpinnings are incompletely understood, the dopamine hypothesis has been a key theory of the pathophysiology of both manic and depressive phases of the illness for over four decades. The increased use of antidopaminergics in the treatment of this disorder and new in vivo neuroimaging and post-mortem studies makes it timely to review this theory. To do this, we conducted a systematic search for post-mortem, pharmacological, functional magnetic resonance and molecular imaging studies of dopamine function in bipolar disorder. Converging findings from pharmacological and imaging studies support the hypothesis that a state of hyperdopaminergia, specifically elevations in D2/3 receptor availability and a hyperactive reward processing network, underlies mania. In bipolar depression imaging studies show increased dopamine transporter levels, but changes in other aspects of dopaminergic function are inconsistent. Puzzlingly, pharmacological evidence shows that both dopamine agonists and antidopaminergics can improve bipolar depressive symptoms and perhaps actions at other receptors may reconcile these findings. Tentatively, this evidence suggests a model where an elevation in striatal D2/3 receptor availability would lead to increased dopaminergic neurotransmission and mania, whilst increased striatal dopamine transporter (DAT) levels would lead to reduced dopaminergic function and depression. Thus, it can be speculated that a failure of dopamine receptor and transporter homoeostasis might underlie the pathophysiology of this disorder. The limitations of this model include its reliance on pharmacological evidence, as these studies could potentially affect other monoamines, and the scarcity of imaging evidence on dopaminergic function. This model, if confirmed, has implications for developing new treatment strategies such as reducing the dopamine synthesis and/or release in mania and DAT blockade in bipolar depression.

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Section: Modulation Of the Dopamine System And Treatment Of Bipolar Dmentioning

confidence: 99%

The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment

et al. 2017

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“…In contrast, non‐ergot dopamine agonists (talipexole, ropinirole and pramipexole) do not have such an effect on cardiac valves because of their low affinity for the 5‐HT2B receptor, although these three agents can potentially cause sleep attack. Table lists the studies that have examined the possible effect of dopamine agonists on treatment‐resistant depression and/or bipolar depression …”

Section: Dopamine Agonists: Evidence For Their Efficacy In ‘Treatmentmentioning

confidence: 99%

“…In the 1990s, several studies, mostly from Japan (particularly from a research group at Hokkaido University in Sapporo), reported the efficacy of the ergot alkaloids bromocriptine and pergolide in the treatment of (treatment‐resistant) depression . More recently, attention has shifted to the efficacy of non‐ergot dopamine agonists pramipexole and ropinirole . In treatment‐resistant bipolar depression, two randomized controlled trials demonstrated that the addition of pramipexole, a D2/D3 receptor agonist approved for the treatment of Parkinson's disease and restless legs syndrome, to existing mood stabilizers resulted in a significant improvement in depressive symptoms .…”

Section: Dopamine Agonists: Evidence For Their Efficacy In ‘Treatmentmentioning

confidence: 99%

Dopamine agonist‐responsive depression

Hori

2013

Psychogeriatrics

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Dopaminergic dysfunction is implicated in the pathophysiology of treatmentresistant depression. In this review, we describe the putative role of dopamine in depression, summarize the evidence for the efficacy of dopamine receptor agonists in the treatment of treatment-resistant depression, and discuss the underlying mechanisms by which these medications work. Both preclinical and clinical data suggest that adjunctive dopamine agonists could be a promising option for the treatment of such a condition, indicating that there is a dopamine agonist-responsive subgroup of depression. Future clinical studies are warranted to clarify unresolved issues regarding dopamine agonists such as long-term efficacy, efficacy as a monotherapy, and efficacy for juvenile and senile depression. Further basic research is also necessary to fully understand how dopamine acts in the brain of depressed patients.

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“…Although preliminary evidence from retrospective studies and case reports [41][42][43] supports the efficacy of pramipexole (Mirapex; Boehringer Ingelheim Pharmaceuticals, Berlin, Germany) as an augmentation strategy in treatment-resistant bipolar depression, thus far, just two randomized controlled studies have analyzed its effectiveness in depressed bipolar patients. In the oldest study, patients with nonpsychotic bipolar depression received pramipexole (as an add-on to their ongoing mood stabilizers) or placebo [44].…”

Section: Pramipexolementioning

confidence: 99%

New Drugs for Bipolar Disorder

Sanches¹,

Soares²

2011

Curr Psychiatry Rep

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Bipolar disorder (BD) is one of the most potentially severe mental disorders. Literature data indicate that despite the current available treatments, a large proportion of patients do not achieve complete remission, with consequent residual symptoms and chronic impairment. We carried out a comprehensive review of new pharmacologic treatments for BD. Even though the core treatment of BD likely will not likely undergo substantial changes over the next few years, many promising results with respect to new augmentation strategies were identified. New treatments for bipolar depression and for BD-related cognitive impairment seem to represent particularly fertile areas of research.

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Long-Term Use of Pramipexole in Bipolar Depression: A Naturalistic Retrospective Chart Review

Cited by 15 publications

References 27 publications

The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment

The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment

Dopamine agonist‐responsive depression

New Drugs for Bipolar Disorder

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