Friday, November 30, 2007

Mirapex – A New Medicine for Depression

Mirapex is a little used and powerful antidepressant option for bipolar depression and treatment resistant depression.

Typically prescribed for the treatment of Parkinson’s—a disease characterized by deficient dopamine production in the motor centers of the brain—Mirapex is a dopamine agonist. Mirapex helps Parkinson’s patients by raising their dopamine levels.

Likewise, depression involves a state of relative deficiency of serotonin, norepinephrine, and/or dopamine in the mood centers of the brain. Studies show Mirapex increases dopamine in the mood centers of the brain. Increased dopamine tends to reduce depression symptoms of low energy, low motivation, low pleasure, and slowed thinking and movement.

How can I get
New Medicine for Depression?
Although I learned about Mirapex’s usefulness in treating depression in 2003, very few psychiatrists prescribe this new medicine for depression.

I have prescribed Mirapex for bipolar depression and treatment-resistant depression for over 200 patients in the last 2.5 years. Many of these patients have found this new medicine for depression to be very effective.

If you’d like to explore this option for treatment of bipolar disorder or depression, call my office today at 770-458-0007 to schedule an appointment.

Effective New Medicine for Depression
I've worked with several treatment-resistant patients who failed to respond adequately or had adverse reactions to as many as 30 previous medicines. Of course, Mirapex is not for everyone. A significant group of patients have not responded or had side effects that required us to stop the medicine. Careful monitoring is required whenever medications are prescribed.

Patients that have responded to this new medicine for depression have been quite grateful for the relief of their symptoms. They also report the lack of weight gain and sexual side effects that plague the typical antidepressants and mood stabilizers. After Lamictal, Mirapex is the medicine I most often prescribe for bipolar depression.

Learn More about New Medicine for Depression
There have been three controlled clinical trials and a review article that provide growing evidence for the safety and efficacy of Mirapex for treatment of bipolar depression and treatment-resistant depressions.

Mirapex has a large effect size of 0.6-1.1. This means it is a lot more helpful than placebo in bipolar depression and treatment- resistant depression. However, it has not been approved by the FDA for these conditions. It is approved for Parkinson's disease and restless legs syndrome.
Mirapex is well tolerated by most patients, although some patients report side effects such as nausea, tiredness, sedation, headache, or insomnia. Less frequent side effects are abnormal muscle movements, restlessness, sleep attacks, faintness when standing.

Rare, more serious adverse reactions include hallucinations, hypersexuality, excess spending, or compulsive eating. So far, mania, hypomania, and psychosis have occurred at lower frequencies for Mirapex than for traditional antidepressants.

You can read an abstract of the review article at: http://www.ncbi.nlm.nih.gov/sites/entrez

Type this article title into the search window:
Pramipexole in Psychiatry: a Systematic Review of the Literature.

You may also purchase the full text of the original article for $15.

Find out whether Mirapex would be helpful for you. Call 770-458-0007 today to make an appointment.

Darvin Hege, M.D.
www.eveningpsychiatrist.com