How to use Pramipexole
- Selective D3 agonist thought to be related to hedonic drive.
- FDA approved for Parkinson’s disease and restless leg syndrome
- 5 randomized controlled trials indicating effectiveness in depression as monotherapy or adjunctive therapy and in bipolar disorder as adjunctive therapy with a mood stabilizer
- Side effects; nausea, hypotension, and fatigue, titrate slowly and give the dose at night
- Start with 0.125-0.25 mg QHS and rise by 0.25 mg every 5-7 days towards a target dose of 0.75-2 mg QHS
- Watch for hedonistic homeostatic dysregulation (HDD) including pathological gambling and shopping