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Dopamine Agonists for Bipolar Depression
(Posted 4/2008)

Based on the data below, at this point this seems an option worth considering only when relatively desperate.

 Published studies as of 4/2008 (not an exhaustive search; just used PUB MED and Google): 

Lead Author Agent Design average final dose Results Bad stuff
Aiken  pramipexole (Mirapex) Review of uncontrolled trials 1.6 mg evidence of benefit Minor: Nausea, headache, sleepiness
Weight: no effect
Risk of psychosis
Risk of pathologic gambling
Risk of inducing mania? suggestive cases
Zarate pramipexole Randomized trial   60% responded,
versus 9% on placebo		 One patient developed hypomania --
versus two on placebo
Goldberg pramipexole Randomized trial 1.7 mg 67% responded,
versus 20% on placebo		 One patient developed hypomania
(none on placebo)
ClinicalTrials.gov identifier: NCT00314821
 ropinirole Randomized trial   Presumably negative?
not published, completed in 2006, not in GSK registry 		 

 

 

The first few times I tried these medications, side effects far outweighed the benefits, so I've backed off, waiting for further data or others' experience.  At least one case report of mania on pramipexole has been published.Sharma