(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. Several case reports of mania on pramipexole has been published; here’s one. (Even good old aripiprazole has been associated with pathologic gambling just recently! Gaboriau )