Review Article

CNS Drugs

, Volume 24, Issue 10, pp 829-841

First online:

Role of Pramipexole in the Management of Parkinson’s Disease

  • Angelo AntoniniAffiliated withDepartment for Parkinson Disease, IRCCS San CamilloUniversity of Padua Email author 
  • , Paolo BaroneAffiliated withDepartment of Neurological Sciences, IDC-Hermitage-Capodimonte
  • , Roberto CeravoloAffiliated withDepartment of Neurosciences, University of Pisa
  • , Giovanni FabbriniAffiliated withDepartment of Neurological Sciences and Neuromed Institute, Sapienza University of Rome
  • , Michele TinazziAffiliated withDepartment of Neurological Sciences, University of Verona
  • , Giovanni AbbruzzeseAffiliated withDepartment of Neurosciences, Ophthalmology and Genetics, Centre for Movement Disorders, University of Genoa

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The non-ergot dopamine agonist pramipexole is currently indicated for the treatment of the signs and symptoms of idiopathic Parkinson’s disease and for the treatment of moderate-to-severe primary restless legs syndrome. A new extended-release formulation of pramipexole has now also been launched in Europe and the US to improve ease of use, compliance and provide a more continuous therapeutic effect over 24 hours. Before initiating any treatment, the benefit-risk ratio to the individual patient must be considered. For pramipexole in the treatment of Parkinson’s disease, this means taking into account the available evidence regarding its symptomatic efficacy, effect on delaying long-term levodopa-related motor complications, beneficial effect on non-motor symptoms such as depression, and its safety and tolerability profile. Studies have shown that pramipexole is effective as monotherapy in early Parkinson’s disease and as adjunctive therapy in advanced disease. Trials further suggest that the benefits of pramipexole may extend beyond the relief of motor symptoms (akinesia, rigidity and tremor at rest) to the amelioration of depressive symptoms in Parkinson’s disease. Pramipexole is generally well tolerated; however, compared with levodopa treatment, pramipexole is associated with a higher rate of some dopaminergic adverse effects