Abstract
A naturalistic retrospective chart review of all patients given pramipexole for bipolar depression in addition to their mood stabilizers was undertaken. Sixteen patients were followed for an average of 6.7 ± SD 9.0 months. Half of the patients stopped the pramipexole an average of 2 months after starting it. For all patients, depressed mood, and the total profile of depressive symptoms improved significantly within 4 weeks and remained significantly improved for as long as 36 weeks. Both global function (GAF), and global impression (CGI) improved with pramipexole. Irritability and insomnia both increased slightly initially, and then subsided. There were no changes in mania ratings for up to 36 months. Long-term outcome of adjunctive pramipexole appears to be adequate, with apparent maintenance of effect for over 9 months.
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References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders-Text Revision, 4th edn., revised. Arlington, Virginia, American Psychiatric Press, 2000
Calabrese JR, Bowden CL, Sachs GS, et al.: A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression Lamictal 602 study group. Journal of Clinical Psychiatry 60:79–88, 1999
Calabrese JR, Bowden CL, Sachs GS, et al.: A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder. Journal of Clinical Psychiatry 64:1013–1024, 2003
Calabrese JR, Keck PE Jr, Macfadden W, et al.: A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. American Journal of Psychiatry 162:1351–1360, 2005
Cassano P, Lattanzi L, Soldani F, et al.: Pramipexole in treatment-resistant depression: an extended follow up. Depression and Anxiety 20:131–138, 2004
El-Mallakh RS, Huff MO: Mood stabilizers and ion regulation. Harvard Review of Psychiatry 9:23–32, 2001
El-Mallakh RS, Karippot A: Chronic depression in bipolar disorder. American Journal of Psychiatry 163:1137–1341, 2006
El-Mallakh RS, Karippot A, Ghaemi SN: Antidepressants in Bipolar Depression. In: El-Mallakh RS, Ghaemi SN (Eds) Bipolar Depression: A Comprehensive Guide. Washington, DC, American Psychiatric Publishing, Inc., pp. 167–183, 2006
El-Mallakh RS, Weisler RH, Townsend MH, et al.: Bipolar II disorder: current and future treatment options. Annals of Clinical Psychiatry 18:259–266, 2006
Frye MA, Ketter TA, Kimbrell TA, et al.: A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders. Journal of Clinical Psychopharmacology 20:607–614, 2000
Ghaemi SN, Boiman EE, Goodwin FK: Diagnosing bipolar disorder and the effect of antidepressants: a naturalistic study. Journal of Clinical Psychiatry 61:804–808, 2000
Ghaemi SN, Ostacher MM, El-Mallakh RS, Borrelli D, Baldassano CF, Kelley ME, Filkowski MM, Hennen J, Sachs G, Goodwin FK, Baldessarini RJ: A randomized clinical trial of long-term effectiveness and safety of modern antidepressants combined with mood-stabilizers. Journal of Clinical Psychiatry, 2010 (in press)
Ghaemi SN, Lenox MS, Baldessarini RJ: Effectiveness and safety of long-term antidepressant treatment in bipolar disorder. Journal of Clinical Psychiatry 62:565–569, 2001
Goldberg JF, Burdick KE, Endick CJ: Preliminary randomized, double blind, placebo controlled trial of pramipexole added to mood stabilizers for treatment resistant bipolar depression. American Journal of Psychiatry 161(3):564–566, 2004
Jensen NH, Rodriguiz RM, Caron MG, et al.: N-desalkylquetiapine, a potent norepinephrine reuptake inhibitor and partial 5-HT1A agonist, as a putative mediator of quetiapine’s antidepressant activity. Neuropsychopharmacology 33:2303–2312, 2008
Judd LL, Akiskal HS, Schettler PJ, et al.: A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Archives of General Psychiatry 60:261–269, 2003
Judd LL, Akiskal HS, Schettler PJ, et al.: The long-term natural history of the weekly symptomatic status of bipolar I disorder. Archives of General Psychiatry 59:530–537, 2002
Kupka RW, Altshuler LL, Nolen WA, et al.: Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder. Bipolar Disorders 9(5):531–535, 2007
Maj J, Rogóż Z, Margas W, et al.: The effect of repeated treatment with pramipexole on the central dopamine D3 system. Journal of Neural Transmission 107:1369–1379, 2000
Nierenberg AA, Ostacher MJ, Calabrese JR, et al.: Treatment-resistant bipolar depression: a STEP-BD equipoise randomized effectiveness trial of antidepressant augmentation with lamotrigine, inositol, or risperidone. American Journal of Psychiatry 163:210–216, 2006
Nemeroff CB, Evans DL, Gyulai L, et al.: A double-blind, placebo-controlled comparison of imipramine and paroxetine in the treatment of bipolar depression. American Journal of Psychiatry 158:906–912, 2001
Post RM, Leverich GS, Nolen WA, et al.: A re-evaluation of the role of antidepressants in the treatment of bipolar depression: data from the Stanley Foundation Bipolar Network. Bipolar Disorders 5:396–406, 2003
Roberts RJ, Yang M, El-Mallakh RS: Validity and reliability of the RAPID (Rapid Psychiatric Interview Data) scale. Presented at the Eighth International Conference on Bipolar Disorder, Pittsburgh, Pennsylvania, pp. 25–27, 2009
Sachs GS, Guille C, McMurrich SL: A clinical monitoring form for mood disorders. Bipolar Disorders 4:323–327, 2002
Sachs GS, Nierenberg AA, Calabrese JR, et al.: Effectiveness of adjunctive antidepressant treatment for bipolar depression. New England Journal of Medicine 356(17):1711–1722, 2007
Spearing MK, Post RM, Leverich GS, et al.: Modification of clinical global impressions (GCI) scale for use in bipolar illness (BP): CGI-BP. Psychiatry Research 73:159–171, 1997
Vieta E, Suppes T, Eggens I, et al.: Efficacy and safety of quetiapine in combination with lithium or divalproex for maintenance of patients with bipolar I disorder (International Trial 126). Journal of Affective Disorders 109:251–253, 2008
Wermuth L: A double-blind, placebo-controlled, randomized, multi-center study of pramipexole in advanced Parkinson’s disease. European Journal of Neurology 5:235–242, 1998
Zarate CA Jr, Payne JL, Singh J, et al.: Pramipexole for bipolar II depression: a placebo-controlled proof of concept study. Biological Psychiatry 56(1):54–60, 2004
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El-Mallakh, R.S., Penagaluri, P., Kantamneni, A. et al. Long-Term Use of Pramipexole in Bipolar Depression: A Naturalistic Retrospective Chart Review. Psychiatr Q 81, 207–213 (2010). https://doi.org/10.1007/s11126-010-9130-6
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DOI: https://doi.org/10.1007/s11126-010-9130-6