Magazine article Clinical Psychiatry News

Pramipexole Acts as Antidepressant in PD

Magazine article Clinical Psychiatry News

Pramipexole Acts as Antidepressant in PD

Article excerpt

SEATTLE -- Pramipexole reduces depressive symptoms in patients with Parkinson's disease, largely independent of its effect on motor symptoms, according to the results of a randomized trial.

An estimated 45% of patients with Parkinson's disease (PD) have a depressive disorder, said lead investigator Dr. Paolo Barone, a neurologist at the University of Naples "Federico II" in Italy. Recent evidence suggests that depression is not simply reactive in this population, but occurs independently of motor symptoms and may be related to dysfunction in limbic dopaminergic circuits.

"Generally speaking, there are very few placebo-controlled studies of depression in Parkinson's disease," he noted. "We have several open-label studies showing that dopaminergic agents, pramipexole [Mirapex] in particular, are able to reduce [or] improve depressive symptoms in Parkinson's disease." Pramipexole is approved by the Food and Drug Administration for the treatment of the signs and symptoms of idiopathic Parkinson's disease and moderate to severe primary restless legs syndrome.

Patients in the trial were 30 years or older and had idiopathic PD with stable motor function; a score of 5 or greater on the Geriatric Depression Scale score; a score of 2 or greater on part I, question 3 (depression) of the Unified Parkinson's Disease Rating Scale (UPDRS); and a score of 24 or greater on the Mini-Mental State Examination, Dr. Barone reported at the annual meeting of the American Academy of Neurology

They were allowed to continue on other medications for PD, depression, and comorbidities at constant doses.

In the 12-week study, 152 patients were randomly assigned to placebo and 144 were assigned to pramipexole, with optional titration up to a dose of 1.0 mg three times a day. Rates of trial completion were 88% and 86%, respectively. …

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