Mirapex (pramipexole)

This thread exists to share experiences with Mirapex (pramipexole).

My experience with Mirapex:

I have had severe depressions, first diagnosed as Atypical Major Depression. I was told, for years, that my depression was treatment resistant. I was told, by pdocs to try ECT. I was doing my best to avoid ECT. Later on, two different pdocs have changed my diagnosis to Bipolar II.

My depressions are called "Bipolar Depression." My depressions are very severe. I do not respond to any antidepressant on the market, old or new. I have not responded to this class of meds for many, many years.

Over this past year, my care has been transferred to a new pdoc. She has treated severe depressions which are resistant to standard antidepressants with a medication called Mirapex. She says it is a "miracle drug" for some of her severely depressed patients.*

I was very skeptical. I was so skeptical, I would not intially take this medication. After retrying high-dose combinations of antidepressants, yet again, without any success, I gave in and agreed to try Mirapex.

I felt a huge differerence within the first week of treatment. I was almost immediately much less suicidal. As time went on, I only got better and better!

I still deal with depression; yet, it is relatively mild compared to prior depressions. It took a little bit of time to find the right dose for me. It was well worth it.

I have been taking MIrapex for about 6 months now. Initially, I'd experienced some dizziness and some dry mouth/throat. I also had a bit of nausea and indigestion. I'd treated the GI side-effects with simethicone and ginger ale (Reed's, which has extra ginger). Within 10 days, the GI side-effects had subsided.

I have a lot more energy, both physical and cognitive, and get much more done most days. I now have some hope that I can have a life!

* Not everyone can tolerate the medication. There are reports and anecdotal information that a large percentage of people have such severe GI side-effects that they cannot tolerate this medication. My pdoc shares the fact that any of her patients who can tolerate Mirapex do well. There is a chance that people can become hypomanic/manic with this medication. My pdoc shares that Mirapex is now used in both BPI and BPII. In both conditions, it is important to watch for symptoms of a problematic upswing in mood.

Mirapex does not disturb my sleep. I take Mirapex twice a day. I won't give dosage information, as we are all different.

I hope you have success with Mirapex!

I've never taken Mirapex, but it was cool to learn about your experiences with it so far. I had read somewhere that such a class of medication shows great promise for people with bipolar disorder. I hope it continues to serve you well, my friend.

Thanks so much BirdDancer!

I do not know what I would do without Mirapex. I am also in a mood stabilizer. I was told by my pdoc that it's best for patients to be on a mood stabilizer before starting Mirapex.

I would be a terrible mess without this medication. .

awesome. i asked my new psych about mirapex. i was kinda disappointed, because she was all "I've never read data on mirapex for depression!?!" and then she asked where I found the info. I said "PubMed," and she smiled, and...ugh. I dunno. each person is different, of course. I hope I can try this and see if it goes well.

WC...thank you for sharing this, and I am -so- thankful that you've found a treatment that makes life...live-able, at long last.

Oh, WILD COYOTE! I am so thrilled to see your post! I, too, have stumbled upon Mirapex/pramipexole. Yes, IT IS A MIRACLE!
I'll try to make my story super quick... I've had TRD for 18 years, doc kept throwing SSRI and various adjuncts, at me. Then Ketamine Nasal (Spravato) was approved in March. Stick with me, this part is a major player. I was ready before to travel out of state to pay thousands for iv ketamine. Then even Spravato was a several hour drive to just try (3 days, a, week for a month). And, even though I have insurance, it infuriates me that Spravato is 500-800$ per DOSE. I requested the referral from my doc... Without a second thought, he sent in a Ketamine Nasal spray to our compounding pharmacy (Spravato is Ketamine- they just mirrored the molecule--it's exactly the same drug!). I now had a month's supply for 50$! I got to try it without traveling, adjust the dosage =with doc's approval, time of day, etc. Magically, by the 2nd or 3rd week I came out of the worst depression of my life by about 70%. I was astounded, but still ill. That's when I researched like crazy why the Ketamine worked--its a Dopamine agonist, hence, I found Mirapex was also a Dopamine agonist with true and tested positive results. I added the Mirapex to the ketamine AND MY LIFE CHANGED. I want to shout on the roof tops (and may yet still do!) that there is another route of treat us TRD patients that hasn't been discovered. I'm angry about big Pharma pushing all of their serotonin concoctions to people like us. I wanted to put my experience in its own thread so it gets seen. (I will later). Mirapex plus the ketamine Nasal (screw Soravato- how dare they use their greed to charge, suffering people 500-800$ per dose). I haven't felt this good in 18 years - yes, God himself gets all the credit for his mercy on me. I actually have a future on this earth.. I'm stunned that is now possible.
Long long message, I know, sorry. But as for you, if you don't feel completely better yet, the combo of ketamine and Mirapex is nothing short of magical. Yes, tears of joy are a constant companion in my life. I do realize every person is unique... But I beg people to keep trying to get better--just staying engaged in the fight is so good for you... Hope is always there. Best wishes!, my brother in depression... We are stronger because of the battle. ❤️❤️❤️

Hi yogamarley! Thanks for sharing your story here in the Mirapex thread!
I find your story very interesting and encouraging!

It would be helpful if you'd consider making a thread on ketamine? Each thread contains the information regarding the experiences of each treatment choice/modality
This is the thread for Mirapex. So it's great you have shared your amazing story here!

If you'd researched dopamine agonists and found Mirapex, how did you convince a doctor to prescribe it? One of the obstacles to people gaining access to Mirapex is the fact that doctors cannot be convinced to prescribe it for their patients.

I have not considered combining Mirapex with ketamine. I can imagine it's quite a cocktail! I am wondering if something as simple as a higher dose of Mirapex might serve to stimulate as much dopamine as when the two are combined?

Do you have links to any of the resources you had read when researching Mirapex? It's fine if you don't. Yet another obstacle to obtaining much needed treatment, patients have some difficulty gathering information they can give to their provider(s). Some providers are not highly motivated to educate themselves.

I am thrilled you have shared your story here for all to read!

By the way, welcome to the PC Bipolar forum!
So glad you are participating with us!

I hope to see you around!

Hi still_crazy!

I am sorry you have not yet been able to convince your pdoc to prescribe Mirapex. It's incredibly unfortunate! it's a relatively safe med and can be so very helpful.

I will ask my pdoc if she has any info/resources I can share here. I understand that my pdoc had learned about Mirapex from a pdoc at Brown University.

I hope we can find scientific resources, listing them here, so people might have access in order to educate their doctors.

Take care, stir_crazy!

Here's a paper/collection of studies (2013, I believe it's from Japan.. But in English of course).
Great info on Dopamine agonists--which Mirapex is the best one for TRD. Might help to convince your doc. It has been a miracle (with nasal Ketamine) - I actually have become myself after 18years. Hope it's helpful... Best wishes!

I'm thrilled you found my post helpful--it was sooo long!
First, I have a super doctor. I guess he respects me.. Plus the suffering he's seen me go through. I am obsessive about researching as well.. So he and I have sort of learned much together (me being a very willing Guinea pig!).
Second: Yes, while I have found a few papers to support Mirapex (which is used off label), the one that has helped the most, I have attached - a 2013 Japanese conglomeration of studies.
And third, you betcha, I'm going to put this post as many places as possible. I have a stewardship of my fellow sufferers.... If it shortens their tough days by one, I will be overjoyed. But, again, every one is different.. No promises. But I was wisely told: if you don't change what you're doing, you can only expect the same results. So to those out there that are stuck in a rut, try something new.. There is always hope.. I can't reiterate that enough!
Finally, here's the dosages for those interested : Ketamine Nasal spray (I figured this out by actually looking at Spravato's dosages : 56mg - 84mg)....I'm at about 60mg. We're in the midst of figuring out the best amount of Mirapex for me.. The literature says 2mg-5mg..I just upped the dose to 3mg, feeling great, but some dumb side effects that we're working on.
Thanks for your interest again.. I'm headed to the Ketamine board right now. The nasal spray is new (not the IV, but the IV is so cost prohibitive.. Insurance doesn't cover any of it). But again.... A compounding pharmacy is the way to go... Spravato's is exactly the same thing as ketamine. Love and laughter in everyone's future! Yogamarley