A Parkinson’s disease drug has been effective in reducing the symptoms of treatment-resistant depression.
Led by the UK’s University of Oxford, the trial (ISRCTN84666271) found pramipexole to be substantially effective at reducing the symptoms of treatment-resistant depression when added to ongoing antidepressant medication.
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Pramipexole is a type of generic dopamine agonist medication used to treat Parkinson’s and restless legs syndrome (RLS). The medication is commonly sold under the brand name Mirapex.
Supported by the National Institute for Health and Care Research (NIHR) and published in The Lancet Psychiatry, the double-blind study enrolled 150 patients with treatment-resistant depression, who were randomised to receive either pramipexole or a placebo, alongside ongoing antidepressant medication for 48 weeks.
Patients who received pramipexole had a significant and substantial reduction in symptoms after 12 weeks, meeting the study’s primary endpoint, but benefits continued for 48 weeks. At the 12-week mark, the change in Quick Inventory of Depressive Symptomatology (QIDS) score was -6.4 in the treatment arm compared with -2.4 in the placebo group, with a mean difference of -3.91.
Despite its positive efficacy, there were also significant adverse events (AEs) suffered by patients including nausea, sleep disturbance and dizziness, with 20% of patients receiving the study dropping out of the trial due to AEs compared to 5% in the placebo arm.
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By GlobalDataUniversity of Oxford’s Professor Michael Browning said: “Effectively treating people who have not responded to first-line interventions for depression is a pressing clinical problem and there has long been an urgent need to find new treatments.
“Pramipexole is a medicine licensed for Parkinson’s disease and works by boosting the brain chemical dopamine. This differs from the majority of other antidepressant medications, which act on brain serotonin and may explain why pramipexole was so helpful in this study.”
As a result of this data, Browning called for more research into the adverse event profile and the cost-effectiveness of using pramipexole to address treatment-resistant depression.
It is currrently recommended to add new treatments such as lithium or antipsychotics to ongoing antidepressant treatment for treatment-resistant depression. However, these have limited effectiveness and do not work for everyone, meaning there is a great need for a new therapy that can benefit a larger group of patients.
