Akdeniz Fisun, Aldemir Ebru, Vahip Simavi
Turk Psikiyatri Derg. 2009 Spring;20(1):94-8.
Despite a wide range of various drugs, a significant proportion of depressed bipolar patients fail to respond to the treatment strategies. Novel theraupetics for bipolar depression are needed. Preliminary studies suggest that pramipexole a dopaminergic agent that has been used in the treatment of Parkinson's disease and restless leg syndrome may have antidepressant properties in unipolar and bipolar depressed patients as well as neurotrophic properties. The optimal antidepressant daily dose of pramipexole is not known. It has been suggested to be used between 0.125 to 9.0 mg/day. In double blind placebo controlled bipolar depression treatment studies, the average daily dose of pramipexole was 1.7 mg. Manic switches have been reported with depressive subjects and with subjects without any mental disorders. We report two cases of treatment resistant bipolar depression. Despite different treatment strategies and treatment adherence, the patients did not give optimal response to the treatments and continue to experience depressive relapses. They have been treated with low dose (0.5-0.75 mg/day) pramipexole augmentation successfully. The severity and the duration of the depressive episodes were decreased. No serious adverse event has been reported with pramipexole during the maintenance treatment.
尽管有各种各样的药物，但相当一部分双相情感障碍抑郁患者对治疗策略没有反应。需要针对双相情感障碍抑郁的新型治疗方法。初步研究表明，普拉克索是一种已用于治疗帕金森病和不安腿综合征的多巴胺能药物，可能对单相和双相情感障碍抑郁患者具有抗抑郁特性以及神经营养特性。普拉克索的最佳抗抑郁日剂量尚不清楚。有人建议使用剂量在0.125至9.0毫克/天之间。在双盲安慰剂对照的双相情感障碍抑郁治疗研究中，普拉克索的平均日剂量为1.7毫克。有报道称，在抑郁患者以及没有任何精神障碍的患者中出现了躁狂发作。我们报告了两例难治性双相情感障碍抑郁病例。尽管采用了不同的治疗策略且患者坚持治疗，但患者对治疗没有给出最佳反应，并且继续经历抑郁复发。他们接受低剂量（0.5 - 0.75毫克/天）普拉克索增效治疗取得了成功。抑郁发作的严重程度和持续时间有所降低。在维持治疗期间，未报告普拉克索有严重不良事件。
