Tundo Antonio, Betro' Sophia, de Filippis Rocco, Marchetti Fulvia, Nacca Daniele, Necci Roberta, Iommi Marica
Istituto di Psicopatologia, Via Girolamo da Carpi, 1, 00196 Rome, Italy.
Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, 40126 Bologna, Italy.
Life (Basel). 2023 Apr 19;13(4):1043. doi: 10.3390/life13041043.
Pramipexole is a dopamine full agonist approved for the treatment of Parkinson's disease and restless legs syndrome. Its high affinity for the D3 receptor and neuroprotective, antioxidant, and anti-inflammatory activity provides a rationale for the treatment of depression. In this paper, we review studies on the effectiveness and safety of antidepressant pramipexole augmentation in treatment-resistant depression.
This comprehensive systematic review and meta-analysis of observational studies on pramipexole-antidepressant augmentation included patients with resistant unipolar and bipolar depression. The primary outcome measure was the treatment response, measured at the study endpoint.
We identified 8 studies including 281 patients overall, 57% women and 39.5% with bipolar disorder and 60.5% with major depressive disorder. The mean follow-up duration was 27.3 weeks (range 8-69). The pooled estimate of treatment response was 62.5%, without significant differences between unipolar and bipolar depression. Safety was good, with nausea and somnolence the most frequent side effects.
The findings of this systematic review, needing further confirmation, show that off-label use of pramipexole as augmentation of antidepressant treatment could be a useful and safe strategy for unipolar and bipolar treatment-resistant depression.
普拉克索是一种多巴胺完全激动剂，已被批准用于治疗帕金森病和不安腿综合征。它对D3受体具有高亲和力以及神经保护、抗氧化和抗炎活性，为其治疗抑郁症提供了理论依据。在本文中，我们回顾了关于普拉克索增强抗抑郁药治疗难治性抑郁症的有效性和安全性的研究。
这项对普拉克索增强抗抑郁药的观察性研究进行的全面系统评价和荟萃分析纳入了难治性单相和双相抑郁症患者。主要结局指标是在研究终点时测量的治疗反应。
我们确定了8项研究，共纳入281例患者，其中57%为女性，39.5%患有双相情感障碍，60.5%患有重度抑郁症。平均随访时间为27.3周（范围8 - 69周）。治疗反应的合并估计值为62.5%，单相和双相抑郁症之间无显著差异。安全性良好，恶心和嗜睡是最常见的副作用。
本系统评价结果尚需进一步证实，表明普拉克索作为抗抑郁治疗增强剂的非标签使用可能是治疗单相和双相难治性抑郁症的一种有用且安全的策略。
