Mirapexin®/Sifrol® (pramipexole)

Mirapexin®/Sifrol® (pramipexole):
>five million patient-years of experience in Parkinson's disease

Clinical evidence: non-motor symptoms

Non-motor symptoms in Parkinson’s disease (PD) remain under-diagnosed and under-treated and a major cause of disability.1-3 Depressive symptoms, a common non-motor complication in PD, have been shown to negatively impact on patients’ quality of life: approximately 40% of people with PD suffer some form of depressive symptom4

  • While emerging data had suggested that Mirapexin®/Sifrol® (pramipexole) may have a positive effect on depressive symptoms associated with PD,5-14 this has recently been demonstrated for the first time in a large-scale, prospective, randomised, double-blind, placebo-controlled trial..15-17 The results also confirm the findings from an earlier clinical study where Mirapexin®/Sifrol® had shown an antidepressive effect comparable to that of an SSRI (selective serotonin reuptake inhibitor) when treating PD-related depressive symptoms,18 and support data from other trials which suggested that Mirapexin®/Sifrol® may have a positive effect on depressive symptoms and motivation associated with PD.5-14
  • It has been suggested that the affinity of Mirapexin®/Sifrol® for D3 might be responsible for the antidepressant properties of this compound18 and clinical research is ongoing to determine this aspect of the pharmacological profile in more detail19,20

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  1. Barone P et al. PRODEST – Depressive symptoms in Parkinson's disease: Patterns across scales. Poster P1.167 presented at XVII WFN World Congress on Parkinson's Disease and Related Disorders 2007, Amsterdam, The Netherlands.
  2. Marsh L et al. Neuropsychiatric aspects of Parkinson’s disease. Psychosomatics 2000; 41(1): 15–23.
  3. Chaudhuri KR et al. The metric properties of a novel non-motor symptoms scale for Parkinson’s disease: results from an international pilot study. Mov Disord 2007; 22(13): 1901-1.
  4. Tandberg E et al. The occurrence of depression in Parkinson's disease. Arch Neurol 1996; 53(2): 175-179.
  5. Lemke MR. Depressive symptoms in Parkinson’s disease. Eur J Neurol 2008 Apr; 15 (Suppl 1): 21-5.
  6. Möller JC et al. Long-term efficacy and safety of pramipexole in advanced Parkinson’s disease: results from a European multicenter trial. Mov Disord 2005; 20(5): 602–610.
  7. Rektorova I et al. Pramipexole and pergolide in the treatment of depression in Parkinson’s disease: a national multicentre prospective randomized study. Eur J Neurol 2003; 10(4): 399–406.
  8. Reichmann H et al. Pramipexole in routine clinical practice. CNS Drugs 2003; 17(13): 965–973.
  9. Lemke MR et al. Depression and Parkinson’s disease. J Neurol 2004; 251(Suppl 6): VI/25–27.
  10. Lemke MR et al. Anhedonia, depression, and motor functioning in Parkinson’s disease during treatment with pramipexole. J Neuropsychaitry Clin Neurosci 2005; 17(2): 214–20.
  11. Rektorova I et al. Cognitive performance in people with Parkinson’s disease and mild or moderate depression: effects of dopamine agonists in an add-on to L-dopa therapy. Eur J Neurol 2005; 12: 9–15.
  12. Goldberg JF et al. Preliminary randomized, double-blind, placebo controlled trial of pramipexole added to mood stabilizers for treatment resistant bipolar depression. Am J Psychiatry 2004; 161(3): 564–566.
  13. Künig G et al. Pramipexole, a nonergot dopamine agonist, is effective against rest tremor in intermediate to advanced Parkinson’s disease. Clin Neuropharm 1999; 22: 301-305.
  14. Leentjens A et al. The effect of pramipexole on mood and motivational symptoms in Parkinson’s disease: a meta-analysis of placebo-controlled studies. Clin Ther 2009 Jan; 31(1): 89-98.
  15. Barone P et al. Pramipexole ameliorates depression in Parkinson's disease: A randomized double-blind vs placebo trial. Abstract S43.004 presented at AAN 61st Annual Meeting 2009, Seattle, USA.
  16. Barone P et al. Efficacy of Double-Blind, Placebo-Controlled Pramipexole Against Depression in Parkinson's Disease. Poster M0-248 presented at MDS 13th International Congress of Parkinson's Disease and Movement Disorders 2009, Paris, France.
  17. Barone P et al. Change in depressive symptoms in a pramipexole trial for Parkinson's disease patients: relative contributions of direct effect on mood vs indirect effect on motor function. Poster P2540 presented at 13th EFNS Congress 2009, Florence, Italy.
  18. Barone P et al. Pramipexole versus sertraline in the treatment of depression in Parkinson’s disease: a national multicenter parallel-group randomized study. J Neurol 2006; 253(5): 601–607.
  19. Maj J et al. The effect of repeated treatment with pramipexole on the central dopamine D3 system. J Neural Trans 2000; 107(12): 1369–1379.
  20. Houben J et al. Pramipexole improves depressive and motivational symptoms in Parkinson’s disease. Abstract P575 presented at MDS 2006; Kyoto, Japan.

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