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When patients with depression do not respond to antidepressant monotherapy, they are usually prescribed a second antidepressant or an atypical antipsychotic. Clinical experience and small studies suggest that pramipexole, a dopamine agonist typically used for Parkinson's disease, might also be effective.
To evaluate further, researchers randomized 150 adults with treatment-resistant depression to add pramipexole (target dose, 2.5 mg) or placebo to their current antidepressant for 48 weeks. Patients were resistant to an average of three antidepressants.
Key findings were as follows:
At 12 weeks, response rates were three times higher with pramipexole than placebo (44% vs. 16%), as were remission rates (28% vs. 8%). Benefits persisted in patient…