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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by jonh kimble on September 4, 2003, at 15:55:03
hi all. ive started mirapex at .25mgs going up to 1mg in a couple weeks. i am taking it for anhedonia, social anxiety, pessimism, depression, etc... what can i expect and when can i expect it? oh and i havent responded to anyother ad's before. thanks alot
Posted by Cruz on September 4, 2003, at 23:12:31
In reply to just started mirapex, posted by jonh kimble on September 4, 2003, at 15:55:03
I have had trials on approximately 75 meds for the same symptoms you state. Parnate is the only one that gave me some help but it only last for 3 months. About a year ago I tried Mirapex but the nausea was overwellming. I think I quit after 2 weeks. I might give it another try but I would also obtain some domperidone and other nausea aids so I could get to a higher dose and at least try it a month.
Posted by Ame Sans Vie on September 5, 2003, at 8:31:54
In reply to Nausea could be a problem, posted by Cruz on September 4, 2003, at 23:12:31
Yeah, the nausea could certainly be an issue -- I titrated my dose upward WAY too quickly and found myself literally spending all day lying on the floor of the bathroom waiting to throw up for the first week or so until the nausea went away. Don't raise anymore than 0.125mg every week, that's my advice. And should you experience any nausea, a tea of 2tsp basil and 1tsp ginger should easily take care of it.
Good luck -- Mirapex is a marvelous medication. So much confidence, drive, determination, assertiveness, and a perfect state of euthymia. I unfortunately had to quit it after a while due to the sleep attacks mentioned in the prescribing info.
Posted by jonh kimble on September 5, 2003, at 17:02:17
In reply to Re: Nausea could be a problem, posted by Ame Sans Vie on September 5, 2003, at 8:31:54
Thanks for the posts. Yes nausea has already set in to a small extent, but its really not a problem at this time.
Ame sans vie, when did it kick in for you and at what dose? Ive tried ssris, maois, antipsychotics etc.. and i know very clearly that none helped, although some caused side effects. what was your experience with other meds? was mirapex one of the first to help you? did you ever try amisulpride? i did and it didnt help. sorry for all the questions but im just so excited about those benefits you listed thats exactly what i need. thanks so much
Posted by btnd on September 6, 2003, at 3:59:32
In reply to Re: Nausea could be a problem, posted by Ame Sans Vie on September 5, 2003, at 8:31:54
> Good luck -- Mirapex is a marvelous medication. So much confidence, drive, determination, assertiveness, and a perfect state of euthymia. I unfortunately had to quit it after a while due to the sleep attacks mentioned in the prescribing info.
How often does this side-effect come up? What other side-effects Mirapex has?
Posted by Ame Sans Vie on September 6, 2003, at 9:07:36
In reply to Mirapex side-effects? » Ame Sans Vie, posted by btnd on September 6, 2003, at 3:59:32
This is an excerpt directly from the Mirapex prescribing info:
"WARNINGS
Falling Asleep During Activities of Daily Living:
Patients treated with MIRAPEX have reported falling asleep while engaged in activities of daily living, including the operation of motor vehicles which sometimes resulted in accidents. Although many of these patients reported somnolence while on MIRAPEX, some perceived that they had no warning signs such as excessive drowsiness, and believed that they were alert immediately prior to the event. Some of these events have been reported as late as one year after the initiation of treatment. Somnolence is a common occurrence in patients receiving MIRAPEX at doses above 1.5 mg/day. Many clinicalexperts believe that falling asleep while engaged in activities of daily living always occurs in a setting of preexisting somnolence, although patients may not give such a history. For this reason, prescribers should continually reassess patents for drowsiness or sleepiness, especially since some of the events occur well after the start of treatment. Prescribers should also be aware that patients may not acknowledge drowsiness or sleepiness until directly questioned about drowsiness or sleepiness during specific activities. Before initiating treatment with MIRAPEX, patients should be advised of the potential to develop drowsiness and specifically asked about factors that may increase the risk with MIRAPEX such as concomitant sedating medications, the presence of sleep disorders, and concomitant medications that increase pramipexole plasma levels (e.g., cimetidine — see PRECAUTIONS, Drug Interactions). If a patient develops significant daytime sleepiness or episodes of falling asleep during activities that require active participation (e.g., conversations, eating, etc.), MIRAPEX should ordinarily be discontinued. If a decision is made to continue MIRAPEX, patients should be advised to not drive and to avoid other potentially dangerous activities. While dose reduction clearly reduces the degree of somnolence, there is insufficient information to establish that dose reduction will eliminate episodes of falling asleep while engaged in activities of daily living."The side effect of "somnolence" was said to occur in 22% of trial subjects, and I'm assuming that includes the sleep attacks.
Should you try Mirapex and end up liking its effects, but have a problem with somnolence/sleep attacks, there are a few options that would allow you to continue taking it -- lowering the dose may help (though will probably decrease therapeutic benefit), supplementing with Provigil, or supplementing with another CNS stimulant. Provigil seems like the most sensible first option, as these effects of pramipexole can pretty much mimic narcolepsy.
The only other side effect I personally experienced was nausea, which subsided over time. Though on one occasion I decided to try 4.5mg all at once (my usual dosage was 1.5mg tid), and there certainly were some prominent hallucinations at this level, though hallucinations are also fairly common if the dose is titrated too quickly. Constipation, insomnia, agitation, and orthostatic hypotension are also some of the more common side effects, though I experienced none of them.
This is the end of the thread.
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