Pramipexole for Bipolar II Depression: RCT
Archives of General Psychiatry (2004)
Response rate of 60% vs 9% placebo in bipolar II depression, supporting off-label use in treatment-resistant mood disorders.
Pramipexole
Oral tablet (0.25mg)Available in all 50 statesMarketing purposes only. Actual medications, if prescribed, are dispensed by a licensed pharmacy.
hormones
PramipexolePramipexole
Non-ergot dopamine agonist with high D2/D3/D4 selectivity. FDA-approved for Parkinson's and RLS. Off-label for treatment-resistant depression, prolactin management, and cognitive/motivational enhancement via D3 mesolimbic effects.
No cardiac valve fibrosis risk (non-ergot)
Strong D3 agonism, antidepressant effects
Effective for RLS
Neuroprotective potential
No commitment · HSA/FSA eligibleNo commitment · HSA/FSA eligible
How it works
Mechanism of action
Direct stimulation of D2, D3, and D4 receptors. D3 activation in the mesolimbic pathway underlies antidepressant and reward-modulating effects. D2 agonism suppresses prolactin.
The baseline panel.
Every Marek client receives this baseline panel before a provider review. Your provider may add additional biomarkers based on your health history, symptoms, and goals, pulling from 1,000+ available markers. See more biomarkers →
Hormone Profile
12 markers
Sex hormones
- Total TestosteroneLC/MS
- Free TestosteroneEquilibrium Dialysis
- Estradiol, Sensitive / UltrasensitiveLC/MS
- Sex Hormone Binding Globulin (SHBG)
- ProgesteroneLC/MSFemale panel
- Prolactin
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- hCG, Total, QuantitativeFemale panel, pre-menopause
Adrenals & neurosteroids
- Cortisol
- DHEA-S
Growth hormone / IGF-1
- Insulin-Like Growth Factor I (IGF-1)
Thyroid Status
3 markers
Thyroid hormones
- Thyroid Stimulating Hormone (TSH)
- Free T4
- Free T3
Heart Health
9 markers
Cardiovascular health
- Total Cholesterol
- HDL Cholesterol
- LDL Cholesterol
- LDL:HDL Ratio
- VLDL Cholesterol
- Triglycerides
- Apolipoprotein-B (ApoB)
- C-Reactive Protein, High Sensitivity (hsCRP)
- Lipoprotein(a) (Lp(a))
Metabolism
3 markers
Insulin sensitivity
- Blood Glucose
- Fasting Insulin
- HbA1c
Organ Function
26 markers
Liver & pancreas
- AST
- ALT
- Bilirubin, Total
- γ-Glutamyl Transferase (GGT)
Kidney function
- BUN
- Creatinine w/ eGFR
Comprehensive Metabolic Panel (CMP)
- Glucose
- Blood Urea Nitrogen (BUN)
- Creatinine
- eGFR
- BUN/Creatinine Ratio
- Sodium
- Potassium
- Chloride
- Carbon Dioxide, Total
- Calcium
- Protein, Total
- Albumin
- Globulin, Total
- Albumin/Globulin (A/G) Ratio
- Alkaline Phosphatase (ALP)
- AST
- ALT
Prostate health
- Prostate-Specific Antigen (PSA)Male panel
- Free PSAMale panel
- % Free PSAMale panel
Nutrient Status
31 markers
Vitamins & minerals
- Vitamin D, 25-OHD (25-Hydroxy)
- Magnesium, RBC
Iron status
- Iron
- Iron Saturation
- TIBC
- UIBC
- Ferritin
Complete Blood Count (CBC)
- White Blood Count (WBC)
- Red Blood Count (RBC)
- Hemoglobin (Hgb)
- Hematocrit (HCT)
- MCV
- MCH
- MCHC
- Red Cell Distribution Width (RDW)
- Platelets
- Neutrophils
- Neutrophils (Absolute)
- Lymphocytes
- Lymphocytes (Absolute)
- Neutrophil/Lymphocyte Ratio
- Monocytes
- Monocytes (Absolute)
- Eosinophils
- Eosinophils (Absolute)
- Basophils
- Basophils (Absolute)
- Immature Cells
- Immature Granulocytes
- Immature Granulocytes (Absolute)
- NRBC, w/ Reflex for Immature Cells
Clinical evidence
The research behind Pramipexole.
Safety profile
Monitoring & safety information.
Commonly reported side effects
- Nausea
- Dizziness
- Somnolence
- Insomnia
- Peripheral edema
Less common but serious risks
- Impulse control disorders (gambling, hypersexuality)
- Sudden sleep attacks
- Psychosis/hallucinations (high doses)
- RLS augmentation with long-term use
Generally not appropriate for
- History of impulse control disorders
- Caution with concurrent antipsychotics
Typical monitoring
- Blood pressure
- Prolactin
- Behavioral assessment (impulse control)
- Sleep symptoms
- Renal function
FAQ
Quick answers.
Non-ergot dopamine agonist with high D2/D3/D4 selectivity. FDA-approved for Parkinson's and RLS. Off-label for treatment-resistant depression, prolactin management, and cognitive/motivational enhancement via D3 mesolimbic effects.
No cardiac valve fibrosis risk (non-ergot). Strong D3 agonism, antidepressant effects. Effective for RLS. Neuroprotective potential.
Common side effects include: nausea, dizziness, somnolence, insomnia, peripheral edema. Most side effects are dose-dependent and may resolve with continued use or dose adjustment.
Non-ergot dopamine agonist with high D2/D3/D4 selectivity. FDA-approved for Parkinson's and RLS. Off-label for treatment-resistant depression, prolactin management, and cognitive/motivational enhancement via D3 mesolimbic effects.
Treatments are dependent on licensed clinical prescription. Client costs vary based on individual labs and panel in treatments and services.