Side Effects of pramipexole: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Major Research Findings

Pramipexole is a dopamine agonist commonly used to treat Parkinson's disease and restless leg syndrome. It works by mimicking the neurotransmitter dopamine in the brain, helping to alleviate symptoms. However, it's important to be aware that pramipexole can have several side effects, some of which can be serious.

A study published in 20 reported a case of photosensitivity reaction in a patient taking pramipexole. Photosensitivity reactions occur when exposure to sunlight after taking pramipexole leads to skin rashes or inflammation. Another study, published in , found that pramipexole can impair behavioral flexibility in rats, which is the ability to adapt behavior to different situations. 17 suggested a possible link between pramipexole and pathological gambling, which is uncontrollable impulsive gambling behavior. In a study using rats with dopaminergic lesions, 24 found that chronic pramipexole treatment induced compulsive behavior, characterized by repetitive, non-pleasurable actions. 6 found that pramipexole can alter the composition of gut microbiota in rats, potentially affecting digestive health. 4 reported that pramipexole may increase the risk of impulse control disorders, a condition characterized by difficulty controlling one's actions.

Reasons for Side Effects

The exact reasons behind these side effects are not fully understood, but it's thought that pramipexole's action on dopamine receptors in the brain may contribute to them. Dopamine plays a crucial role in regulating pleasure, reward, and motor control. By affecting dopamine receptors, pramipexole may indirectly influence these functions, leading to side effects.

Common Side Effects

Photosensitivity Reaction

Patients taking pramipexole may experience skin rashes or inflammation when exposed to sunlight. 20 documented a case of a patient experiencing photosensitivity reaction after starting pramipexole. Using sunscreen and avoiding excessive sun exposure is recommended to prevent photosensitivity reactions.

Impaired Behavioral Flexibility

Pramipexole may reduce the ability to adapt behavior to different situations. reported this effect on behavioral flexibility in rats. It's important to monitor any changes in behavior patterns while taking pramipexole.

Pathological Gambling

There is a potential for pramipexole to trigger pathological gambling. 17 reported cases suggesting a possible link between pramipexole and pathological gambling. Careful monitoring for gambling tendencies is crucial.

Compulsive Behavior

Pramipexole might induce compulsive behavior, characterized by repetitive, non-pleasurable actions. 24 found this effect in rats with dopaminergic lesions. It's essential to observe for any changes in behavioral patterns and consult a doctor if compulsive behaviors are noticed.

Gut Microbiota Changes

Pramipexole can alter the composition of gut microbiota, which plays a significant role in digestive health. 6 reported this effect in rats. Monitoring for any digestive issues while taking pramipexole is recommended.

Increased Risk of Impulse Control Disorders

Pramipexole may increase the risk of impulse control disorders, where controlling one's actions becomes difficult. 4 suggested this potential risk. Close observation of behavioral patterns is important, and consulting a doctor if any symptoms of impulse control disorders arise is vital.

Side Effect Management

Photosensitivity Reaction

Using sunscreen and avoiding excessive sun exposure are important measures to prevent photosensitivity reactions.

Impaired Behavioral Flexibility

Monitor for changes in behavior patterns and discuss any concerns with your doctor.

Pathological Gambling

Be vigilant about gambling tendencies and consult your doctor if excessive gambling occurs.

Compulsive Behavior

Pay attention to behavioral patterns and seek medical advice if compulsive behaviors are observed.

Gut Microbiota Changes

Monitor for any digestive issues and discuss them with your doctor.

Increased Risk of Impulse Control Disorders

Observe for any changes in behavior patterns and consult your doctor if symptoms of impulse control disorders arise.

Comparing Studies

Similarities

Multiple studies indicate a potential for pramipexole to induce various side effects, including photosensitivity reactions, impaired behavioral flexibility, pathological gambling, compulsive behavior, changes in gut microbiota, and impulse control disorders.

Differences

The specific side effects and their severity can vary across studies due to factors such as the study participants, methodologies, and other influencing factors.

Practical Considerations

While pramipexole is an effective treatment for Parkinson's disease and restless leg syndrome, it's crucial to be aware of its potential side effects. Discuss any concerns with your doctor, especially if you experience increased urges related to gambling, shopping, or sexual behavior. Additionally, if you're prone to photosensitivity reactions, take precautions such as using sunscreen and avoiding excessive sun exposure.

Limitations of Current Research

The research on pramipexole is still ongoing, and further investigation is needed to fully understand the mechanisms behind its side effects and develop effective management strategies. The long-term effects of pramipexole on the body are also not completely known.

Future Research Directions

Future research should focus on elucidating the mechanisms behind pramipexole's side effects and establishing safe usage guidelines. Additionally, studying the long-term effects of pramipexole on the body is crucial to ensure its safe and effective use.

Conclusion

Pramipexole is an effective medication for treating Parkinson's disease and restless leg syndrome, but it has the potential to cause various side effects. It's crucial to be aware of these side effects and seek medical advice from your doctor if you experience any concerning symptoms. By understanding the risks and taking appropriate precautions, pramipexole can be used effectively and safely for managing these conditions.

Literature analysis of 28 papers
Positive Content
16
Neutral Content
6
Negative Content
6
Article Type
1
2
1
6
28
2.

Exploring the underlying mechanisms of drug-induced impulse control disorders: a pharmacovigilance-pharmacodynamic study.

Author: FusaroliMichele, GiunchiValentina, BattiniVera, GringeriMichele, RimondiniRoberto, MenchettiMarco, RadiceSonia, PozziMarco, NobileMaria, ClementiEmilio, De PontiFabrizio, CarnovaleCarla, RaschiEmanuel, PoluzziElisabetta

Impulse control disorders
Treatment failure

Impulse control disorders, like pathological gambling and hypersexuality, may develop as adverse reactions to drugs, prompting investigation into underlying mechanisms beyond D3-receptor agonism.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Assessment of Repetitive and Compulsive Behaviors Induced by Pramipexole in Rats: Effect of Alpha-Synuclein-Induced Nigrostriatal Degeneration.

Author: DecourtMélina, BaladoEric, Jiménez-UrbietaHaritz, FrancheteauMaureen, FernagutPierre-Olivier, Benoit-MarandMarianne

compulsive behaviors

Dopamine agonists are used to treat Parkinson's disease (PD) but can cause neuropsychiatric side effects. This study investigates the effects of the dopamine agonist pramipexole and nigrostriatal degeneration on repetitive and compulsive behaviors in rats.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Impulse control disorders associated with dopaminergic drugs: A disproportionality analysis using vigibase.

Author: De WitLaura E, WiltingIngeborg, SouvereinPatrick C, van der PolPeggy, EgbertsToine C G

Impulse control disorders

This study investigated whether drugs with dopaminergic properties, beyond dopamine receptor agonists, also increase the risk of impulse control disorders (ICDs).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Comparison of pramipexole versus ropinirole in the treatment of Parkinson's disease.

Author: GenclerOnur Serdar, OztekinNese, OztekinMehmet Fevzi

Pramipexole and ropinirole for Parkinson's disease

This study compared the efficacy of pramipexole and ropinirole, potent nonergoline dopamine agonists, in treating Parkinson's disease. These medications are used for both monotherapy and as add-on therapy to levodopa. The study also evaluated the effects of these agents on depression and their safety profiles.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Parkinson's Disease Medication Alters Small Intestinal Motility and Microbiota Composition in Healthy Rats.

Author: van KesselSebastiaan P, BullockAmber, van DijkGertjan, El AidySahar

PD medication impact

This study investigated the impact of Parkinson's disease (PD) medications on gastrointestinal function and microbiota composition in the small intestine. Dopamine agonists significantly reduced small intestinal motility and increased bacterial overgrowth, potentially affecting levodopa bioavailability and influencing microbiota composition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Efficacy and safety of 24-week pramipexole augmentation in patients with treatment resistant depression. A retrospective cohort study.

Author: TundoAntonio, Betro'Sophia, IommiMarica, de FilippisRocco

Improved mood
Safety of pramipexole
Hypomanic switch

This study investigated the safety and efficacy of pramipexole, a dopamine agonist, as augmentation therapy for treatment-resistant depression for 24 weeks. 74.1% of patients responded and 66.4% remitted. The most common side effect was hypomanic switch in 1% of patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Implications of dopaminergic medication withdrawal in Parkinson's disease.

Author: KoschelJ, Ray ChaudhuriK, TöngesL, ThielM, RaederV, JostW H

Withdrawal symptoms

Tapering off dopamine replacement therapy (DRT) in Parkinson's disease (PD) requires careful consideration due to the risk of severe withdrawal symptoms. Abrupt discontinuation or rapid reduction of dopamine agonists or amantadine can lead to life-threatening consequences. Further research is needed to establish evidence-based recommendations for tapering off DRT.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

The role of pramipexole in the treatment of patients with depression and Parkinson's disease: A meta-analysis of randomized controlled trials.

Author: JiangDe-Qi, JiangLi-Lin, WangYan, LiMing-Xing

Depression relief
Motor dysfunction improvement
Well tolerated

This systematic review found that pramipexole therapy was effective in alleviating depressive symptoms and motor dysfunction in patients with depression and Parkinson's disease (dPD). It was associated with no additional side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

12.

Focus on Depression in Parkinson's Disease: A Delphi Consensus of Experts in Psychiatry, Neurology, and Geriatrics.

Author: Agüera-OrtizLuis, García-RamosRocío, Grandas PérezFrancisco J, López-ÁlvarezJorge, Montes RodríguezJosé Manuel, Olazarán RodríguezF Javier, Olivera PueyoJavier, Pelegrín ValeroCarmelo, Porta-EtessamJesús

Improved depression symptoms
Side effects

This study used a modified Delphi survey to assess the knowledge and understanding of depression in Parkinson’s disease among experts in the field. The results provide guidance for the diagnosis and treatment of depression in patients with Parkinson’s disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Chronic Pain Treatment Strategies in Parkinson's Disease.

Author: EdinoffAmber, SathivadivelNiro, McBrideTimothy, ParkerAllyson, OkeaguChikezie, KayeAlan D, KayeAdam M, KayeJessica S, KayeRachel J, M ShethMeeta, ViswanathOmar, UritsIvan

Pain reduction

This study reviews the management of chronic pain in patients with Parkinson's disease. It discusses various treatment options, including medications, physical therapies, and deep brain stimulation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Dilemma in Parkinson's Treatment; Levodopa Monotherapy May be the Best Choice.

Author: AbbasiMohammad Hossein, EsmaeiliSara, HabibiSeyed Amirhassan, ShahidiGholam Ali

Improved Parkinson's disease symptoms

This study compared Levodopa monotherapy versus Pramipexole in combination with Levodopa for treating Parkinson's disease (PD) in terms of efficacy and side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Selective serotonin reuptake inhibitors and the risk of restless legs syndrome: a symmetry analysis.

Author: DunvaldAnn-Cathrine Dalgård, HenriksenDaniel Pilsgaard, HallasJesper, ChristensenMette Marie Hougaard, LundLars Christian

RLS

No association was found between the initiation of an SSRI and the development of RLS assessed by the prescription of an RLS drug.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Subthalamic Nucleus Stimulation Impairs Motivation: Implication for Apathy in Parkinson's Disease.

Author: VachezYvan, CarcenacCarole, MagnardRobin, Kerkerian-Le GoffLydia, SalinPascal, SavastaMarc, CarnicellaSebastien, BouletSabrina

Apathy Risk
Motor Symptom Relief

This study aims to clarify the potential for subthalamic nucleus deep brain stimulation (DBS) to induce apathy in Parkinson's disease (PD) patients. While DBS is effective for motor symptoms, its impact on motivation is a concern. The study seeks to definitively address the question of whether DBS can cause apathetic behaviors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Management of Depression in Parkinson's Disease: A Systematic Review.

Author: StarksteinSergio E, BrockmanSimone

Depression treatment

Selective serotonergic reuptake inhibitors and cognitive-behavioral therapy are currently first-line treatments for depression in patients with PD, although the evidence is still weak.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Lesson of the month 2: An unusual adverse reaction associated with pramipexole.

Author: TashkentYasmina, AiyappanVinod

RLS treatment
Photosensitivity reactions

Pramipexole is a common medication for restless legs syndrome and Parkinson's disease. While its common side effects are well-documented, photosensitivity reactions are less known. A 45-year-old male farmer developed a rash on sun-exposed areas after starting pramipexole. This case highlights the potential for photosensitivity reactions to pramipexole, especially in countries with high UV radiation.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Dexpramipexole as an oral steroid-sparing agent in hypereosinophilic syndromes.

Author: PanchSandhya R, BozikMichael E, BrownThomas, MakiyaMichelle, PrussinCalman, ArchibaldDonald G, HebrankGregory T, SullivanMary, SunXiaoping, WetzlerLauren, WareJeanAnne, FayMichael P, DunbarCynthia E, DworetzkySteven I, KhouryPaneez, MaricIrina, KlionAmy D

GC-sparing
Hypereosinophilic syndromes treatment

Dexpramipexole, a synthetic aminobenzothiazole, was found to be promising as a glucocorticoid (GC)-sparing agent in patients with hypereosinophilic syndromes (HESs), potentially by affecting eosinophil maturation in the bone marrow.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., IntramuralFunding provided by the NIH for research projects within the NIH.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Adverse effects produced by different drugs used in the treatment of Parkinson's disease: A mixed treatment comparison.

Author: LiBao-Dong, BiZhen-Yun, LiuJing-Feng, SiWei-Jun, ShiQian-Qian, XueLi-Peng, BaiJing

Improved treatment comparison

This mixed treatment comparison assessed the adverse effects of eleven drugs for Parkinson's disease (PD): ropinirole, rasagiline, rotigotine, entacapone, apomorphine, pramipexole, sumanirole, bromocriptine, piribedil, pergolide, and levodopa.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

25.

Dopamine, T cells and multiple sclerosis (MS).

Author: LeviteMia, MarinoFranca, CosentinoMarco

T cell activation
Treg suppression

Dopamine is a key neurotransmitter that induces critical effects in the nervous system and in many peripheral organs. This review focuses on dopamine receptors, effects and production in T cells. Dopamine itself and dopaminergic drugs have direct effects on human T cells.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

28.

Advances in dopamine receptor agonists for the treatment of Parkinson's disease.

Author: StocchiFabrizio, TortiMargherita, FossatiChiara

Efficacy in PD
Improved motor function

Dopamine agonists (DA) are a class of medications that directly stimulate dopamine receptors. While DA was initially used as an adjunct therapy for Parkinson's disease (PD), it has become a first-line treatment option for early-stage PD. This review will examine the recent updates in DA therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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