Have a bipole who is doing quite well on augmentation with pramipexole - 1mg bid. Only issue is they are experiencing increasing compulsive behaviors in the form of unhealthy eating, excessive masturbating. I can confidently say they are not experiencing a manic episode and this is likely 2/2 the medication. I'd hate to stop it as its having very positive effects on their mood. Any suggestions?
How to treat compulsive side effects of pramipexole?
- Thread starter Psychresy
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Sounds like Hedonistic Homeostatic Dysregulation Syndrome which is seen more commonly in PD more with dopamine replacement than with mood disorders.
I agree with nexus to lower the dose of pramipexole. I tend to start with 0.125mg and go up by 0.125 to 0.25mg up to 2.5 mg. You're on the upper end of this. You can also split the dose into three times a day.
You can try a low-dose antipsychotic therapy with an atypical agent such as olanzapine or quetiapine. I would avoid aripiprazole since it can worsen HHD.
I agree with nexus to lower the dose of pramipexole. I tend to start with 0.125mg and go up by 0.125 to 0.25mg up to 2.5 mg. You're on the upper end of this. You can also split the dose into three times a day.
You can try a low-dose antipsychotic therapy with an atypical agent such as olanzapine or quetiapine. I would avoid aripiprazole since it can worsen HHD.
