Pramipexole (Success)

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Jaxx
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Re: Pramipexole (Success)

Unread post by Jaxx »

sorry, i misread that, my mobile screen is a bit too small for this board :D

Think prami is generally tried here to trigger a balance anyway, rather than continious use
tonyareias
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Re: Pramipexole (Success)

Unread post by tonyareias »

There are many possible solutions (temporary or permanent) but in case of people with anxiety (my case) dopaminergics should be avoided.
Blueturtle
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Re: Pramipexole (Success)

Unread post by Blueturtle »

Mesolimbo wrote:
How so? Chronic Prami intake would cause further desensitization, making things worse.
Could chronic cabergoline intake make things worse as well?

I’ve read testimonies of people with similar symptoms to me who greatly improved with cabergoline. Cabergoline is an agonist of D2 receptors and it Lowers prolactin and increases T and especially DHT quite a Bit in hypogonadic hyperprolactict men. It obviously is a pretty potent substance and it can have dangerous side effects so I’m not going to jump into taking anything like that without serious and careful weighing of the pros and cons. It seemed to help some guys with PFS and Goldstein likes to prescribe it... perhaps a bit too enthusiastically...

Also my T is very high and my prolactin is normal so perhaps it’s not the smartest thing to do something that raises t and lowers prolactin out of the normal range. Although I haven’t tested my DHT yet, maybe my DHT is too low it looks like cabergoline raises DHT a lot more then T so that’s fascinating. Enhanced 5-alpha-reductase activity?

https://forum.propeciahelp.com/t/caberg ... s-dht/3183
PSSD from citalopram.
Took it Winter 2012-Summer 2016
Cut cold turkey. Symptoms include genital anesthesia, ejaculatory anhedonia, low libido, Burning/tingling genital pain.
My story: http://www.pssdforum.com/viewtopic.php?f=14&t=2536
taarn
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Re: Pramipexole (Success)

Unread post by taarn »

Mesolimbo wrote:I came across this today:
It was observed that sustained pramipexole administration produced desensitization of D2/D3 and 5-HT1A cell body autoreceptors, as well as a decrease in sensitivity of α2-adrenergic cell body autoreceptors
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101890/

Have this been discussed here already?
Have you seen these as well?

Pramipexole upregulates dopamine receptor D₂ and D₃ expression in rat striatum.
https://www.ncbi.nlm.nih.gov/pubmed/22986363

Low dose pramipexole is neuroprotective in the MPTP mouse model of Parkinson's disease, and downregulates the dopamine transporter via the D3 receptor.
https://www.ncbi.nlm.nih.gov/pubmed/15473914

Prolonged treatment with pramipexole promotes physical interaction of striatal dopamine D3 autoreceptors with dopamine transporters to reduce dopamine uptake.
https://www.ncbi.nlm.nih.gov/pubmed/25511804

Although what is alarming is that it seems to reduce SERT binding in the nigrostriatal and limbic systems.
https://www.sciencedirect.com/science/a ... 2215010489
Scout19
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Re: Pramipexole (Success)

Unread post by Scout19 »

Blueturtle wrote:
Mesolimbo wrote:
How so? Chronic Prami intake would cause further desensitization, making things worse.
Could chronic cabergoline intake make things worse as well?

I’ve read testimonies of people with similar symptoms to me who greatly improved with cabergoline. Cabergoline is an agonist of D2 receptors and it Lowers prolactin and increases T and especially DHT quite a Bit in hypogonadic hyperprolactict men. It obviously is a pretty potent substance and it can have dangerous side effects so I’m not going to jump into taking anything like that without serious and careful weighing of the pros and cons. It seemed to help some guys with PFS and Goldstein likes to prescribe it... perhaps a bit too enthusiastically...

Also my T is very high and my prolactin is normal so perhaps it’s not the smartest thing to do something that raises t and lowers prolactin out of the normal range. Although I haven’t tested my DHT yet, maybe my DHT is too low it looks like cabergoline raises DHT a lot more then T so that’s fascinating. Enhanced 5-alpha-reductase activity?

https://forum.propeciahelp.com/t/caberg ... s-dht/3183
I believe dopamine agonists are not a good idea. I took just one pill of Cabergoline, and experienced adverse effects. Had a severe reaction for the first few days after I took he pill, which included flu-like symptoms. Then, my libido, orgasms, and erection quality all completely tanked. This continued, without any relief, for three weeks. Only after three weeks did I begin to return to my baseline PSSD. I’m very much turned against dopamine agonists. There is something called DAWS (dopamine agonist withdrawal syndrome). At this point I will consider trying serotonin antagonists if things get better with me.
Blueturtle
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Re: Pramipexole (Success)

Unread post by Blueturtle »

Scout19 wrote:
I believe dopamine agonists are not a good idea. I took just one pill of Cabergoline, and experienced adverse effects. Had a severe reaction for the first few days after I took he pill, which included flu-like symptoms. Then, my libido, orgasms, and erection quality all completely tanked. This continued, without any relief, for three weeks. Only after three weeks did I begin to return to my baseline PSSD. I’m very much turned against dopamine agonists. There is something called DAWS (dopamine agonist withdrawal syndrome). At this point I will consider trying serotonin antagonists if things get better with me.
I am sorry to hear you had such a negative experience with cabergoline.

What dose did you try? They recommend an extremely slow tapper up, I believe .5 mg a day is a very big dose. They start you off at like .25 or even lower from what I heard.

Yeah, Daws is awful, A big thread on this forum describes trying things like serotonin antagonists/dopamine agonists only after trying atypical antidepressants/psychological therapy/ physical testing/ hormonal treatment etc. Powerful meds like dopamine agonists are the last step basically.

Has anything else related to dopamine helped you like wellbutrin/supplement etc?
PSSD from citalopram.
Took it Winter 2012-Summer 2016
Cut cold turkey. Symptoms include genital anesthesia, ejaculatory anhedonia, low libido, Burning/tingling genital pain.
My story: http://www.pssdforum.com/viewtopic.php?f=14&t=2536
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nasibi
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Re: Pramipexole (Success)

Unread post by nasibi »

Just reporting that I did a second run with Prami for about over a month. I did so because the last time I tried it I had been on Mirtazipine so I thought the results of that one didn't really count. This time I did it clean with Prami being the only drug in my system. Dosing was as follows:

Week One: 0.35 mg/day
Week Two: 0.5 mg/day
Week Three-Four: 0.7 mg/day
Week Five: 0.35 mg/day

It had no positive effects on me. For side effects the first few days it gave me some feelings of nausea and caused dry throat on waking up. It made me persistently wake up ~2 hours before my usual wake up time throughout the whole trial period. Besides that some nightmares here and there, and twitching. That is it.

Edit: I forgot to add that it also supressed my appetite and I also had those "sleep attacks" during the day.
Death is not the greatest loss in life. The greatest loss is what dies inside us while we live. :(
lepardglass
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Re: Pramipexole (Success)

Unread post by lepardglass »

nasibi wrote:Just reporting that I did a second run with Prami for about over a month. I did so because the last time I tried it I had been on Mirtazipine so I thought the results of that one didn't really count. This time I did it clean with Prami being the only drug in my system. Dosing was as follows:

Week One: 0.35 mg/day
Week Two: 0.5 mg/day
Week Three-Four: 0.7 mg/day
Week Five: 0.35 mg/day

It had no positive effects on me. For side effects the first few days it gave me some feelings of nausea and caused dry throat on waking up. It made me persistently wake up ~2 hours before my usual wake up time throughout the whole trial period. Besides that some nightmares here and there, and twitching. That is it.

Edit: I forgot to add that it also supressed my appetite and I also had those "sleep attacks" during the day.
Almost identical to my experience, here's what I posted in the other thread:
0.25mg 1x/day for 2 days
0.50mg 1x/day for 30 days
1mg 1x/day for 3 days

I can't say I noticed much on the sexual side unfortunately. It made me very tired at night after taking it, strong sedative. Also made me unable to sleep after sun rise which is very unusual for me but a positive thing. After 10 days at .50mg I did notice mood improvement and better outlook in general, in line with the study suggesting it's use as an antidepressant. Besides that not much at all so I tried going up to 1mg with what was left and didn't noticed anything besides more tiredness, then tapered off for 2 weeks, no withdrawal symptoms.
I can also confirm the mid day sleepiness, I actually took a few afternoon naps which I absolutely never do. It's like it made me one of those morning people that are most active in the morning, tired at night, and are able to just sleep for 1-2 hours mid day, weird stuff. I might try a higher dosage some time in the future, I do not think it is as dangerous as people make it to be, as long as you're not taking it for many months. Dosages of 2mg or more are common in Parkinson patients
jaiho
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Re: Pramipexole (Success)

Unread post by jaiho »

Those doses are too low. We've had alot of pramipexole success stories on the FB group for anhedonia.
I think PSSD & Anhedonia are closely linked. Dose ranges for anhedonia are generally in the 1.5mg - 5mg daily range.
Numby
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Re: Pramipexole (Success)

Unread post by Numby »

jaiho wrote:Those doses are too low. We've had alot of pramipexole success stories on the FB group for anhedonia.
I think PSSD & Anhedonia are closely linked. Dose ranges for anhedonia are generally in the 1.5mg - 5mg daily range.
@jaiho: Can you tell a little more about the positive experiences? Did people also see improvemenmts on the sexual side?

Concerning dose: I just checked what my pharmacology book (Karow & Lang-Roth: Allgemeine und spezielle Pharmakologie und Toxikologie 2018) says about Pramipexole doses and the doeses mentioned in the above posts seem very low. For Parkinson's disease they recommend the following:
  • Week one: 3 x 0,088 mg Pramipexole base (= 3 x 0,125 mg Pramipexole salt, so 0,375 mg per day)
  • Week two: 3 x 0,18 mg Pramipexole base (= 3 x 0,250 mg Pramipexole salt, so 0,75 mg per day)
  • Week three: 3 x 0,35 mg Pramipexole base (= 3 x 0,5 mg Pramipexole salt, so 1,5 mg per day)
  • Maintenance treatment: see week three (minimum!)
  • Maximum dose: 3,3 mg per day (= 4,7 mg Pramipexole salt per day)
The European commission (EMA??) recommends the same dose (https://ec.europa.eu/health/documents/c ... 976_en.pdf, p. 3, section 4.2):
Initial treatment Doses should be increased gradually from a starting dose of 0.264 mg of base (0.375 mg of salt) per day and then increased every 5 - 7 days. Providing patients do not experience intolerable undesirable effects, the dose should be titrated to achieve a maximal therapeutic effect. [...]

If a further dose increase is necessary the daily dose should be increased by 0.54mg of base (0.75 mg of salt) at weekly intervals up to a maximum dose of 3.3 mg of base (4.5 mg of salt) per day. However, it should be noted that the incidence of somnolence is increased at doses higher than 1.5 mg(of salt) per day (see section 4.8).

Maintenance treatment
The individual dose of pramipexole should be in the range of 0.264 mg of base (0.375 mg of salt) to a maximum of 3.3 mg of base (4.5 mg of salt) per day. During dose escalation in pivotal studies, efficacy was observed starting at a daily dose of 1.1 mg of base (1.5 mg of salt). Further dose adjustments should be done based on the clinical response and the occurrence of adverse reactions. In clinical trials approximately 5 % of patients were treated at doses below 1.1 mg of base (1.5 mg of salt).
In advanced Parkinson’s disease, pramipexole doses higher than 1.1 mg of base (1.5 mg of salt) per day can be useful in patients where a reduction of the levodopa therapy is intended. It is recommended that the dose of levodopa is reduced during both the dose escalation and the maintenance treatment with Pramipexole Teva, depending on reactions in individual patients (see section 4.5).
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