I was wondering if anybody had tried a dopamine agonist like Pramipexole to treat their negative symptoms, especially lack of motivation/pleasure, also called anhedonia. Interestingly, Vraylar’s (cariprazine) main mechanism of action is the potent partial agonism of the dopamine D3 receptors and according to studies, that would explain why this antipsychotic is more effective at treating negative symptoms than any other medication on the market. Abilify also is a D3 partial agonist although much weaker than Vraylar.
Dr. Jan Fawcett has been treating refractory (treatment-resistant) depressed and bipolar patients with pramipexole for several years and has reported his very promising findings in the article below. It mainly focuses on anhedonic patients. Importantly, finding the right dosage seems to be key (some needed much lower dosages, some needed much higher dosages)
Clinical Experience With High-Dosage Pramipexole in Patients With Treatment-Resistant Depressive Episodes in Unipolar and Bipolar Depression
Here’s an excerpt from the article
Dopamine agonists, such as pramipexole—a relatively selective dopamine D3 receptor agonist—are thus potential treatments for depression, especially anhedonic depression. D3 receptors are found in the mesolimbic system, which in turn has been implicated in the motoric and hedonic deficits in depression (9, 10). Parkinson’s disease (22, 23) is associated with dysfunction in the dopamine systems. In fact, among the 45% of Parkinson’s patients who suffer from depression, anhedonia is a prominent symptom (24, 25). Both the depression and the anhedonia are frequently reduced with pramipexole (24–26).
It was once tried in schizophrenia patients and resulted in improvements ranging from 22 to 62% as you can see in the article below.