In this episode of Deep Dive with Lindsay Hill, we explore pramipexole (Mirapex) as an evidence-based augmentation strategy for treatment-resistant unipolar depression. Lindsay breaks down the PAX-D trial published in The Lancet Psychiatry, which demonstrated significant symptom reduction at 12 weeks that persisted through 48 weeks when pramipexole was added to existing antidepressants at a target dose of 2.5 mg/day. You'll learn why dopamine matters when serotonergic strategies have failed, particularly in patients with anhedonia, low motivation, and psychomotor slowing. Lindsay walks through the precise titration protocol that separates success from early discontinuation, explains why most clinicians stop too early at subtherapeutic doses, and details the critical safety monitoring required for impulse control disorders including compulsive gambli ...