In this deep-dive episode, we unpack Pramipexole for Treatment-Resistant Depression: What PMHNPs Should Know. Audio Overview Listen to an in-depth podcast of this post Two hosts break down the full article — no reading required. Your browser does not support audio playback. TL;DR Pramipexole (Mirapex), a dopamine D3 receptor agonist FDA-approved for Parkinson’s disease, showed strong results in the PAX-D trial published in The Lancet Psychiatry for treatment-resistant unipolar depression. At a target dose of 2.5 mg/day added to existing antidepressants, patients saw significant symptom reduction by week 12, with benefits lasting through 48 weeks. PMHNPs should know the titration protocol, watch for impulse control disorders and nausea, and understand where this fits in the treatment algorithm after two or more failed antidepressant trials. In This  ...