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Efficacy of Low-dose Pramipexole Augmentation in the Treatment of Refractory Psychotic Depression Complicated with Tardive Dyskinesia: A Case Report

Arzu Erkan, Sebnem Pirildar, Ahmet Acarer, Fisun Akdeniz.

Abstract
Tardive dyskinesia (TD) is a severe complication of antipsychotics. Pramipexole can be effective in the treatment of TD with its D3 dopamine receptor agonist effect. Studies conducted with bipolar depression and treatment-resistant depression (TRD); support the antidepressant effect of pramipexole. Here we present a 55-years-old female case. For the treatment of depression, she received antidepressant, anxiolytic and antipsychotics for 2,5 years. When severe bruxism, fidgeting, and serious functional impairment emerged, she was re-hospitalized and diagnosed with TRD and TD. Several combinations of antidepressant, anxiolytic, and antipsychotics were administered. The depression improved partially, but hypochondriac preoccupations and dyskinesia persisted. At the sixth month, pramipexole 0.125 mg/day was added to sertraline 200 mg/day, amitriptyline 60 mg/day, clonazepam 2 mg/day, and biperiden 4 mg/day. The depression and dyskinesia improved and she was discharged. TRD and TD improved within the first 4 weeks of pramipexole administration and no relapse was observed. Pramipexole is a promising agent in the treatment of TRD and TD.

Key words: Pramipexole, Depression, Psychotic; Dyskinesia, Drug-Induced


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