Reactions 1084 - 14 Jan 2006

Pramipexole/ropinirole

Mania: case reportA 37-year-old woman developed mania during treatment

with pramipexole and ropinirole for Parkinson’s disease.The woman started receiving pramipexole, which was

titrated to 1.5mg twice daily, in addition to her existingregimen of levodopa and selegiline. In the first week afterpramipexole initiation, she developed an elevated mood, anincrease in sex drive, psychomotor activity and energy, and adecrease in the need for sleep. After 6 months, she developedparanoia, irritability and delusions of jealousy.

Pramipexole and selegiline were stopped and the womanstarted receiving quetiapine. In 1 month her psychomotorsymptoms resolved; quetiapine was stopped. Two monthslater, levodopa was decreased because of dyskinesia andtremors and ropinirole was initiated and titrated to 0.75mgthree times daily. She rapidly developed insomnia andincreased agitation and energy. Ropinirole was stopped andher symptoms resolved.

After several months, ropinirole was restarted [dosage notstated], but the woman’s manic symptoms recurred.Ropinirole was stopped and her manic symptoms ameliorated.Singh A, et al. Pramipexole, ropinirole, and mania in Parkinson’s disease.American Journal of Psychiatry 162: 814-815, No. 4, Apr 2005 - USA 801019458

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Reactions 14 Jan 2006 No. 10840114-9954/10/1084-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved