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Pramipexole to Improve Cognition in Bipolar Disorder: A Randomized Controlled Trial
Anna R Van Meter, M Mercedes Perez-Rodriguez1, Raphael J Braga
1Icahn School of Medicine at Mount Sinai, New York, NY.
Journal of Clinical Psychopharmacology
|May 6, 2021
Summary
Pramipexole did not improve cognitive function in adults with bipolar disorder (BD). This dopamine agonist showed no significant benefit over placebo for neurocognitive deficits in BD patients. Further research is needed for personalized treatment strategies.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Adults with bipolar disorder (BD) frequently experience neurocognitive impairment, impacting daily functioning and quality of life.
- Dopamine agonists have shown potential in improving cognition in healthy individuals.
- Previous research suggested potential benefits for adults with BD experiencing stable mood and mild cognitive deficits.
Purpose of the Study:
- To investigate the efficacy of pramipexole, a dopamine agonist, in enhancing neurocognitive function in adults with bipolar disorder.
- To test the hypothesis that pramipexole improves neurocognitive function in patients with BD.
Main Methods:
- An 8-week, double-blind, placebo-controlled trial involving 60 adults (aged 18-65) diagnosed with BD I or II.
- Participants had stable mood and clinically significant neurocognitive impairment at baseline.
- Randomized assignment to pramipexole (n=31) or placebo (n=29), with pramipexole dosage initiated at 0.125 mg twice daily and titrated up to 4.5 mg/day.
Main Results:
- The primary outcome, the MATRICS Consensus Cognitive Battery composite score, did not show significant improvement in the pramipexole group compared to the placebo group (P=0.049).
- Mixed-effects models, controlling for symptoms, indicated no association between treatment group and cognitive battery scores.
- No serious adverse events were reported during the trial.
Conclusions:
- Pramipexole demonstrated no efficacy as a cognitive enhancement agent in adults with bipolar disorder, even in a selected patient group.
- Distinct cognitive subgroups within the BD population may exist, potentially due to neurobiological differences influencing treatment response.
- Further research is essential to understand the nuances of cognitive deficits in BD for developing personalized treatment approaches.
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