PERGOLIDE - AN ANTIDEPRESSANT ADJUVANT FOR MOOD DISORDERS

Pergolide, a dopamine (DA) agonist, can be a useful adjunct to antidep ressant pharmacotherapy, both with tricyclic antidepressants and with monoamine oxidase inhibitors (MAOIs). Pergolide improved or very much improved (as measured by the Clinical Global Impressions Global Improv ement Scale) 11 of 20 previously refractory unipolar and bipolar patie nts. Patients typically described an improvement in their mood, intere st, and energy within a week. The range of effective dosage is from 0. 25 mg to 2 mg, typically 0.5 mg to 1 mg. Pergolide does not work alone . There must be a concomitant antidepressant, either MAOI or non-MAOI type. Nausea and vomiting are sometimes treatment-limiting side effect s. Hypomania is a risk but is quickly and permanently reversible by lo wering the pergolide dose. The treatment implication for the future is that potent DA agonists such as pergolide may have a role as antidepr essant adjuvants. This possibility is in contrast to the negative impr essions of weaker DA agonists used alone.