The drug I am currently taking is named Mirapex (generic name Pramipexole). One of the more hopeful things about Parkinson’s is that there are several different classes of drugs in the toolbox. Mirapex is in the class of dopamine “agonists”. Agonist does not mean (as my waggish brother proposed) a constant complainer or a person always in agony. Per Dr. Wikipedia, a dopamine agonist is a mimic for the missing dopamine and activates dopamine receptors in the absence of the real thing. If the word sounds sort of familiar, yes, it is etymologically connected to agony, protagaonist and antagonist, and comes from Greek agonistes meaning rival (there’s the mimic part), contestant, struggle (there’s the agony part).
The pro of Mirapex is that it has slightly helped my symptoms. I still vibrate quite a lot but less than when I took a lower dosage. The doctor thinks my gait and flexibility are better and I can do fine motor things like brushing my teeth and clapping hands (which I had trouble with before).
The con? You know that big dense piece of paper that comes with your drug prescription describing side effects? You throw it away, right? I’ve now entered a totally new world where I actually read that wad of paper. To say that Mirapex has put me in agony would be far too dramatic. However, among its many side effects are dry mouth and insomnia (related for me because I wake up due to the dry mouth). Staring at the inside of your eyeballs at 2 in the morning isn’t agony, but it’s not fun either. I’m hoping I’ll pass through this side effect as I have at lower dosages.
There’s all sorts of other fun side effects which mercifully I haven’t encountered (yet), such as:
—Falling asleep suddenly “during ..usual daily activities (talking on the phone, driving)” (!)
—Decreased sexual ability (but also “increased sexual urges”)
–and my personal favorite, “pathological gambling” — Vegas, here we come!
FDA Safety Alert
Mirapex has been around a long time (by Parkinson’s standards), approved by FDA in 1997. FDA recently caused a scare for this old standby. In September 2012, it issued a safety alert with the scary headline: “Ongoing Safety Review, Possible Risk of Heart Failure”. The alert went on to say “FDA evaluated a pooled analysis of randomized clinical trials and found that heart failure was more frequent with Mirapex than with placebo…”
(Are you scared yet?) However, there were two “howevers”:
–“However, these results were not statistically significant.”
–‘However, study limitations make it difficult to determine whether excess heart failure was related to Mirapex use or other influencing factors”
In other words, now that we’ve scared the beejezuz out of you, we were just kidding…
The medical director of the National Parkinson Foundation, Dr. Michael Okun, writes this reassuring comment in his blog: “The bottom line is there is not enough data to recommend discontinuation of dopamine agonist therapy. However, given the availability of an alternative and safe drug (levodopa), patients and doctors should discuss all potential risks and benefits of dopamine agonists.”