Mirapex: A Miracle Treatment with Troubling Effects for Some
Mirapex (pramipexole), a common treatment for Parkinson’s disease, is believed to work by boosting the action of whatever dopamine is available, which is low in people with Parkinson’s. It is a dopamine agonist that directly stimulates nerves in the brain that are not naturally being stimulated by dopamine.
Several years ago, my doctor diagnosed me with Parkinson’s. Immediately, he placed me on Mirapex (pramipexole dihydrochloride). I can’t say that I’ve had a problem with this particular medication, except that sometimes I felt as if I could lie down right where I was and have a glorious nap about half an hour after taking it.
Although I haven’t had many side effects, others have. Just as PD affects each individual differently, so do the medications.
My reactions were mild, and yet at each checkup, my doctor did not fail to ask if I had started having addictive behaviors with gambling, shopping, or sex. Fortunately, I was able to answer no to his questions, but that is not the case with three people I became acquainted with through a PD support group I belong to through Facebook. I am going to call them Cora, Jim, and Carl.
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Cora’s father is a PD patient and has taken Mirapex for two years. During this time, he developed serious gambling problems, delusions, and hallucinations.
Meanwhile, Jim had been taking Mirapex for restless leg syndrome (RLS), often a complication of PD. He read up on some undesirable side effects that included compulsive gambling, excessive spending, and compulsive, excessive sexual behavior.
What disturbed Jim most was that patients taking Mirapex often are unaware that a change is occurring. Jim began engaging in several of these atypical behaviors. He was unaware that they were actually becoming addictive behaviors. Fortunately for Jim, his doctor recognized that Mirapex was causing the addictions. Jim thought he was the only one with these side effects until his doctor put him in touch with Carl.
Carl first noticed his bowel movements had changed and constipation was regular. He gained 40 pounds in the first five months and couldn’t sleep. He understood it was the medication but had another issue: He was embarrassed by the things he couldn’t seem to quit doing. He never read the informational insert inside the drug box. He was just following the doctor’s orders.
Carl began to lose control sexually, and his internet use became an outlet for improper behavior. He was ashamed and felt isolated in his problem. He went to see a new neurologist and discovered he wasn’t alone. Several other PD patients who were prescribed Mirapex were dealing with similar issues. [Such extreme side effects in Mirapex users are considered unusual, but are known and reported. Here’s the Mayo Clinic’s list of common and uncommon reactions; here’s a similar one on Drugs.com. The possibility of “unusual urges” — gambling, compulsive eating, compulsive buying, and increased sex drive —  is also noted on Mirapex’s online information page.]
Carl’s neurologist diagnosed the problem and he stopped the drug. Sheryl, however, lost everything to gambling before learning the likely cause of her problem. After her house, savings, retirement, husband and children were gone, and she found herself taking money from the church offering, she sought help. Her doctor, too, took her off Mirapex, and her gambling urges ceased.
I also came to know a woman I’ll call Becky. Her story isn’t as devastating, unless you count Becky’s painting the outside of her house 17 times in one year.
While the incidence of such behavior is low — psychiatric effects are estimated to involve 0.1% to 1% of all PD and RLS Mirapex users — it is troubling. So why do physicians continue to prescribe such a drug?
According to the website CanadianMedsUSA, “Mirapex eases the symptoms of Parkinson’s disease, a progressive disorder marked by muscle rigidity, weakness, shaking, tremor, and eventually difficulty with walking and talking. Parkinson’s disease results from a shortage of the chemical messenger dopamine in certain areas of the brain. Mirapex is believed to work by boosting the action of whatever dopamine is available.”
With relief like that, it’s hard to not want to take it. It also is a miracle drug of sorts for RLS, providing relief almost instantaneously.
Chances are that your doctor will prescribe Mirapex if your diagnosis is PD or RLS, and most likely you will experience some sort of side effect while you’re on it. It is extremely important to keep the communication open between you and your doctor and to make sure you’re checking in regularly.
Each case is different. Don’t hesitate to seek help if you begin to notice changes or to feel different. You may be fine. It may be nothing. Nevertheless, your health is ultimately your responsibility and hesitation could be costly. Be proactive in your care. It could be what saves your family, your job, and your life.
***
Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.Â
About the Author
David Hewitt
I could have told you this info 12 yrs ago. Miropexin cost me my house and nearly my family. Gambling was never mentioned on the original info sheet that comes in packet, but with the mention of going to court it soon appeared. L still have both info sheets.
Sherri Woodbridge
Thanks for sharing your information, David. It is a crazy drug, for sure.
Hal
I had problems with online shopping with Mirapex. Now I have credit card debt that I can't really handle.
I am now using Requip / ropinerole for RLS with pretty good success at 2 mg. at night (non-PD related RLS.)
I haven't had any trouble with unusual urges, but do have blurry vision at night.
Butorphanol also seems to help with RLS when I happen to take it for migraine (this is an opiod med.)
My father does have PD, and is also tormented by RLS.
I was prescribed gabapentin for RLS, and ended up with serious dental problems; cavities and perhaps the need for a root canal. It didn't work well for the RLS either. Mirapex had some effect, but not enough.
Sherri Woodbridge
Thank you so much for sharing your helpful comment!
Marcus wall
I have been taking pramipexole for a few years for RLS.My sexual behaviour changed, becoming more and more risky until, I was unfortunately the victim of a violent sexual assault by putting myself in a dangerous situation. This finally resulted in a psychotic episode that has left me on further medication. Also, at the end of 2019 I acquired a nasty online gambling habit that has cost too much to mention because it is embarrassing. Just one example. Within two minutes of starting a game I won £3500. Within one minute I had lost it. My expectation of winning became much stronger than the reality of what I was losing. This medication can cause devastation. I was never warned.
Maren
Yeah...my doctor just prescribed this for my RLS. I will NOT be taking it!!! For the record, small doses of opiates can completely "cure" RLS symptoms when taken at night. But doctors have a hard time prescribing opiates to people these days.
M.R. Borscht
For the past 18 months I have been taking generic Mirapex for treatment-resistant depression as has my twin brother (identical). The side effect has been hypersexuality -- not "out-of-control" (and not altogether unpleasant to be honest) -- but distracting and leading to some border-line compulsive internet use.... I don't have the time luxury for this at this stage of my life. Exact same with my twin brother. I went down from 3mg to 1pm a few months ago and now have gone down to 1/2mg intending to phase it out entirely if I can do that without having the depression return (Mirapex is part of a mix I take, so we'll see). MY POINT IS THIS: I JUST DON'T BELIEVE THAT THE COMPULSIVITY SIDE EFFECTS ARE RARE - I can't prove that on data but these complaints are just too common from other patients for it to be rare --
Sherri Woodbridge
Matt - Thanks for your comment. I can’t say whether it’s rare or not either, but you sure tend to want to think it isn’t. It may get put into a false category of being rare or uncommon (hte side effects) because people are embarrassed to talk about their experience with the medication’s interactions.
Ted L. Nancy
I fully agree with M.R. 100% this drug messed my father up, and my parents lost friends and a family member to it because of the odd behavior. The issue is that a lot of these doctors don't ask about the deep behavioral issues that are sometimes embarrassing to the patients but could be helpful to the prescriptions and research. It's really sad and I feel bad for people suffering with PD that have to go through another layer of awfulness because of greed with the drug companies. Fix your stupid drug, do more research or pull it off the market.
Mark Merrifield
It took 9 months for me to begin to have any kind of impulse problem. I have always controlled my money extremely well and the possibility of me blowing my money seemed ridicules. But, I was only aware of the gambling and reckless spending part. Sexual impulses are a little more confusing. I did not see that problem coming. Sexual impulses are not measured in dollars and it is not easy to understand what is happening to you when you are blind sided by this kind of impulse. 1%, my a##! My problem is I have refractory depression and the one drug that helps just happens to be Mirapex.
lu s.
Fix your stupid drug, do more research or pull it off the market.
i am so sorry that people have such terrible side effects, but mirapex has helped me more than i can say. it has been terrific for me and i would be in an intolerable place without it. so while you hate the drug because of your experience with it, know that it has been a lifesavor for some, myself included.
Sherri
I have taken Mirapex for 20 yrs. for RLS. I wasn’t aware of the side affects but have experienced them all. I was in denial that anything was wrong, blamed the problems on everyone else, and nearly ruined my life. A new Dr. was appalled that I had taken it that long so I am now trying to reduce my dosage with the end result of deleting it from my life. It is so difficult to stop using this drug. Wish I had never started it.
Pearl
Thank you for sharing this.
Sherri Woodbridge
You’re so welcome.
B Susan Weaver
What did he reccommend you take? Sometimes my mirapex does not work, but its the best med I have
had for my restless legs. Please tell me.
Sherri Woodbridge
I now am on (have been for several years now with good success) sinemet four times a day.
John T
The side-effects of dopamine-agonist (Mirapexin) drugs can be life-destroying.
Ellen Henderson
I can empathize. Like you I have been on pramipexole for close to 20 years for severe RLS. I too have experienced compulsive behaviors. In recent years I have had an increase compulsive eating, especially at night. Have been trying to cut back to just .125 mgs each night but the resulting RLS from augmentation is almost unbearable. Have a good neurologist but there she is really not able to offer any alternative meds that effectively address RLS. Feeling a bit hopeless.
Pearl
I have just read this article and was absolutely blown away by it. I started taking Mirapex over a year ago for RLS and have a serious internet shopping and overspending problem. I had always been so in control when it came to money. I’ve been so perplexed. Could this really be the cause? I’m just stunned.
Sherri Woodbridge
Hi Pearl - I’m sorry to say that, yes, there is a great possibility that this could be the cause which is why it is so important to get into your doctor right away. I have more information on my blog about this medication and the ramifications it has had in other patients. It might not be the problem, and I am no doctor, but I’d say the chances are there. Please make an appt with your neurologist as soon as you can. My blog is www.parkinsonsjourney.com
J
Not sure where that 1% came from. One of the most conservative studies done showed 17% will experience compulsive side effects and even that study concludes the incidence is likely higher due to not embarrassment and/or not realizing there is a problem. Taking an altered form of Meth to cope with a disease seams like pure insanity.
Julie
My husband is on this drug for RLS. He has Secretly ran up $30,000 in credit card debt!! Buying Lottery tickets and compulsive shopping this is not who he is. He does not see that he has a problem but is very embarrassed and ashamed! I called Doctors and said I think he is have side effects from this drug. They Keep Prescribing him the medication,I don’t know what to do except to get a divorce and save myself. This side affect is much higher than reported. The doctors need to wake up and stop prescribing this medication or Monitor patient and caregiver because the patient does not see they have a problem. The greedy drug companies need to be sued for releasing a drug without proper testing!! The side effects from this medication is bankrupting and destroying peoples lives!!
Antony
I don't think my partner's problem with this drug is addiction although she does like clothes shopping, but I think she was like this before although I didn't know her then.Her problem with this drug I think is that she has developed dystonia and tremor. I have read that Pramipexole can cause these things. She has a bent over gait from middle back.She also falls straight asleep as soon as she takes it. She just completely goes unconscious it's quite scary to be honest. She often falls asleep in the cinema as well as she has to take this drug so her legs don't start. It's a vicious circle really and I think she gets quite frustrated with it as she usually wants to enjoy a film with me. It's probably the least of her problems at the moment as the Urologist has found a growth in her bladder. But it is an awful drug. Has anyone else developed dystonic or parkinsonism symptoms from this drug.There is a very good academic book in this subject where they have done research on this drug with it's effects on iron (she is also anaemic) but it is 208 pounds to buy once my university funding is up an running I will try and get it from my library, but at the moment my account is locked.
Annie
I just wanted to write in and say that I asked my doctor what the side effects were when she put me on this drug and she said "none." NONE! I've been on it for 6 months now and have been needing to take it more and more. A few months ago I noticed I started having days where I could NOT get out of bed. I would take 4 2-hour naps throughout the day then sleep at night. I felt weak, foggy and swollen. It was hard to talk. On one occasion I managed to force myself to get dressed to take the dogs on a walk, got downstairs and just could not do it. I sat on the couch with the leashes in my hands and fell asleep. I also noticed my RLS was getting worse and worse- I had been starting to experience it in the car which I never had before. I also noticed my arms were becoming restless.
So I went to the doctor with my concerns- thinking it was due to an iron deficiency (which I had had in the past). She ran a lot of blood test on me and told me that I should really just push myself to not take naps...
When my iron, thyroid, sugar, cholesterol, etc. levels came back normal I went back and stressed that this was not normal and please help me.
SHE NEVER EVEN THOUGHT TO MENTION IT COULD BE THE MIRAPEX SIDE EFFECTS. I randomly googled "pramipexole side effects" yesterday and all of my symptoms shows as side effects.
I didn't take a pill last night for the first time in a few months and I was awake until 5am.
I'm hoping this is what is causing all of my exhaustion, weakness and fogginess...and on top of it my compulsive eating behavior.
Thanks for this article.
Sherri Woodbridge
You’re so welcome, Annie and I hope you get some help/relief
soon!
Bethann Nye
I have Same health issues plus more just started mirapex. My dad had Parkinson's u haven't been diagnosed yet but I do have rls. This scares me reading the side effects. I already get IV iron. Sometimes blood transfusions. Ugh. Please me updated.
Pam Curtis
Have you stopped taking this drug? It was prescribed to me to support my levadopa/carbidopa in addressing rigidity concerns on my left side.
I am experiencing some similar side effects from it. I feel very tired soon after taking it and fall asleep if I sit down to watch television, increased RLS symptoms in the night, dizziness in the morning when getting up, constipation, dry mouth, concern with dental problems (appt to see the dentist in a couple of weeks).
P Margolis
Mirapex has been miraculous at getting rid of most of my PD symptoms!
Sherri Woodbridge
Glad to hear!
Tammy Coulter
I have RLS,and received a script for this drug today along with a stern warning regarding its side effects being one of gambling issues. So my question is this...If I'm aware of these side effects,will that help me to not get into trouble any?
Leeann mitchell
I have been taking mirapex and caba dopa levedopentacap for 15 years without much problem but lately symptoms have gotten worse My dr has prescribed rytary. She took me off cabidopa Levidopa and mirapex. Is it okay to be taken off of both
Sherri Woodbridge
I might seek a second opinion if you don’t feel confident with her care.
Michele Jene
I have fought with RLS all my life. I remember my mother sitting on my legs trying to give me relief when I was 5 yrs old. Finally about 3 years ago I was perscribed Ropinirole 1mg tab at bedtime. Still the problem presisted, as time passed I began to up the dose myself and I have found that 3mg does the trick Thank God! RLS is so frustrating with the discomfort becoming unbearable causing extreme exhaustion to say the least. The doctor I have now perscribed me 9 days worth of Pramipexole going from 1, then 2 and ending with 3 at bedtime. I found myself getting into the Ropinirole to fix what the Mirapex didnt.When it gets into my arms too Im really beside myself its so abusive to me. After what I have read about Mirapex, luckily I didnt suffer any side affects but I find Ropinirole much better giving me relief and I can sleep without worries of RLS kicking in...Whew! I am so grateful to finally find relief after all these years batteling and losing to RLS, finally an end to my misery! Thank you!
Maren
Yeah...my doctor just prescribed this for my RLS. I will NOT be taking it!!! For the record, small doses of opiates can completely "cure" RLS symptoms when taken at night. But doctors have a hard time prescribing opiates to people these days.
Lisa
Nobody should be taking opiods for RLS, talking about addiction problems.
Linda Boone
I’ve been on Mirapex for many years for RLS and it has been a life saver for me but …. I recently acknowledged my compulsive shopping, eating and over all hoarding behaviours ? and came to the conclusion it was these meds. So I weaned down once it didn’t work so went back on them then I tried once again but lowered the dose by smaller increments every 2 days but the night I tried to go to bed with none in my system was a huge eye opener! I could feel the RLS kicking in watching TV with the need to move and feeling frustrated but kept at it. At bedtime I have never had such violent spasms or twitches in my life! They seemed to start at my lower back and just move to my legs. I finally had no choice but to restart my medication if I wanted to control the bucking bronco legs! But what concerns me is I’ve had major internal vibrations and a feeling of being on tilt and confusion where I feel I can’t talk right but I can …. Is it possible that being on these meds has covered up me possibly have PD not just RLS???