Mirapex (pramipexole dihydrochloride). This anti-Parkinson’s drug is being used off-label for depression. Mirapex is a dopamine agonist, so it enhances the effects of what dopamine you have and stimulates additional production of it. But it’s not so over-the-top in its effects like the amphetamine class of drugs, hence it can be considered for treating depression, including bipolar depression, well before the treatments of last resort like CNS stimulants. Even though Mirapex stimulates dopamine production, it can knock you out in the middle of the day, which is why it is also used off-label for a variety of sleep disorders. Common side effects are the usual suspects for antidepressants, although it’s hard to tell about any side effects as the difference between Mirapex and placebo isn’t all that great. Freakiest rare side effects: pneumonia, apathy (like we need meds to not give a damn). The dosages for depression follow the dosages for Parkinson’s. You start with 0.125 mg three times a day. If needed that may be increased, with at least a week between increases, to 0.25, 0.5, 0.75, 1.0, 1.25 then 1.5 mg three times a day to a maximum dose of 4.5 mg a day. After that you can go up to 6.0 mg a day divided over three to four doses a day. Mirapex’s half-life is 8-12 hours. Pharmacia & Upjohn.