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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO167

Pramipexole in the treatment of depression: a systematic review and meta-analysis of randomized controlled trials

PRAMIPEXOLE FOR THE MANAGEMENT OF DEPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RCTS

Pramipexole increases clinical response compared with placebo in depression, does not significantly change remission rates, and more than doubles treatment discontinuation due to adverse events.

The aim was to evaluate the efficacy and tolerability of the dopamine D2/D3 receptor agonist pramipexole in depressive disorders using evidence from randomized controlled trials (RCTs). CENTRAL, MEDLINE, Embase, and the WHO trial registry platform were searched from inception to February 2026; 7 RCTs involving 457 participants that compared pramipexole with placebo or selective serotonin reuptake inhibitors (SSRIs) in adults with unipolar or bipolar depression were included. The primary outcomes were response (at least a 50% reduction in depressive symptoms) and remission, and risk ratios (RRs) and standardized mean differences were pooled using a random-effects model. Of the included studies, 71.4% involved samples with treatment-resistant depression; 4 studies were conducted in unipolar depression and 3 in bipolar depression, with a typical duration of 6 to 12 weeks. Compared with placebo, pramipexole significantly increased the response rate (RR 1.89; 95% confidence interval [CI] 1.33 to 2.68; Z = 3.55; p = 0.0004; I² = 8%), but there was no significant difference in remission (RR 1.19; 95% CI 0.41 to 3.49; Z = 0.32; p = 0.75; I² = 70%). Overall adverse events (RR 1.06; 95% CI 0.90 to 1.26), all-cause discontinuation (RR 1.60; 95% CI 0.83 to 3.11), and serious adverse events (RR 1.53; 95% CI 0.54 to 4.30) were similar between groups, whereas discontinuation due to adverse events was higher in the pramipexole arm (RR 2.16; 95% CI 1.20 to 3.86); the most commonly reported adverse events were nausea, somnolence, dizziness, and constipation. In comparisons with SSRIs, no significant differences were found in response (RR 1.02; 95% CI 0.70 to 1.48), remission (RR 0.50; 95% CI 0.05 to 4.86), or adverse events (RR 1.04; 95% CI 0.91 to 1.20), while discontinuation due to adverse events was again higher (RR 6.02; 95% CI 1.15 to 31.62). The authors report that although efficacy appears similar to that of SSRIs, tolerability may be less favorable, the evidence base is relatively small, and further high-quality RCTs are needed to define its role in carefully selected patients with difficult-to-treat depression.

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