Efficacy and target engagement of dopamine agonist pramipexole for anhedonic depression: a randomized placebo-controlled trial - Report - MDSpire

Efficacy and target engagement of dopamine agonist pramipexole for anhedonic depression: a randomized placebo-controlled trial

  • By

  • Filip Ventorp

  • Marie Asp

  • Sofia Olsson

  • Jesper Lindahl

  • Stefan Möller

  • Martina Svensson

  • Filip Ängeby

  • Armida Pravdinske

  • Johanna Tjernberg

  • Susann Schrey

  • Darya Ståhl

  • Viktor Magnusson

  • Emilia Eliasson

  • Anna Agelii-Weber

  • Erika Stålhammar

  • Danielle van Westen

  • Tomas Deierborg

  • Kristoffer N. T. Månsson

  • Diego A. Pizzagalli

  • Åsa Hammar

  • Åsa B. Tornberg

  • Johannes Björkstrand

  • Daniel Lindqvist

  • June 12, 2026

  • 0 min

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Clinical Report: Effectiveness and Mechanism of Action of Pramipexole in Anhedonic Depression

Overview

This study evaluates the efficacy of high-dose pramipexole in treating anhedonia in mood disorders through a randomized placebo-controlled trial.

Background

Mood disorders, particularly those featuring anhedonia, present significant challenges in treatment, with low remission rates and high functional impairment. Anhedonia, characterized by a diminished ability to experience pleasure, is linked to poor treatment responses and increased suicide risk. Current treatment strategies often lack precision.

Data Highlights

ParameterPramipexole Group (n=43)Placebo Group (n=42)
Change in SHAPS Score[Data not provided][Data not provided]

Key Findings

  • Pramipexole was administered for 9 weeks to patients with MDD, dysthymia, or bipolar depression with significant anhedonia.
  • The primary outcome was the change in total score on the Snaith−Hamilton Pleasure Scale (SHAPS).
  • Secondary outcomes included various expert-rating and self-rating scales assessing depression-related symptoms.
  • Functional MRI was used to assess the engagement of pramipexole on reward-related neurocircuitry.
  • Long-term administration of pramipexole may normalize reduced dopaminergic tone associated with anhedonic depression.

Clinical Implications

The findings suggest that pramipexole may be a viable option for patients with mood disorders characterized by anhedonia, particularly in those who have not responded to traditional antidepressants. Clinicians should consider the potential role of dopamine agonists in treating this specific symptomatology.

Conclusion

The study provides evidence supporting the efficacy of pramipexole in alleviating anhedonia in mood disorders, warranting further investigation into its mechanisms and long-term effects.

Related Resources & Content

  1. Brain, 2025 -- Impaired reward sensitivity in Parkinson's depression is unresponsive to dopamine treatment
  2. JAMA Neurology, 2025 -- Fixed-Dose Tavapadon for Early Parkinson Disease: A Randomized Clinical Trial
  3. Drugs - Real World Outcomes, 2020 -- Impact of Extended-Release Pramipexole Launch on Prescription Trends: A Comprehensive Analysis in Taiwan
  4. American College of Physicians, 2025 -- Recommends Cognitive Behavioral Therapy or Second-Generation Antidepressants for Adults With Major Depressive Disorder
  5. NICE, 2022 -- Overview | Depression in adults: treatment and management
  6. JAMA Network Open — Intermittent Theta-Burst Stimulation for Depressive Symptoms in Parkinson Disease: A Randomized Clinical Trial
  7. Clinical practice guidelines for the management of bipolar disorder: 2025 update
  8. Pramipexole augmentation for the acute phase of treatment-resistant, unipolar depression
  9. American College of Physicians Recommends Cognitive Behavioral Therapy or Second-Generation Antidepressants for Adults With Major Depressive Disorder | ACP Online
  10. Overview | Depression in adults: treatment and management | Guidance | NICE
  11. Results - Pramipexole in addition to mood stabilisers for treatment-resistant bipolar depression: the PAX-BD randomised double-blind placebo-controlled trial - NCBI Bookshelf
  12. Comparative efficacy of antidepressant augmentation with amantadine vs pramipexole in treatment-resistant unipolar depression: A randomised controlled trial - PubMed
  13. Anhedonia in patients with major depressive disorder (MDD): state-of-the-art consensus review - ScienceDirect
  14. Evaluating the efficacy of psychotherapeutic and pharmacological treatments for depression on anhedonia: A systematic review and meta-analysis - PubMed
  15. Using the experience sampling methodology to measure anhedonia and its correlates in mental health research: A systematic review - PubMed

Original Source(s)

Efficacy and target engagement of dopamine agonist pramipexole for anhedonic depression: a randomized placebo-controlled trial

  • by Filip Ventorp, Marie Asp, Sofia Olsson, Jesper Lindahl, Stefan Möller, Martina Svensson, Filip Ängeby, Armida Pravdinske, Johanna Tjernberg, Susann Schrey, Darya Ståhl, Viktor Magnusson, Emilia Eliasson, Anna Agelii-Weber, Erika Stålhammar, Danielle van Westen, Tomas Deierborg, Kristoffer N. T. Månsson, Diego A. Pizzagalli, Åsa Hammar, Åsa B. Tornberg, Johannes Björkstrand, Daniel Lindqvist

  • June 12, 2026

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