Pramipexole, sold under the brand Mirapex among others, is a medication used to treat Parkinson's disease (PD) and restless legs syndrome (RLS).

Its effectiveness as an antidepressant may be a product of its strong partial agonistic activity on and preferential occupation of dopamine D3 receptors at low doses (see table below); as well, the drug has been shown to desensitize the inhibitory D2 autoreceptors but not the postsynaptic D2 receptors, leading to an increase in dopamine and serotonin levels in the prefrontal cortex.

For example, Pramipexole has been used (in combination with D2- and or D3-preferring antagonists) to discover the role of D3 receptor function in rodent models and tasks for neuropsychiatric disorders.

[35] Of note, it appears that Pramipexole , in addition to having effects on dopamine D3 receptors, may also affect mitochondrial function via a mechanism that remains less understood.

When neurons of the substantia nigra deteriorate in Parkinson's disease, the striatum no longer properly receives dopamine signals.

As a result, the basal ganglia can no longer regulate body movement effectively and motor function becomes impaired.

Pramipexole is eliminated via the renal organic cation transporter as an unchanged drug showing no signs of any hepatic-mediated metabolism.

Pramipexole has been shown to inhibit CYP2D6 with a Ki of 30μM which is significantly higher than the maximum approved dosage of 4.5mg/day thus any enzyme-mediated drug interactions wouldn't be clinically relevant.

[citation needed] Pramipexole has been evaluated for the treatment of sexual dysfunction experienced by some users of selective serotonin reuptake inhibitor (SSRI) antidepressants.