Pramipexole and yohimbine

Below a comment from a good friend (whom I have never met personally):

"I obtained a supply of pramipexole (Mirapex). This is one of the recent non-ergot dopaminergic drugs, used mainly for Parkinson's. I find that it has a modest pro-sexual effect, in that it increases the intensity or erotic sensations somewhat. However, what is most impressive is its synergistic effect with yohimbine. The two together can produce remarkably powerful sensations. I have read that some of yohimbine's effects are attributed to dopamine, even though it is most well-know for its effects on A2 [alpha-2-adrenergic receptors]. Thus the synergy is probably due to an interaction in the dopamine system.

"I take 0.25mg of pramipexole, along with 2.7-5.4 mg of yohimbine. The pramipexole side effects have been mild. There was slight nausea the first couple of times, but now I don't experience the nausea. I still find yohimbine's side effects unpleasant, but I can use less of it in combination with pramipexole."

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1 Harriet de Wit, Pramipexole, Springer Berlin Heidelberg, Encyclopedia of Psychopharmacology, 2010, p 1054.

2 Olivier Rascol MD, PhD, Paolo Barone MD, Robert A. Hauser MD, Yoshikuni Mizuno MD, Werner Poewe MD, Anthony H.V. Schapira MD, DSc, FRCP, FmedSci, Laurence Salin MD, Mandy Sohr PhD, Catherine Debieuvre PharmD, PhD, and for the Pramipexole Switch Study Group, Efficacy, safety, and tolerability of overnight switching from immediate - to once daily extended-release pramipexole in early Parkinson's disease, Wiley Online Library, Movement Disorders, Volume 25, Issue 14, pages 2326-2332, 30 October 2010

3 E. R. Samuels, R. H. Hou, R. W. Langley, E. Szabadi, C. M. Bradshaw, Comparison of pramipexole and modafinil on arousal, autonomic, and endocrine functions in healthy volunteers, SAGE Journals, J Psychopharmacol November 2006 vol. 20 no. 6 756-770.

4 Renato P. Munhoz MD, Giorgio Fabiani MD, Nilson Becker MD Increased Frequency and Range of Sexual Behavior in a Patient with Parkinson's Disease After Use of Pramipexole: A Case Report, Wiley Online Library, The Journal of Sexual Medicine, Volume 6, Issue 4, pages 1177-1180, April 2009.