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You severely overestimate the quality of care you would receive in a psychiatrist's office when thinking that lithium and lamotrigine wouldn't be prescribed for no reason. Prescription of pramipexole should have given it away.

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In general, it would be difficult to tell with an incomplete patient history whether a psychiatrist prescribing pramipexole for depression was making an irresponsible shot in the dark, or a calculated attempt to address something like treatment-resistant anhedonic depression after a few first lines, an MAOI, and referrals to an endocrinologist and a sleep study failed. That being said, I cannot think of any reasonable scenario that leads to simultaneously prescribing pramipexole and mood stabilizers. Perhaps it's too idealistic of me to hope that the pharmacist filling all three of those (plus two controlled substances...) would have called and asked for an explanation.

Probably not no reason, but... yeah.

The article even says later that "[t]he state medical licensing board disciplined the psychiatrist", so I don't understand why people here are critiquing care that was literally censured by the board!

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