Cabergoline or bromocriptine for prolactinoma?

Abstract

Cabergoline and bromocriptine are among the most commonly used drugs to treat prolactinoma. Cabergoline is a long-acting dopamine receptor agonist which might offer advantages over bromocriptine. However, it is not clear if this translates into clinical benefits. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including 12 studies addressing the question of this article, including five randomized controlled trials. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded cabergoline is more effective than bromocriptine in resolution of amenorrhea/oligomenorrhea and galactorrhea, it probably increases pregnancy rate, and it is associated to less adverse effects. It is not clear whether cabergoline is also more effective with respect to tumor growth because the certainty of the evidence is very low.

Computational study on new natural compound agonists of dopamine receptor

“…Additionally, elevated prolactin levels can damage the reproductive system and sexual function through the various links of the hypothalamus-pituitary-gonadal axis. Currently, it is believed that DAR agonists can inhibit the secretion of PRL by binding to D2 DAR expressed on the surface of normal prolactin and pituitary tumor cells [10]. And the reduction of PRL secretion is achieved through the following mechanisms after DAR agonists activated D2 DAR: Within a few seconds, hyperpolarization of the cell membrane causes an increase in K + conduction, and an increase in K + conduction causes the voltagegated Calcium channel to close, resulting in a decrease in intracellular free Ca2 +.…”