Treatment of hyperprolactinemic states with different drugs: a study with bromocriptine, metergoline, and lisuride

Crosignani, Pier Giorgio; Ferrari, Carlo; Liuzzi, Antonio; Benco, R.; Mattei, A; Rampini, P.; Dellabonzana, Daniela; Scarduelli, Claudia; Spelta, Barbara

doi:10.1016/s0015-0282(16)45978-9

Cited by 48 publications

(17 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The initial choice of the medical treatment with bromocriptine or cabergoline for patients bearing PRL-secreting adenomas seems sensible, unless one is dealing with an acute neurological emergency such as the sudden amaurosis in one of our cases. Medical treatment [2,3,6] should also be advocated before considering surgery for aged patients harbouring GH-secreting adenomas, although a much lower efficacy of the drugs has been demonstrated in this particular age group [8].…”

Section: Discussionmentioning

confidence: 99%

The surgical treatment of pituitary adenomas in the eighth decade

et al. 1999

View full text Add to dashboard Cite

BACKGROUND The surgical treatment of pituitary adenomas in elderly patients (i.e., over 70 years of age) is a special problem because of the increased rate of perioperative complications and the reduced tolerance of postoperative fluid and electrolyte imbalance. Therefore, the unquestionable progress in the pharmacological and radiotherapy may not allow these patients the option of radical surgical treatment, We report our experience with the transsphenoidal procedure for pituitary adenomas in aged patients in an attempt to contribute to a better definition of the actual role of surgery. \ud \ud METHODS Transsphenoidal surgery was performed in 11 patients over 70 years of age affected by various histological types of pituitary micro- and macroadenomas, ranging from Hardy Grade I through IIIc, Special care was dedicated to the postoperative treatment, in particular to water and electrolyte balances, and to the immediate treatment of any pathological variation of these parameters. \ud \ud RESULTS We had no mortality and no postoperative adjunctive morbidity, All the patients recovered well from the operation with an average hospital stay of 20 days. The tumor removal was complete in six cases and partial in the remaining five. With an average follow-up of 2 years, we did observe only one case of symptomatic recurrence of the disease. \ud \ud CONCLUSIONS Transsphenoidal surgery in the elderly is feasible and quite safe in the hands of an experienced team, if special care is devoted to the preoperative selection of patients and to the postoperative treatment of fluid and electrolyte imbalanc

show abstract

Section: Discussionmentioning

confidence: 99%

The surgical treatment of pituitary adenomas in the eighth decade

et al. 1999

View full text Add to dashboard Cite

show abstract

“…Metergoline At the common dosage of 4 mg t.i.d., metergoline is as active as bromocriptine, or slightly less active [10], In the largest series reported to date, PRL returned to normal in 57.8% of idiopathic hyperprolactinemias (n = 45). in 43.4% of microadenomas (n = 30).…”

Section: Effectiveness Of Other Dopaminergics Relative To Bromocriptinementioning

confidence: 90%

“…the PRL value returned to normal in 75% of the cases [10] and the antitumoral action was observed in 60% of the cases [6].…”

Section: Lisuridementioning

confidence: 91%

See 1 more Smart Citation

Medical Treatment of Hyperprolactinemia

Fossati¹,

Dewailly²,

Thomas-Desrousseaux³

et al. 1985

Horm Res

View full text Add to dashboard Cite

The current treatment of choice for primary hyperprolactinemia is medical. This is true not only for idiopathic forms, but also for micro- and macroprolactinomas, which are the most frequent causes of this pathology. Although questioned by some authors, the slow evolution of the illness, the rarity of transformation of a microadenoma into a macroadenoma, and the possibility of spontaneous cure cause most authors to favor medical treatment, with which they observe both normalization of gonadal function and tumor regression. By retrospective analysis of 95 hyperprolactinemic patients (72 women and 23 men including 26 cases of suspected microadenoma and 44 macroadenomas) treated with 3 dopamine agonists (bromocriptine, metergoline and CU 32085) between 1975 and 1983, and with the help of large series published in the literature, we have tried to review the present knowledge of this subject. After a quick review of different medications, we will consider their prolactin-suppressing effects, their influences upon gonadal and gonadotropic functions, and their antitumoral action. More specific problems will then be discussed: side effects, resistance, possibility of cure, the evolution of the prolactinoma, the place of medical therapy relative to surgery, and contraception in association with dopaminergics.

show abstract

“…Patients with secreting prolactinomas are commonly treated with bromocriptine [1,2] and other dopamine agonists [3,4], In most cases, normal plasma prolactin [ 8,9] in that they remain secretory and in some cases con tinue to grow under treatment [ 10]. In a few cases, growth hormone (GH)-secreting adenomas are also treated with bromocriptine since dopamine agonists were shown to reduce GH levels in some patients [11].…”

Section: Introductionmentioning

confidence: 99%

Decreased Expression of the Two D<sub>2</sub> Dopamine Receptor Isoforms in Bromocriptine-Resistant Prolactinomas

et al. 1994

View full text Add to dashboard Cite

Bromocriptine or other dopamine agonists are usually effective for the treatment of prolactin-secreting adenomas. Five to 18% of prolactinomas, however, do not respond to such therapy. We have shown previously that such resistance to bromocriptine correlates with reduced binding to the D₂ receptor subtype of dopamine, the major PRL inhibiting factor. In the present work, we demonstrated that reduced binding actually corresponds to decreased expression of the gene coding for the D₂ receptor in the pituitary from bromocriptine-resistant patients, as shown by 4-fold lower levels of the corresponding mRNAs compared to those coding for actin. The existence of two D₂ receptor isoforms, D₂S and D₂L generated by alternative splicing, has been described in several tissues, including the pituitary. Both are negatively coupled to adenylyl cyclase and inhibit prolactin secretion, but, in addition, the shortest one (D₂S) is more efficiently coupled to phospholipase C. Consequently, we also investigated whether expression of a particular D₂ receptor isoform was preferentially affected in resistant adenomas. The proportion of messengers corresponding to the short receptor isoform (D₂S) was lower in resistant compared to responsive adenomas: D₂S/D₂L = 0.74 ± 0.08 and 1.00 ± 0.07, respectively. In parallel, much lower levels of D₂ receptor mRNAs were found in growth hormone-secreting adenomas, with a D₂S/D₂L ratio comparable to those of both normal human pituitary and bromocriptine-sensitive prolactinomas (1.05 ± 0.11). Thus, resistance to bromocriptine therapy seems to involve defects in D₂ dopamine receptor expression and possibly in posttranscriptional splicing.

show abstract

Treatment of hyperprolactinemic states with different drugs: a study with bromocriptine, metergoline, and lisuride

Cited by 48 publications

References 17 publications

The surgical treatment of pituitary adenomas in the eighth decade

The surgical treatment of pituitary adenomas in the eighth decade

Medical Treatment of Hyperprolactinemia

Decreased Expression of the Two D<sub>2</sub> Dopamine Receptor Isoforms in Bromocriptine-Resistant Prolactinomas

Contact Info

Product

Resources

About