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At least 721 records · Page 40Linked to original sources
PubMed2000

Abnormal LH pulsatility in women with hyperprolactinaemic amenorrhoea normalizes after bromocriptine treatment: deconvolution-based assessment.

OBJECTIVE: The present study examines the LH secretory process in hyperprolactinaemic women before, during and after bromocriptine therapy, using restrictive clinical selection criteria as well as improved methodological tools. PATIENTS AND DESIGN: Six women (aged 20-40 years) with microprolactinomas (mean +/- SE prolactin, PRL: 2478 +/- 427 mU/l, range: 1370-3800 mU/l) and four age- and sex-matched healthy controls were admitted to the study. After an overnight fast, all patients and controls had blood samples withdrawn at 10 minute intervals for 6 h (during saline infusion) from 0800 h to 1400 h to determine serum LH and PRL concentrations. After baseline evaluation, patients were treated with bromocriptine, which was started at a daily dose of 1.25 mg for 7 days; the dose was then increased to 2.5 mg daily for the next 7 days and subsequently to 2.5 mg twice daily. PRL levels were evaluated at weekly intervals after the beginning of bromocriptine therapy for the duration of the study. The 6 h pulsatility study was repeated on four patients during treatment at a time when PRL levels were decreased, although not normalized (PRL range: 450-1350 mU/l) and, on four patients, with the attainment of normal serum PRL levels (PRL < 450 mU/l) in the early follicular phase of the menstrual cycle (days 2-5). The LH instantaneous secretion rate was reconstructed by a nonparametric deconvolution method. In addition to pulse analysis made using the program DETECT, the evaluation of the secretion rate yielded the pulse frequency as well as the pulse amplitude distribution. RESULTS: Each time series was submitted to deconvolution analysis using a nonparametric method in order to estimate the instantaneous secretion rate (ISR). Hyperprolactinaemic patients had very few high-amplitude LH pulses above 0.2 IU/(l minutes) before treatment (average frequency: 0.83 +/- 0.40 pulses/6 h) and at the intermediate evaluation (0.25 +/- 0.25 pulses/6 h). In both cases, the pulse frequency was significantly lower than in controls (P < 0.05 and P < 0.01, respectively). When PRL was normalized, the number of high-amplitude LH pulses (4.25 +/- 1.03 pulses/6 h), became statistically different from the pulse number before (P < 0.01) and during (P < 0.01) therapy; in particular the pulse frequency after therapy rose to a level not statistically different from that in controls. CONCLUSION: The present study shows the presence of reduced LH pulsatility in hyperprolactinaemic women that recovers completely to within the physiological distribution when PRL levels are normalized by bromocriptine therapy.

Adult↗
PubMed2000

Cabergoline and hyperprolactinaemia: new preparation. Better than bromocriptine.

(1) Cabergoline, a dopamine agonist already marketed in about 40 countries, is indicated in France for the treatment of hyperprolactinaemia (idiopathic or caused by a pituitary microadenoma). The reference drug in this setting is bromocriptine. (2) The clinical file on cabergoline is methodologically sound, albeit limited mainly to women with amenorrhoea. (3) Two partially blinded comparative trials have shown that cabergoline is significantly more effective than bromocriptine in restarting ovulatory cycles with menstruation. (4) In these trials the incidence of nausea was significantly lower on cabergoline than on bromocriptine. Other adverse events seem to be equally frequent with the two drugs. (5) Cabergoline is effective when taken once or twice a week, while bromocriptine needs to be taken several times a day.

Bromocriptine↗
PubMedDate not supplied

A prospective, double-blind, randomized, placebo-controlled clinical trial of bromocriptine in clomiphene-resistant patients with polycystic ovary syndrome and normal prolactin level.

OBJECTIVE: To evaluate the effects of administration of bromocriptine combined with clomiphene citrate (CC) in CC-resistant patients with polycystic ovary syndrome (PCOS) and normal prolactin (PRL) level. DESIGN: Prospective double-blind, placebo-controlled, randomized. SETTING: Referral university hospitals. PATIENTS: One hundred women with PCOS and normal PRL who failed to ovulate with a routine protocol of CC. INTERVENTIONS: Treatment group received 150 mg of CC from day 5 to 9 and 7.5 mg bromocriptine continuously, with hCG 10,000 units on day 16 or 17. Control group received the same protocol of CC combined with placebo. MAIN OUTCOME MEASURES: Follicular development, hormonal changes, ovulation rate, pregnancy rate. RESULTS: Follicular development (follicular size greater than 15 mm) was observed in 12 (25.5%) and 8 (15.1%) women in the treatment and placebo group, respectively (p = 0.29). The serum prolactin level was within normal limits in all patients before treatment. After 3 and 6 months of treatment with bromocriptine, there was a significant decrease in serum level of prolactin (p = 0.000001). No significant differences were seen in ovulation, pregnancy rate, or serum levels of FSH, LH, DHEAS, and progesterone between treatment and placebo groups after treatment. CONCLUSIONS: The only significant effect of long-term bromocriptine therapy in CC-resistant women with PCOS was to lower the serum PRL concentration. It is also concluded that 10%-15% of patients with PCOS experienced occasional ovulatory cycles and pregnancy whether or not they were on treatment.

Adult↗
PubMed1992

Mixed pituitary tumours--effects of bromocriptine treatment: Parlodel MR and Parlodel LAR.

Majority of pituitary tumours secrete one of the named hormones: PRL, GH, ACTH, proopiomelanocortine, alpha and beta subunit of TSH, LH, and FSH. Some of those tumours secrete two or more hormones. The aim of this study was to determine the effect of bromocriptine (Parlodel MR and LAR) upon secretion of hormones and tumour size in 10 patients with mixed pituitary tumours. In all patients pituitary and peripheral hormones, CT scan and visual fields were examined before and after treatment with bromocriptine: Parlodel MR and LAR. Bromocriptine treatment decreased PRL secretion in all 10 patients; GH--in all 6 in whom it was increased; TSH--in 2, FSH--in 2 and alpha-subunit in all 6 in whom they were increased. In 5 patients treatment resulted in shrinkage of the tumour mass by 20 to 35%. In all examined subjects clinical improvement was achieved. Our results demonstrate that bromocriptine (Parlodel MR and LAR) is very effective and well tolerated in the treatment of patients with mixed pituitary tumours particularly those with hyperprolactinemia.

Adult↗
PubMed1992

Neuroleptic-associated hyperprolactinemia. Can it be treated with bromocriptine?

Six stable psychiatric outpatients with hyperprolactinemia and amenorrhea/oligomenorrhea associated with their neuroleptic medications were treated with bromocriptine. Daily dosages of 5-10 mg corrected the hyperprolactinemia and restored menstruation in four of the six patients. One woman, however, developed worsened psychiatric symptoms while taking bromocriptine, and it was discontinued. Thus, three of six patients had their menstrual irregularity successfully corrected with bromocriptine. This suggests that bromocriptine should be further evaluated as potential therapy for neuroleptic-associated hyperprolactinemia and amenorrhea/galactorrhea.

Adult↗
PubMed1992

[The use of the bromocriptine test in schizophrenia patients resistant to neuroleptic therapy].

To choose differentiated therapy, 62 patients suffering from refractory schizophrenia were administered bromocriptine in a dose of 7.5-15 mg/day after they had been placed on placebo. According to the bromocriptine test, the treatment was changed in 53 patients. After the occurrence of the picture of hallucinatory stupor remission was attained with the aid of less doses of neuroleptics given before. In patients who responded to bromocriptine by anxious excitation, the health status noticeably improved after administration of anxiolytics and lithium carbonate. Those patients in whom bromocriptine eliminated psychosis were treated later with the drugs belonging to the group of monosubstituted benzamides.

Adult↗
PubMed1992

Bromocriptine reverses the elevation in intracranial self-stimulation thresholds observed in a rat model of cocaine withdrawal.

Cocaine use frequently occurs in episodic prolonged binges. Following such a cocaine binge, the user suffers from severe depression mixed with irritability, anxiety, anergia and anhedonia. These symptoms constitute the cocaine withdrawal syndrome. Since cocaine's rewarding effects are mediated by enhanced dopaminergic neurotransmission in the mesocorticolimbic system, it is possible that a long-acting dopamine agonist might block the withdrawal effects associated with the termination of a prolonged bout of cocaine self-administration. An animal model of post-cocaine anhedonia was developed using the elevation in intracranial self-stimulation (ICSS) thresholds following the termination of prolonged periods of cocaine self-administration as a measure of an animal's "anhedonic" state. In the present study, an attempt was made to reverse the postcocaine elevation in ICSS thresholds with acute administration of a dopaminergic agonist, bromocriptine. Rats were allowed to self-administer cocaine for 24 hours continuously. Four hours after the termination of the self-administration session, animals were injected with either vehicle or bromocriptine (1, 2, or 4 mg/kg, IP). Two hours later (6 hours post cocaine), the animals' self-stimulation thresholds were assessed. Confirming previous work, treatment with the vehicle following a cocaine "binge" resulted in elevated ICSS thresholds compared to predrug baseline levels or to control rats' thresholds. Bromocriptine, at doses that had no effect on ICSS thresholds in control rats, reversed the postcocaine anhedonia in a dose-related manner. These results indicate that bromocriptine-like drugs (pharmacological agents that enhance dopaminergic neurotransmission) may be able to ameliorate some of the effects of cocaine withdrawal on mood and motivational state. In addition, the results of the present study indicate that the proposed animal model of cocaine withdrawal could be useful in the discovery and development of new pharmacotherapies for cocaine withdrawal.

Analysis of Variance↗
PubMedDate not supplied

Macroprolactinomas: serial MR imaging in long-term bromocriptine therapy.

PURPOSE: To study the changes in macroprolactinomas during long-term bromocriptine therapy by means of serial MR imaging, and to correlate the findings to the serum prolactin (S-PRL) levels. PATIENTS AND METHODS: Thirteen patients with macroprolactinomas were studied before and during bromocriptine therapy; six to 11 MR examinations were performed with a duration of follow-up of 22 to 74 months. Tumor size, extension, relationship to adjacent structures, and signal intensity patterns were evaluated. Signal intensity ratios and T2 values were calculated in areas of apparently solid tumor tissue. RESULTS: Bromocriptine effectively reduced the size of all tumors; the size reduction was already significant at 1 week, but often continued for several years. Reenlargement during therapy was seen in three cases. The development of chiasmal herniation parallel to increasing cisternal invagination into the sella was a common finding, but was not correlated to visual symptoms. Signal intensity patterns corresponding to hemorrhage, cysts or necrosis were frequently observed, and transitions from one pattern to another were common. Hemorrhage occurred mainly in tumors corresponding to high initial serum prolactin levels. After 1 year of therapy, there was a significant increase in T2 values, indicating an increased water content in residual solid tumor tissue. CONCLUSIONS: MR is valuable for follow-up in bromocriptine therapy of macroprolactinomas, and provides new information on the tumor size changes, the inner structure of the tumors, and the optic chiasm.

Bromocriptine↗
PubMed1992

[Experiences with bromocriptine treatment of female infertility due to hyperprolactinemia].

From July 1981 to September 1988, 106 infertile patients with hyperprolactinemia treated with bromocriptine were reviewed retrospectively with special attention to the dosage of bromocriptine and the evaluation of infertility before treatment 84 patients (79.2%) became pregnant. The patients were divided into 3 groups according to the following doses of bromocriptine: 7.5, 5.0, and less than 5.0 mg/day. The pregnancy rate was 90.7%, 84.6%, and 66.7% respectively with the highest at 7.5mg/day, which was significantly higher than that at less than 5.0mg/day (P less than 0.02). The average duration from treatment to pregnancy was 3.6, 3.4, and 7.4 months respectively. The duration in the less than 5mg/day group was twice that in the other two groups. 84.5% of the pregnancies occurred within 6 months of treatment. Pretreatment of organic lesions and additional therapy for induction of ovulation were given to 29.8% of patients who later became pregnant. Systematic evaluation of the causes of infertility other than hyperprolactinemia before the use of bromocriptine and an optimal dose of 5-7.5mg/day will give the best results.

Adult↗
PubMedDate not supplied

[Comparison of administration of low doses of bromocriptine and levodopa in the early treatment of Parkinson disease].

Results og an open, controlled three-month clinical trial of therapeutical efficacy of a combination of a low doses of levodopa/carbidopa and bromocriptine in 20 de novo patients with Parkinson's disease (PD) are presented. All patients received the same daily doses of levodopa/carbidopa (250 mg), while daily dosage of bromocriptine was gradually increased from 1.25 mg to 30 mg. Owing to development of adverse effects 3 patients dropped out of the study, while in 70% of the patients who completed the protocol improvement of motor functioning exceeded 50%. Those with bradykinesia and rigidity responded most favorably. For all our patients the mean daily dose of bromocriptine was 26.25 mg. The most common adverse effects of the therapy were orthostatic hypotension (7 pts) and nausea (5 pts). The results of the study coincide with the hypothesis that comparative administration of low doses of bromocriptine and levodopa is the best approach to treatment of early phases of PD.

Aged↗
PubMed1991

[Bromocriptine in therapy of chronic recurrent anterior uveitis].

In animal studies, bromocriptine (Pravidel) has demonstrated immunosuppression because of inhibition of prolactin. After publication of positive results in the treatment of uveitis in a few case reports and in an uncontrolled study we conducted a double-blind placebo-controlled study in 13 patients with chronic recurrent anterior uveitis who had experienced three or more recurrences during the previous year. Therapy was started gradually during the symptom-free interval and continued for 1 year with 2.5 mg twice daily. Two recurrences or relevant side effects led to discontinuation of the therapy. In the bromocriptine group, 2 of 7 patients had no recurrences during the study period. Two patients had to stop because of two recurrences but, in contrast to earlier recurrences, they responded to local corticosteriod treatment within a few days. The remaining 3 patients (1 with one recurrence, 2 without) had to stop because of the side effects (arterial hypotension, arthritic complaints). In 5 of 6 patients in the placebo group treatment was stopped because of recurrences and in 1 patients because she believed she was experiencing a side effect from bromocriptine (breast atrophy). In summary, bromocriptine seems to have a prophylactic effect on anterior uveitis. Side effects were frequent but mild compared to other immunosuppressives. In case of arterial hypotension, additional therapy could make this drug more tolerable.

Adolescent↗
PubMed1991

Experience with bromocriptine for the treatment of female infertility due to hyperprolactinemia.

From July 1981 to September 1988, 106 infertile patients with hyperprolactinemia treated with bromocriptine were reviewed retrospectively with special attention to the dosage of bromocriptine and the evaluation of infertility before treatment. 84 patients (79.2%) became pregnant. The 106 patients were divided into 3 groups according to the following doses: 7.5, 5.0, and less than 5.0 mg/day. The pregnancy rate was 90.7%, 84.6%, and 66.7% respectively with the highest at 7.5 mg/day, which was significantly higher than that at less than 5.0 mg/day (P less than 0.02). The average duration from treatment to pregnancy was 3.6, 3.4 and 7.4 months respectively. The longest duration in the less than 5 mg/day group was twice that in the other two groups. 85% of the pregnancies occurred within 6 months of treatment. Pretreatment of organic lesions and additional therapy for induction of ovulation were given to 29.8% of the pregnancies. The causes of infertility other than hyperprolactinemia were evaluated systemically before the use of bromocriptine. The optimal dose was 5-7.5 mg/day. Macroprolactinomas can be treated with bromocriptine, but should be followed up closely for the development of symptoms of intracranial pressure during pregnancy.

Adult↗
PubMed1991

Cocaine abstinence following chronic treatment alters cerebral metabolism in dopaminergic reward regions. Bromocriptine enhances recovery.

2-[14C]deoxyglucose autoradiography was used to determine local cerebral glucose utilization (lCGU) in rats following chronic cocaine treatment and subsequent abstinence. lCGU was examined in 43 discrete brain regions in animals which had received daily injections of cocaine for 14 days (10 mg/kg) followed by 3 days of saline or bromocriptine (10 mg/kg) treatment. Cocaine abstinence following chronic treatment significantly reduced lCGU in several regions including mesocorticolimbic structures such as ventral tegmental area, medial prefrontal cortex, and nucleus accumbens (NAc). Within the NAc, however, only the rostral pole showed significant reduction. In contrast, when bromocriptine treatment accompanied abstinence, lCGU was no longer reduced in mesocorticolimbic and most other regions, implying that metabolic recovery was enhanced by bromocriptine treatment during early abstinence following chronic cocaine treatment. These data suggest that cerebral metabolism is decreased during cocaine abstinence following chronic treatment in critical brain regions, and that this alteration can be prevented by treatment with direct-acting dopamine agonists such as bromocriptine.

Analysis of Variance↗
PubMed1990

Pleuropulmonary fibrosis due to bromocriptine treatment for Parkinson's disease.

Pleuroplumonary fibrosis is an uncommon but potentially serious adverse effect of bromocriptine used in the treatment of Parkinson's disease. Two cases of this reaction, which occurred 12 months and 5 months respectively after commencing therapy are here reported. In both instances prompt clinical and radiological improvement occurred when bromocriptine intake was ceased. Fibrotic reactions to bromocriptine may be mediated by a serotonergic mechanism. Periodic monitoring of pulmonary symptoms is warranted in patients receiving bromocriptine treatment for Parkinson's disease.

Aged↗
PubMed1990

[Comparison of bromocriptine and levodopa as first line treatment of Parkinson's disease: results of a 3-year prospective randomized study].

The long term effects of a first line treatment with levodopa or bromocriptine were compared in 36 previously untreated patients with Parkinson's disease in a prospective randomized trial: 18 patients were treated with levodopa alone (mean dose: 485 +/- 71 mg daily) whereas 18 others received bromocriptine alone (mean dose: 55 +/- 6 mg daily) during 36 +/- 3 and 31 +/- 3 months respectively. We observed a similar decrease in the Columbia rating scale but the nature of long term side effects was different in the two groups: patients on levodopa developed peak-dose dyskinesias (5 cases), wearing off akinesia (1 case) and on-off effects (1 case). Under bromocriptine treatment, 2 patients developed severe psychosis whereas one suffered from primary lack of drug effectiveness and 5 others from late decrease of drug effectiveness. These results suggest the potential value of relatively high doses of D2 dopamine agonists (such as bromocriptine) in the first line treatment of Parkinson's disease: however, their use can be limited by their decrease of effectiveness after several years and/or the occurrence of severe neuropsychiatric side-effects.

Bromocriptine↗
PubMed1990

Normoprolactinemic anovulation nonresponsive to clomiphene citrate: ovulation induction with bromocriptine.

Ovulation under bromocriptine was studied in 14 women with normoprolactinemic amenorrhea (5 primary, 9 secondary), unresponsive to clomiphene citrate (CC). On bromocriptine alone, ovulation occurred in 4 (28.6%). In the same subjects, bromocriptine was subsequently associated with CC. Seven patients ovulated (50.0%), including 3 that had responded to bromocriptine alone. Ovulation occurred once or twice in 6 of the 9 cases of secondary amenorrhea (66.6%). In several occasions, when ovulation induction failed, luteinized unruptured follicles were found under ultrasonographic monitoring. Four patients who had a negative response to progestin challenge did not ovulate with the treatment. Women with plasma prolactin in the upper normal range had a greater probability of achieving ovulation induction.

Adolescent↗
PubMed1990

[Pleural effusion induced by bromocriptine].

Bromocriptine, a derivative of ergot of rye, is used in high doses for the treatment of Parkinson's disease and may be responsible for pleuro-pulmonary complications. We report a case of a 72 year old patient treated for 2 years for Parkinson's disease with a daily dose of 30 mgms. of bromocriptine and in whom a pleural effusion, initially unilateral then bilateral, was discovered with a deterioration in the general physical state. The effusion was a transudate and examination did not give any clues as to aetiology, there was a rapidly favourable outcome following the cessation of treatment. Amongst the respiratory complications of bromocriptine it is the pleuro-pulmonary fibrosis which is most frequently reported. The cases of isolated pleural effusions are rare and are generally exudates. Several hypotheses have been put forward to explain the pathogenesis of these disorders: there is a theory that the molecule induces a toxic fibrogenesis, there is a vascular theory analogous with the secondary effects of methysergide and finally immunological theory. The frequency of the disorder is probably underestimated and these drug reactions justify a close follow up for any respiratory problems in patients who are subjected to treatment with bromocriptine.

Aged↗
PubMed1990

[Treatment of prolactin-secreting pituitary tumors with bromocriptine].

9 women and 6 men with prolactin-secreting pituitary tumors--prolactinomas (mean age 41 years, range 28-57), were treated conservatively with bromocriptine. The women usually presented with galactorrhea, menstrual disorders and headaches, and the men with headaches, decreased libido or impotence, and visual abnormalities. The symptoms had lasted from several months to 20 years, but were not correlated with tumor size. Between 77-100% of symptoms improved during bromocriptine. Prolactin levels, which correlated with the size of the tumor, averaged 1241 ng/ml before treatment and became normal in 80% of the patients. Tumor size decreased in 58% of those with macroprolactinomas. Lesions of decreased density were found in another 17% of the patients. Side-effects of bromocriptine were minor and disappeared despite continuation of therapy. The results of this series, as well as those of others, indicate that bromocriptine is the treatment of choice for micro- and macroprolactinomas.

Adult↗