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Use of bromocriptine in unexplained infertility.

In order to determine whether infertility of unexplained aetiology would respond to therapy with bromocriptine, 50 regularly ovulating infertile patients were studied in a double-blind placebo controlled trial. Following an observation cycle in which midluteal urinary oestrogen and pregnanediol excretion and late luteal serum PRL and hCG levels were determined, patients were randomly allocated to treatment with either bromocriptine or placebo for three cycles. Patients who did not conceive were then treated for three cycles with the alternative therapy. Eighteen women (36%) conceived, five during the observation cycle, four during treatment with bromocriptine, four whilst receiving placebo and five during the 12 month follow-up period. The pregnancy rate achieved in patients treated with bromocriptine was thus no better than that for the group as a whole.

Bromocriptine↗

Influence of bromocriptine on glucose-3-H3 metabolism in vivo.

The dopaminergic agonist Bromocriptine has been perfused in vivo in normal Wistar rats to control its activity on Glucose-3-H3 metabolism. Bromocriptine shows a rapid influence on glucose production rate (Ra) and glucose utilization rate (Rd). Both rates increase, but since Bromocriptine effects on glucose production rate is more significant than the ones on glucose utilization, the final results is an increase in plasma glucose levels. Since glucose production rate in normal animals is practically equal to hepatic glucose output, the most logical explantation of Bromocriptine activity is the activation of glycogenosis with a rise of plasma glucose levels.

Animals↗

Bromocriptine therapy of luteal insufficiency accompanied with hyperprolactinemia in the follicular phase.

The therapeutic effectiveness of bromocriptine was studied in 24 patients (40 cycles) with luteal insufficiency accompanied with hyperprolactinemia in the follicular phase. Treatment with bromocriptine was started on day 5 of each menstrual cycle and continued for 7 days per cycle. In the first menstrual cycle, this 7-day treatment lowered the blood prolactin level, and significantly increased blood estradiol and progesterone in 83.3% of the patients. Among the patients whose prolactin levels were not lowered by bromocriptine, only a few showed increases in estradiol or progesterone. In many of the patients whose prolactin levels were excessively lowered to 5 ng/ml or less, progesterone was decreased. These results suggests that bromocriptine produces a favorable effect on hyperprolactinemic luteal insufficiency by secondarily stimulating progesterone secretion as a result of suppressing the follicular growth "inhibiting action of prolactin. Prolactin of an appropriate concentration, however, was considered to be needed for the maintenance of normal function of the corpus luteum.

Anovulation↗

Lactation suppression with bromocriptine.

The efficacy and acceptability of bromocriptine in suppressing postpartum lactation was determined in a double blind study in which bromocriptine 2.5 mg twice daily for 14 days was compared with a placebo. Forty women who decide during the antenatal period not to breast feed entered the study. The bromocriptine treated group had significantly less mammary secretion and breast engorgement than the control group and also required less analgesia. The most noticeable side effects during the trial were dizziness, headache and abdominal pain. The only statistical difference between the two groups was a higher incidence of dizziness in the bromocriptine treated group.

Adult↗

[Bromocriptine as the 1st treatment of Parkinson's disease. Long term results].

Bromocriptine (mean dose: 48 mg daily) was studied during 38 months (mean value) in 20 patients with Parkinson's disease who had never received levodopa treatment. Eight of these 20 patients were treated during a period up to 4 years. Fourteen patients had an "excellent" or "good" improvement with a significant decrease of extrapyramidal symptoms. The side effects were those seen with levodopa but they did not lead to stop the treatment. The most important finding was the lack of long term side effects similar to those usually seen under levodopa treatment: in this group, dyskinesia, oscillations in performance (and specially "on-off" effect) were not noted. A tendency for deterioration of therapeutic efficiency was observed in 2 (or 3) cases. Bromocriptine could be an useful antiparkinsonian drug for previously untreated patients. The pharmacological (importance of the post-synaptic action of bromocriptine) and therapeutic (indications of bromocriptine versus levodopa) implications are discussed.

Adult↗

Bromocriptine associated with symptom exacerbation during neuroleptic treatment of schizoaffective schizophrenia.

Bromocriptine is a dopamine agonist with potential mental side effects. The authors report a case involving a patient with neuroleptic-induced remission of psychiatric symptoms in whom bromocriptine was associated with temporary exacerbation of schizophrenic symptoms. Other treatment approaches than bromocriptine are suggested for amenorrhea-galactorrhea induced by neuroleptic medication. The use of bromocriptine requires monitoring for changes in mental status.

Adult↗

Bromocriptine and premenstrual tension: a clinical and hormonal study.

Thirty-four patients suffering from the premenstrual syndrome were studied during 5 consecutive menstrual cycles. After a control cycle, bromocriptine and placebo were given during the luteal phase of the cycle in a random, double-blind manner, each patient serving as her own control. Bromocriptine (1.25 mg twice daily) was given for 3 cycles and placebo for 1 cycle. Serum prolactin levels were within normal limits without treatment and were significantly reduced by bromocriptine. Serum progesterone did not change during treatment. Medication considerably improved all the premenstrual symptoms but bromocriptine was not significantly better than placebo. These results do not support the hypothesis that prolactin alone causes premenstrual symptoms.

Adult↗

Clinical and hormonal response to short-term intermittent versus continuous oral bromocriptine in hyperprolactinemic women.

UNLABELLED: OBJECTIVE -- To determine if intermittent oral bromocriptine administration could be a useful therapeutic alternative in infertile hyperprolactinemic women. DESIGN -- Open, randomized and prospective study. SETTING -- Outpatient infertility clinic of a third-level medical institution. PATIENTS -- Fourteen low-income women, 23 to 36 years of age with anovulatory infertility (1-13 years in duration) secondary to hyperprolactinemia (>35 ng/mL). Endocrine profile ruled out anovulation of other origin. INTERVENTIONS -- After a control period of 30 days, seven women (group 1) received daily oral bromocriptine (2.5-10.0 mg/day) continuously during two consecutive 30-day periods (T-1 and T-2), and seven women (group 2) received oral bromocriptine only from day 1 to 15 of each 30-day period of treatment. Morning blood samples were drawn similarly during the three periods on days 6 to 8, 13 to 15, and 21 to 23. MAIN OUTCOME MEASURES -- FSH, LH, and prolactin were determined in all samples, estradiol only in samples of days 6 to 8 and 13 to 15, and progesterone exclusively between days 21 and 23. RESULTS: Mean serum prolactin levels during the control period were similarly elevated in groups 1 and 2. A marked decrease occurred during period T-1 (P < .004) and further during period T-2 (P < .05) in both groups, but at no time were significant intergroup differences documented. During the control period all women had a serum progesterone < 3.0 ng/mL (<9.54 nmol/L); during period T-2 it was > or = 3.0 ng/mL in three and five women of groups 1 and 2, respectively. Over the following 10 months of treatment, two and three normal pregnancies and deliveries ensued in groups 1 and 2, respectively. CONCLUSION -- The intermittent use of oral bromocriptine may indeed be a useful therapeutic approach in treating infertile hyperprolactinemic women.

Adult↗

Induction of apoptosis in rat somatotrophin-secreting pituitary adenoma cells by bromocriptine.

Bromocriptine, a dopamine agonist, is now an accepted primary therapeutic agent for patients with prolactinomas and other pituitary adenomas. In this study, we demonstrated that bromocriptine inhibited the proliferation of rat somatotrophin-secreting pituitary adenoma (GH1) cells. In addition, the antitumor activity of bromocriptine was inhibited both by actinomycin D and cycloheximide, suggesting that it was dependent upon new RNA and protein synthesis. Interestingly, the results of DNA fragmentation assay and cell cycle analysis clearly demonstrated that bromocriptine induced apoptosis in GH1 cells.

Adenoma↗

Shrinkage of pituitary PRL-secernent adenoma after short-term treatment with bromocriptine long-acting repeatable injections.

The efficacy, safety and tolerability of a single bromocriptine-LAR injection (50 mg) and of a 6 injection course at 28-day intervals, were evaluated respectively in 13 and in 9 hyperprolactinemic women with radiological signs of PRL-secreting pituitary adenoma. The long-lasting repeatable formulation of bromocriptine induced a rapid and prolonged hypoprolactinemic effect. Side effects related to central activity of the compound were observed only on the first day of compound administration in all subjects except one, whereas no modifications of cardiologic and haematologic parameters were observed. In one subject the occurrence of side effects was observed also during the 6 injection course of treatment. A significant shrinkage of pituitary adenoma was observed at the second CT scan performed in 7 of the 9 subjects treated for 6 months with bromocriptine-LAR. CT scan was not performed in one subject who achieved pregnancy after second bromocriptine-LAR injection, whereas unmodified size of pituitary microadenoma was found in one subject whose PRL secretion did not decrease during the treatment and who referred severe side effects.

Adolescent↗

Alopecia: an adverse effect of bromocriptine.

We report the cases of two patients who experienced a poorly known adverse effect of bromocriptine-alopecia. The first patient was an infertile 34-year-old woman treated with 2.5 mg of bromocriptine per day. The second patient was a 45-year-old woman with Parkinson's disease treated with 40 mg of bromocriptine per day. In both cases there was no preexisting hair loss. Hair loss ceased when bromocriptine was withdrawn and was not attributed to another etiology. Pathophysiological mechanisms are unknown.

Adult↗

[The treatment of pseudopregnancy in the bitch with prolactin inhibitors metergoline and bromocriptine].

In the present study, the prolactin inhibitor Metergoline was compared with Bromocriptine and tested against a placebo in 63 pseudogravid bitches. Bromocriptine has already been tested successfully in numerous investigations on the therapy of canine pseudogravidity, but--probably because of its high price and vomitus as a frequent side effect--it has not been really introduced as a therapeutical device in canine practice. It can be deduced from the results presented herein that prolactin is essential for maintaining the pseudogravidity, but keeping up the lactation process--especially galactopoiesis--can probably not be ascribed solely to prolactin. However, prolactin definitely plays an essential role in the hormonal scenario, the detailed regulating mechanisms of which are not known until today. Thus, no statistically convincing therapy outcome could be achieved by the prolactin inhibitors compared to the placebo group. A tendency towards earlier regression of the symptoms "mammogenesis", "behavioural change" and "galactorrhea" was however present in the treated animals. A striking difference was the much more lively behaviour of the bitches with 53% being more lively in the Metergoline group, 37% in the Bromocriptine and 10% in the placebo group. There were also clear differences in the compatibility of the drugs; in the Bromocriptine group, 30% of the animals vomited, in the Metergoline only 6.3%. This however did not lead to termination of the therapy in any case. In two cases of the Metergoline group (6.3%), the medication was ended due to extreme restlessness.

Animals↗

Bromocriptine related atypical vascular accidents postpartum identified through medicolegal reviews.

Recent literary case reports indicate that bromocriptine mesylate, when used for the suppression of lactation in the puerperium, can cause serious and even lethal side effects. The untoward sequelae are attributed to generalized or focal vasospasm affecting the cardiac and/or cerebral bold vessels. Apart from pre-existing hypertension and use in association with other ergot derivatives, the factors predisposing to such complications have not been elucidated, The authors present three atypical bromocriptine related postpartum accidents which may expand the understanding both of the predisposing factors and the potential consequences of bromocriptine related severe side effects. One of the cases raises the suspicion that the manifestations of hyperthyroidism may be aggravated by this method of pharmacologic ablactation. Another observation appears to imply that the drug may trigger the onset of chronic hypertension in women so predisposed. The development of cerebral infarcts, identified by MRI, in a clinically asymptomatic woman, exemplifies the threat of recurrent seizure activity in cases of bromocriptine related stroke.

Adult↗

Bromocriptine for cocaine dependence. A controlled clinical trial.

On the basis of the dopamine depletion theory, bromocriptine has been tested to treat cocaine withdrawal and dependence. The authors conducted a 6-week study with 1 week of pretreatment observation and 5 weeks of a randomized, double-blind, placebo-controlled clinical trial of bromocriptine for DSM-III-R-defined cocaine dependence in methadone-maintained male patients. The bromocriptine group (n = 24) did not differ from the placebo group (n = 26) in self-reported cocaine use, proportion of positive urine toxicology samples, craving for cocaine, resistance to cocaine use, or mood symptoms between the pretreatment baseline and the last week of the clinical trial. Both groups showed significant reduction in self-reported frequency of cocaine use, resistance to craving, and mood symptoms during participation in the protocol. The results of this study are consistent with recent clinical and laboratory findings in primary cocaine users. Despite initially promising pilot studies, recent evidence does not support the efficacy of bromocriptine to reduce cocaine use or craving.

Adult↗

Postpartum psychosis induced by bromocriptine and pseudoephedrine.

Bromocriptine is an ergot-derived dopamine agonist sometimes used for postpartum suppression of lactation. On rare occasions (a total of seven previous reports in the literature), use of the medication has been associated with psychotic symptomatology in postpartum patients. This case report describes a 19-year-old postpartum woman who developed severe psychotic symptoms while taking low doses of bromocriptine and pseudoephedrine. The use of bromocriptine for suppression of lactation is controversial. If prescribed for postpartum patients, bromocriptine alone or in combination with sympathomimetic drugs should be used only with caution.

Adult↗

[A comparative study of the effect of bromocriptine and pergolide on Parkinson disease].

INTRODUCTION: Bromocriptine and pergolide are the two dopamine agonists most often used in Parkinson's disease. Few comparative studies of the efficacy of both compounds are available. OBJECTIVE: To compare the relative efficacy of bromocriptine and pergolide in patients with Parkinson's disease and intermediate stages of evolution. METHODS: Open label study of 5-months of duration. The first agonist was given for two months and, after a period of substitution of one month, the second agonist was also maintained for two months. RESULTS: Pergolide was more effective than bromocriptine for global scores of the UPDRS, total motor scores, clinical symptoms, akinesia and rigidity. Both compounds were equal effective for the treatment of tremor and fluctuations. Both agonists produced similar side effects. CONCLUSIONS: At the ration 1/10 mg/day pergolide was more effective than bromocriptine in patients with Parkinson's disease at intermediate stages of evolution.

Aged↗

[Diffuse interstitial lung disease without pleural involvement and high-dose bromocriptine].

Bromocriptine, used in the treatment of acromegaly, hyperprolactinemia and Parkinson's disease, may be responsible in this last case, for pleuro-pulmonary complications in higher doses. Since 1981 about thirty cases were described. It was mostly pleural effusions, pleural thickening and parenchymal lung fibrosis. The prevalence of pleuro-pulmonary diseases is between 2 to 5% after 5 years with bromocriptine that varied in dosage from 20 to 90 mg daily. The patients developed symptoms from nine months to four years. We report a case of a patient treated for one year for Parkinson's disease with daily dose of 105 mg of bromocriptine in whom bilateral pulmonary infiltrate was discovered with a deterioration in the general physical state and dyspnea. There was a favorable clinical and chest roentgenogram outcome following the cessation of treatment, in six months. The hypotheses to explain the pathogenesis of these disorders were always discussed: a vascular theory, an immunological theory or a toxic fibrogenesis induced by the molecule acting on dopaminergic receptors and serotonergic synapses. Now, in our knowledge, these complications justify a clinical and chest roentgenogram follow up for any patients treated with bromocriptine.

Aged↗

Idiopathic parkinsonism treated with bromocriptine.

The efficacy and toxicity of bromocriptine, a drug which simulates dopamine, have been studied in twenty-eight patients with idiopathic parkinsonism. A double-blind, within-patient comparison between maximum tolerated doses of bromocriptine (mean 46-9 mg daily) and placebo revealed a substantial and statistically significant therapeutic response to the active drug. Adverse reactions were dose dependent, reversible, and similar to those encountered with levodopa. While taking bromocriptine fourteen patients were able to stop levodopa (with or without carbidopa); in five patients the dose of levodopa was reduced by 54% (mean). Eight patients could not tolerate bromocriptine; one patient failed to comply with prescribed adjustments of dosage.

Aged↗