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PubMed1981

Prolactinomas and optic nerve compression: disappearance of suprasellar extension and visual recovery after two weeks bromocriptine treatment.

4 patients with prolactinomas and visual field defects are presented. 2 were treated with bromocriptine alone; 1 patient with an 8-month history of visual disturbance had complete recovery of visual fields after 2 weeks and an acute fall in serum prolactin levels. This coincided with disappearance of the suprasellar extension on computer tomography (CT) scanning. The second patient, with a 2-year history, had no visual improvement after 1 year of treatment, although CT scanning showed absence of the suprasellar extension when repeated after 3 months. 2 other patients initially had neurosurgery; 1 with a 2-year history had complete visual recovery, the other with a 1-year history did not recover. Both needed subsequent bromocriptine treatment. In all 4 patients this drug produced a sustained fall in serum prolactin levels. We conclude that bromocriptine therapy can rapidly reduce prolactinoma tumor size and should obviate the necessity for acute neurosurgical intervention in carefully selected patients.

Adenoma↗
PubMed1984

Effect of bromocriptine on serum hormones in acromegaly.

Clinical and hormonal responses to bromocriptine therapy were assessed in 10 patients with acromegaly. Although substantial falls (greater than or equal to 50%) in serum GH occurred in only 4 of the patients, subjective clinical improvement and improved glucose tolerance were seen in 9, including 2 subjects in whom serum GH rose in response to bromocriptine. Serum somatomedin levels, measured by both radioimmunoassay and radioreceptor assay, fell in only 2 subjects (both of whom had falls in GH) and did not correlate with clinical status. These results suggest that some of the reported beneficial effects of bromocriptine in acromegaly may be independent of GH secretion or somatomedin generation.

Acromegaly↗
PubMed1985

Prolactin levels in pregnancy: comparison of normal subjects with patients having micro- or macroadenomas after early bromocriptine withdrawal.

14 previously infertile patients, 11 with radiologically abnormal fossae, and a mean prolactin level of 761 ng/ml (range 49-4,500 ng/ml) conceived on 19 occasions during bromocriptine treatment. So far, 15 healthy infants have been delivered. Treatment was withdrawn soon after conception and the subsequent prolactin changes compared with those of 44 normal subjects. Prolactin levels returned to pretreatment values in 7, but stayed within our normal range (less than 350 ng/ml) in the 6 remaining patients studied. No patient developed signs or symptoms of tumor enlargement. 2 patients, 1 of them with the largest tumor, have now normal prolactin levels and can be considered as cured. Bromocriptine treatment can restore fertility and be safely withdrawn during pregnancy even in patients presenting with large tumors. Nevertheless, patients should be carefully monitored and treatment with bromocriptine re-introduced if necessary.

Adenoma↗
PubMed1985

Bromocriptine treatment in tall adolescents: two years of clinical experience.

34 adolescents referred for excessive height prediction (HP) (11 boys with HP greater than 196 cm, 23 girls with HP greater than 180 cm) were treated for 9-15 months with bromocriptine (5-7.5 mg/day). Minor and transient side effects were observed in 20% of the subjects at the beginning of the treatment. Treatment had to be stopped in 1 boy complaining of asthenia and headache. Puberty developed normally, 19 girls experienced menarche during treatment and 1 continued regular menses. Bromocriptine treatment induced: (1) a significant decrease (p less than 0.001) in growth velocity from (mean +/- SEM) 8.6 +/- 0.4 to 5.3 +/- 1.5 cm/year in boys and from 7.1 +/- 0.2 to 4.6 +/- 0.6 cm/year in girls; (2) a twofold mean increase in skeletal maturation rate. Adult HP was reduced significantly from 202 +/- 1.4 to 195.4 +/- 1.2 cm in boys, and from 184 +/- 0.7 to 179.8 +/- 0.7 in girls. These results confirm our previous report suggesting that bromocriptine is a valuable alternative to sex steroid treatment in order to limit the final height in excessively tall adolescents.

Adolescent↗
PubMed1986

Extrasellar prolactinomas: successful management of 24 patients using bromocriptine.

24 patients with an extrasellar prolactinoma (mean prolactin 4,722 ng/ml), 8 of whom had previously had surgery, received 5-40 mg bromocriptine daily for 13-252 weeks. The mean prolactin level had fallen 89% at 2 days, 95% at 6 weeks, and 15 patients achieved normal values. Tumor shrinkage occurred in all 9 patients rescanned within 2 weeks and later was documented in 23; in 18 the extrasellar tumour disappeared. 12 patients had visual abnormalities; 7, including 2 who had been completely blind, improved within 1 week. 2 patients had normal prolactin levels after withdrawal of bromocriptine, 1 following radiotherapy and the other during two uncomplicated pregnancies. Bromocriptine is safe and effective. We conclude that medical treatment should always precede surgery unless pituitary apoplexy causes sudden deterioration of vision. Most patients will subsequently require radiotherapy or surgery for permanent cure.

Adult↗
PubMed1988

Effect of bromocriptine on secretion and morphology of human prolactin cell adenomas in vitro.

The direct effect of short-term bromocriptine administration on human prolactin cell adenomas in vitro was studied by light and electron microscopy and correlated with the effect on hormone release. The light microscopic and, for the first time, ultrastructural characteristics of adenomatous prolactin cells in control and treated cultures were analyzed morphometrically and the changes induced by bromocriptine were quantified. Following 72 h treatment which lowered levels of prolactin release, there was a marked reduction in cell size, cytoplasmic volume and cytoplasmic volume densities of endoplasmic reticulum and Golgi apparatus. In contrast, the percentage of cytoplasm occupied by lysosomes increased. There was no consistent change in number and diameter of secretory granules. These findings indicate that prolactin cell involution is a direct effect of bromocriptine and suggest that reduction in endoplasmic reticulum and Golgi complex is largely responsible for the decreased cell size. Lysosomal degradation of cytoplasmic components may play a role in this process.

Adult↗
PubMed1989

Rapid improvement of visual defects with parenteral depot-bromocriptine in a patient with a non-functioning pituitary adenoma.

The management of non-functioning pituitary adenomas with bromocriptine is controversial, and surgical treatment is usually prescribed when the visual field is affected. Here we report, what we believe to be the first case of a patient with a non-functioning pituitary adenoma who experienced normalization of visual field defects and a substantial improvement in visual acuity after the parenteral administration of depot-bromocriptine. The patient's tolerance to the drug was excellent. The results of the immunohistochemical study of the surgically removed tumor were negative for PRL, GH, LH, FSH, TSH and ACTH. In our opinion, the use of depot-bromocriptine may represent an alternative to surgery in patients with non-functioning pituitary adenomas associated with visual lesions.

Adenoma↗
PubMed1993

Efficacy of bromocriptine administration for selective pituitary resistance to thyroid hormone.

The relation between thyroid-stimulating hormone (TSH) and triiodothyronine (T3) was evaluated in a girl with the selective pituitary type of thyroid hormone resistance for more than 7 years to clarify whether bromocriptine was an effective treatment or not. Levels of T3 (before: 2.44 +/- 0.64 nmol/l, mean +/- SD) and TSH (4.81 +/- 2.52 mU/l) were significantly decreased during therapy (T3: 2.15 +/- 0.44 nmol/l; TSH: 1.59 +/- 0.78 mU/l). T3 x TSH, calculated as one of the indices of pituitary resistance, on bromocriptine therapy (3.229 +/- 1.255 mU/l x nmol/l) was significantly (p < 0.005) smaller than the product before the administration (11.298 +/- 5.891 mU/l x nmol/l). The results suggest that bromocriptine should be one of the agents initially considered for the treatment of pituitary resistance to thyroid hormone.

Bromocriptine↗
PubMed1979

[Bromocriptine for palliation of advanced prostatic carcinoma. Experimental and clinical profile of a drug (author's' transl)].

Since prolactin has several modes of action on prostatic growth and physiology, the effect of the antiprolactin bromocriptine on plasma kinetics and intraprostatic metabolism of testosterone was studied in patients with untreated prostatic cancer; a therapy protocol was deduced which was controlled in 27 patients with advanced inoperable prostatic adenocarcinoma. Bromocriptine resulted in a significant suppression of prolactin and testosterone as well and favored testosterone elimination from the plasma pool. Prostatic androgen uptake was enhanced and the intraprostatic metabolism altered in relation to tumor grade. Adjunctive administration of bromocriptine to 27 patients, mostly in the state of hormone resistance, resulted in an overall objective regression of 22.2% and in stable disease in 55.6% of the patients. In half of the individuals a prompt relief of bone pain from osseous metastases was observed as well as improvement of micturition and decline of phosphatase activity. This preliminary data justify further investigations under controlled and randomized conditions.

Adenocarcinoma↗
PubMed1991

Cabergoline versus bromocriptine in suppression of lactation after cesarean delivery.

We evaluated the efficacy of cabergoline, a new ergoline derivative, in blocking puerperal lactation in a group of women delivered by cesarean section. In a single-blind controlled trial 36 women were randomly allocated to treatment with cabergoline 1 mg in a single dose p.o. (n = 18) or bromocriptine 5 mg/day p.o. for 14 days (n = 18). Treatment was started about 50 h after delivery. Clinical assessment of breast signs and determination of serum prolactin were performed just before treatment and at 3, 5, 7 and 14 days. In the cabergoline-treated group milk secretion was inhibited in 17 women (94.4%). Maximum decrease of serum prolactin was -89.7% at 5 days, and the prolactin-lowering effect of cabergoline was still present at 14 days. In the bromocriptine group milk secretion was inhibited in 16 women (88.9%). Maximum prolactin decrease (-86.9%) was reached at 3 days. Persistent side effects were comparable in the two groups. This study demonstrates that a single oral dose of 1 mg cabergoline is as effective in suppressing puerperal lactation as a full treatment with bromocriptine, even in women delivered by cesarean section.

Administration, Oral↗
PubMed1997

Central retinal vein occlusion in a woman receiving bromocriptine.

We evaluated a unilateral retinal vascular abnormality in a 34-year-old woman receiving bromocriptine mesylate for the suppression of postpartum lactation. After using bromocriptine, 2.5 mg twice daily for 1 week, the patient complained of metamorphopsia in the left eye. A central retinal vein occlusion was found. We believe that central retinal vein occlusion in patients receiving bromocriptine, as demonstrated in our patient, is rare.

Adult↗
PubMed1981

Human benign prostatic hypertrophy: role of prostaglandin E2 and its relationships to bromocriptine therapy.

To examine the mechanism of bromocriptine effects in patients suffering from benign prostatic hypertrophy (BPH), urinary prostaglandin E2 (PGE2) contents were investigated before and during treatment. An active PGE2 synthesis was detected within the BPH area. Yet, PGE2 concentration in urine could be related neither to the severity of disease nor to the clinical response observed in patients under bromocriptine therapy. Under treatment, a considerable urodynamic improvement was observed in 75% of patients suffering from BPH. In these cases, the prostatic hypertrophy was not markedly reduced. PGE2 urinary contents lowered under treatment provided a beneficial clinical response in patients. The results are discussed with respect to PGE2 involvement in the mechanism of action of prolactin. It is suggested that a direct role of PGE2 and a local effect of bromocriptine in BPH urinary dysfunctioning of the lower urinary tract could not be excluded.

Aged↗
PubMed1995

Postpartum cerebral angiopathy possibly due to bromocriptine therapy.

BACKGROUND: Eight cases of benign angiopathy of the postpartum period have been reported previously, none of which involved the administration of bromocriptine. CASE DESCRIPTION: We describe a case of benign cerebral angiopathy in a 20-year-old woman in the postpartum period occurring after bromocriptine therapy prescribed to suppress lactation. CONCLUSIONS: Other adverse effects due to vasoconstriction have been reported during bromocriptine therapy, such as myocardial infarction and arterial hypertension. This case suggests that a similar mechanism may be possible in cerebral arteries, although the cause of vasoconstriction remains uncertain.

Adult↗
PubMed1987

Effect of bromocriptine on affect and libido in hyperprolactinemia.

Six women with primary hyperprolactinemia (mean prolactin level, 50 ng/ml) were matched with six normal women on eight factors influencing life style. Observers blind to endocrine status followed the subjects weekly for 10 weeks. Patients took bromocriptine, 2.5 mg twice daily, or placebo in a randomized double-blind sequence with crossover at 5 weeks. The mean Hamilton score for the patients was compatible with mild depression and higher than that for normal subjects during placebo but not during bromocriptine treatment. Libido was similar in both groups during placebo and bromocriptine. The mean number of orgasms reported per day was lower in patients than in normal subjects during both treatment conditions, although one patient reported orgasms during drug treatment only. Hyperprolactinemia in women may be associated with mild depression and a decrease in orgasmic frequency.

Adult↗
PubMed2004

Increasing dopaminergic activity: effects of L-dopa and bromocriptine on human sensory gating.

Schizophrenic patients show a loss of sensory gating, which is reflected in a reduced P50 suppression. Because most of the symptoms in schizophrenia can be reduced by antagonists of the dopaminergic (D2) system, the loss in sensory gating might be related to an increased dopaminergic activity. Therefore, in the present study, the effects of increased dopaminergic neurotransmisson on sensory gating in healthy volunteers were investigated. In a double-blind, balanced, placebo-controlled design, healthy male volunteers were challenged in two separate studies with either 300 mg L-dopa (precursor of dopamine) or placebo (n=16) and 1.25 mg bromocriptine (D2 agonist) or placebo (n=17). Subsequently, they were tested for their sensory gating (P50 suppression). P50 suppression values in the placebo condition were comparable to those found in literature. Although both L-dopa and bromocriptine reduced P50 amplitude, they did so in an equal ratio for both the response to the conditioning (C) and the testing (T) stimuli, therefore not resulting in a reduction of the P50 suppression ratio (T/C). In the present study, neither L-dopa nor bromocriptine reduced sensory gating in healthy volunteers. This suggests that an increased dopaminergic activity in humans is not responsible for the reduction in sensory gating as seen, for example, in schizophrenia.

Acoustic Stimulation↗
PubMed1978

Bromocriptine in the treatment of secondary amenorrhoea and ovarian dysfunction in hyper- and normo-prolactinaemic patients.

The clinical use of bromocriptine (2.5 mg twice daily) was investigated in 40 women attending an infertility clinic and presenting with secondary amenorrhoea (18) or with ovarian dysfunction (22) which had failed to respond to anti-oestrogen therapy. Patients in each group were sub-divided into those with raised and those with normal prolactin levels, and re-examined at 3 and 12 months after the start of treatment. The results confirmed that bromocriptine is effective in the treatment of hyperprolactinaemic states whether there is amenorrhoea or not. Moreover, in cases of ovarian dysfunction as well as of amenorrhoea where the prolactin levels were within the normal range, there was evidence to suggest that bromocriptine can be associated with a return of ovulation, although the mechanism by which it might do so still needs evaluation.

Amenorrhea↗
PubMed2001

Treatment of systemic lupus erythematosus with bromocriptine.

Prolactin, a lactogenic hormone, is a cytokine and an important link between the immune and endocrine systems. Prolactin stimulated disease in autoimmune NZB/NZW mice. Treatment of the mice with the prolactin-lowering dopamine agonist, bromocriptine, suppressed anti-DNA and prolonged life spans. These findings have been applied to humans with systemic lupus erythematosus (SLE). An open-label study, a double blind study, and a study comparing bromocriptine to hydroxychloroquine provided evidence that bromocriptine therapy reduced flares and suppressed disease activity in SLE.

Animals↗
PubMed1981

Effects of bromocriptine administration to pregnant rabbits upon fetal lung maturation.

If endogenous prolactin secretion is important in normal development of fetal lung surfactant, the inhibition of its secretion should be associated with delayed maturation of fetal lung. We therefore studied the effect of bromoergocriptine administration to pregnant rabbits upon lecithin content of fetal lung washes. The does were treated since the 27th day of gestation with either Mesilate of 2-Bromo-alpha-ergocriptine (C32H40BrN5O5, CH3SO3H) (Bromocriptine) (Parlodel, Sandoz) (1 mg/kg/day) or solvent twice daily until delivery. The newborns were killed immediately by intraperitoneal administration of sodium pentobarbital and tracheostomized; then lung washes were performed. The extracted lipids were plated and run on heat-activated thin layers of silica gel H. Lecithin was eluted, and phosphorus determination was performed. The level of lecithin phosphorus in the lung washes of the fetuses whose mothers received Bromocriptine was X = 2.24 +/- 0.39 microgram/g dry lung weight, whereas that of fetuses of control does was X = 6.93 +/- 2.64 microgram/g dry lung weight (P less than 0.001). The mean body weight of the fetuses from treated mothers was 38.22 +/- 6.39 g whereas that of fetuses from control rabbits was 47.63 +/- 6.94 g (P less than 0.001). The mother's body weight gain from days 26 to 30 in Bromocriptine-treated rabbits was 156.11 +/- 99.4 g, whereas that of controls was 374.38 +/- 166.21 g (P less than 0.01).

Animals↗