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PubMed2003

[Efficacy of oral bromocriptine in protecting the postpartum systemic lupus erythematosus patients from disease relapse].

OBJECTIVE: To explore the efficacy of oral bromocriptine in protecting the postpartum patients with systemic lupus erythematosus (SLE) from disease relapse. METHODS: The research strategy was a randomized controlled trial. 68 consecutive pregnancy patients with SLE from July 1995 to June 2002 followed up in the teaching hospital were included in the study. The patients were randomly divided into the treatment group and the control group according to their expected date of confinement. The patients in the treatment group had bromocriptine (2.5 mg bid) for 14 days started within 12 hours of postpartum and didn't nurse their infants. The patients in the controlled group didn't have any treatment of influence on prolactin or other sexual hormones. 21 patients nursed and 13 didn't nurse their infants in the controlled group. All patients were followed up for 12 months. RESULTS: The serum prolactin and estradiol levels in treatment group were lower than in nursing controlled group and in non nursing controlled groups, at second week and second month after delivery. The relapse rate in the treatment group was lower than in nursing controlled group and in non nursing controlled groups. The result of Log-rank test was chi(2) = 8.90, P = 0.007 5 comparing three group data of following up with SLEDAI increase 3 as endpoint. The number needed treatment was 3.1, 95% CI (1.9-8.5). Accumulative doses of prednisone within the 12 months were (3.90 +/- 1.82) g in the treatment group and (8.92 +/- 3.36) g in the controlled group, P < 0.001, and cyclophosphamide were (1.41 +/- 0.83) g in the treatment group and (4.27 +/- 2.38) g in the controlled group, P < 0.001. CONCLUSIONS: Oral bromocriptine for 2 weeks in postpartum patients with SLE may relieve the disease from hyperprolactinemia and hyperestrogenemia, and may be beneficial in protecting the patients from disease relapse and in reducing the usage of steroid and immunosuppressant.

Administration, Oral↗
PubMed1992

Bromocriptine-induced implantation failure in mice: failure of the stud male to protect pregnancy.

The presence of the stud male failed to prevent implantation failure in newly inseminated females induced by administration of bromocriptine. This is in contrast with the ability of the stud male to prevent implantation failure in females induced by alien male exposure, and nutritional stress. Since bromocriptine is a potent inhibitor of hypophysial prolactin release by virtue of its stimulatory effect on hypothalamic dopaminergic activity, the results suggest that the stud male-originating luteotrophic stimulus is incapable of overriding the dopaminergic activity in bromocriptine-treated females.

Animals↗
PubMed2004

The combined oral contraceptive pill versus bromocriptine to suppress lactation in puerperium: a randomized double blind study.

A randomised double blind comparative study of 230 HIV infected mothers who had a normal delivery at 37-42 weeks' gestation were divided into two groups; 116 combined pill users and 114 bromocriptine users to suppress lactation. There were 33 cases (28.5%) of combined pills users and 29 cases (25.4%) of bromocriptine users who had breast engorgement without statistical difference. All of them had mild breast engorgement without any treatment except one case (0.9%) in the bromocriptine group had severe breast engorgement with puerperal fever and needed an analgesic drug. There were no side effects of the drugs. This study showed that combined pills were beneficial to suppress lactation in HIV infected mothers to prevent postnatal mother-to-child transmission because of low risk and low cost.

Adult↗
PubMed1992

Associated effects of bromocriptine on neoplastic progression of mouse mammary preneoplastic hyperplastic alveolar nodule line C4 and on hyperplastic alveolar nodule-infiltrating and splenic lymphocyte function.

Progression of the mouse mammary preneoplastic hyperplastic alveolar nodule (HAN) line C4 to carcinoma can be enhanced by stimulators and depressed by inhibitors of host lymphocyte function (W.Z. Wei et al., Cancer Res., 49: 2709-2715, 1989). The purpose of the present study was to ask whether prolactin (PRL), a regulator of both mammary epithelial and lymphoid cells, might be a factor in the association between lymphocytic function and HAN progression. Daily administration of bromocriptine, a suppressor of pituitary PRL secretion, increased the latency period and decreased the incidence of tumor development in HAN bearing mice. Bromocriptine treatment suppressed in vitro responsiveness of HAN-infiltrating lymphocytes and, to some extent, spleen cells, to T- and B-cell mitogens, without altering the relative proportion of lymphocytic subsets. Suppression could be partially reversed by PRL treatment. Natural killer cell activity of HAN-infiltrating lymphocytes was also reduced by bromocriptine. In vitro incubation with anti-PRL antisera inhibited both lymphocyte mitogen responsiveness and natural killer activity in a concentration-dependent manner. PRL reversed this inhibition also. Altogether, these results demonstrate a correlation among tumor development, PRL levels, and lymphocyte function and suggest that an immune-endocrine network involving PRL may play a role in C4 HAN progression.

Animals↗
PubMedDate not supplied

[Use of Bromocriptin tablets in physiologic and pathologic hyperprolactinemia].

The authors used Bromocriptine tablet, made by Chemical Works of Gedeon Richter Ltd. in 11 cases to alleriate a physiological milk secretion and in 15 cases as a treatment for extra-puerperal galactorrhea. Under treatment the serum prolactin level dropped exponentially while under Norcolut administration a linear regression was shown and the mammary activity abated after 14 days. The best method for treating the physiological hyperprolactinemia is to give the Bromocriptine before starting milk secretion. In cases of extra-puerperal galactorrhea. The patients become free from complaint after 8 weeks. In both cases the dose was 5-7.5 mg Bromocriptine. When galactorrhea and amenorrhoea occur together during the treatments second month menstruation begins and in two cases unwanted pregnancies happened. It has been found that the latent functional hyperprolactinemia can also be galactorrhea. The result were verified in ten cases by testing the metoclopramide-burden.

Adult↗
PubMed2005

[Akinetic mutism related to hydrocephalus and cerebellar surgery treated with bromocriptine and ephedrine. A pathophysiological review].

Akinetic mutism (AM) is a behavioral disorder characterized by impossibility to move or speak in awake patients. lt has been typically described as a transient disorder following posterior fossa tumour resection. Besides, AM may also appear after recurrent shunt failures in hydrocephalic patients, with no tendency towards improvement, either spontaneously or with shunt revisions. However successful treatment of this second type of AM has been achieved with bromocriptine. We present a patient who developed AM after a posterior fossa surgery complicated by ventriculitis and multiple hydrocephalic events. AM only improved with bromocriptine. We review AM pathophysiology. Although not well known, it appears to be quite different, depending on its cerebellar or hydrocephalic origin. Damage to dentate nucleus or its efferents (mainly of glutamate) should promote AM of cerebellar origin, while damage to paraventricular monoaminergic pathways could explain AM related to repeated shunt failures which has successful response to bromocriptine treatment. However, a more complete study of this disorder is required to ascertain its aetiology.

Akinetic Mutism↗
PubMed2005

[Synergistic effect of bromocriptine combining tumor necrosis factor-alpha on reversing multidrug resistance in a nude mouse model of liver neoplasm].

OBJECTIVE: To investigate synergistic effect of bromocriptine (BCT) combining tumor necrosis factor-alpha (TNF-alpha) on reversing multidrug resistance in a nude mouse model of liver neoplasm. METHODS: Human hepatocarcinoma cell line HepG(2) (HepG(2) group), drug resistant hepatocarcinoma cell line HepG(2)/adriamycin (HepG(2)/ADM group) and hepatocarcinoma cell line transfected with TNF-alpha gene HepG(2)/ADM/TNF (TNF group and BCT group) were injected into the liver of nude mice via orthotopic implantation to establish multidrug resistance model of liver neoplasm in vivo. All the mice were injected with 5-fluouracil + adriamycin + mitomycin in abdominal cavity for 7 d. The mice in BCT group was simultaneously given bromocriptine through gastric canal. Size and weight of the tumor were measured. Furthermore tumor histological character and growth of the nude mice was observed and its chemosensitivity was tested. MDR associated genes and proteins (MRP, LRP) of implanted tumors were detected by immunohistochemical staining and reverse transcriptive polymerase chain reaction (RT-PCR), and apoptosis rate of hepatocarcinoma cells was detected by TUNEL assay. RESULTS: The nude mouse model of each cell line was all inoculated successfully. The tumor growth rate and weight were significantly different among groups (P < 0.05). After chemotherapy tumor growth inhibition rate was higher in BCT group (67%) compared to ADM and TNF groups (P < 0.01), and similar to HepG(2) group (54%). MDR1 and LRP mRNA could be detected in all groups, but TNF-alpha was detected only in TNF-alpha and BCT groups. Furthermore, MDR1 and LRP protein expression of tumors in TNF-alpha and BCT groups was low similar to HepG(2) group. The apoptosis rate of hepatocarcinoma cells was much higher in BCT group than in other groups (P < 0.05) with TUNEL assay. CONCLUSIONS: TNF-alpha gene can down-regulate the MDR associated genes and proteins expression for example MDR1, LRP, and lower its tumorgenesis. Moreover, bromocriptine can enhance the susceptibility of HepG(2)/ADM cells to cytotoxic drugs.

Animals↗
PubMed1991

[Pleural effusion and constrictive pericarditis secondary to bromocriptine treatment].

The case of a 60 year old patient with Parkinson's disease is reported, who, following 2 years of treatment with bromocriptine, presented a left pleural effusion in which chronic constrictive pericarditis was demonstrated. Studies aimed at establishing the etiology were negative. Upon withdrawal of bromocriptine, the pleural effusion disappeared and the patient remained asymptomatic, with only pleural thickening persisting in the thoracic radiography. The appearance of polyserositis as an undesirable effect of the use of bromocriptine is discussed. The first case associated to chronic pericarditis is reported.

Bromocriptine↗
PubMed1991

The levels of pituitary-testicular axis hormones and SHBG in active acromegaly following bromocriptine treatment.

Pituitary and testicular hormone secretion and sex-hormone binding globulin (SHBG) level were investigated in 15 males with active acromegaly in normal and hyperprolactinemic state. Basal serum folitropin (FSH) and lutropin (LH) levels did not change before and after the administration of bromocriptine and remained in normal range compared with those in healthy men. Serum total testosterone concentration and SHBG were decreased particularly in hyperprolactinemic patients, but their levels were significantly increased to the normal limits following bromocriptine application. Although slight changes in serum concentration of free testosterone (fT) and circadian rhythm of fT in saliva was observed before and following bromocriptine treatment, the statistical differences were not significant. The results of the present study suggest that in acromegaly the alterations in peripheral metabolism of sexual steroids may exist.

Acromegaly↗
PubMed1991

[Short-term effect of delayed-action injectable bromocriptine in macroprolactinoma. French multicenter study].

In this prospective multicenter trial, 61 patients presenting with a macroprolactinoma were studied over a 1 month-period following a single 50 mg intragluteal injection of the long-acting repeatable (L.A.R.) form of bromocriptine. The effects of the drug were evaluated mainly by repetitive plasma prolactin measurements on days 1, 3, 7, 14 and 28 after injection, and by repeated visual-field and computed tomography scanning examinations. Normalization of PRL levels was obtained in 23% of patients during the first month following injection. In 6 patients (9.8%), PRL values remained within normal range on day 28 after injection. In these latter patients, PRL levels were significantly lower than in the patients whose PRL values were not normal on day 28 (312 +/- 111 vs 2454 +/- 484 ng/ml [m +/- SEM]). The mean lowest PRL levels were achieved on day 3. The mean percent maximal decrease in PRL levels ranged between 70 and 72% from days 3 to 14 but constantly remained below 50% in 6 patients. An improvement in visual field was observed by day 7 in 45% of patients presenting initially with visual field defects. In particular, in half of the patients with bilateral quadranopsia or hemianopsia, such visual impairments had disappeared after 1 month of treatment. Computed tomography scanning examinations showed in 11% of the patients a more than 20% reduction in tumor mass by day 7 following injection. On day 28, the percent reduction in tumor size was 20-40% in 28% and above 40% in 10% of the patients. Most adverse effects (digestive symptoms, dizziness, postural hypotension) were observed during the first 24 hours of treatment. Local and systemic tolerability was in general good. In macroprolactinoma patients, a single 50 mg injection of bromocriptine LAR was thus able to achieve in the short-term a clear cut reduction in tumor size in 2/5 patients and normalization of PRL levels in 1/10 of patients. A study of the effects of monthly administration of bromocriptine LAR is currently under progress to assess the long-term efficacy of this drug.

Adult↗
PubMed1991

Bromocriptine-associated headache: possible life-threatening sympathomimetic interaction.

We present two cases of severe headache associated with the use of bromocriptine for lactation suppression in otherwise healthy women. In each case, the additional use of a therapeutic sympathomimetic agent resulted in extreme worsening of symptoms with development of hypertension and life-threatening complications (ventricular tachycardia and cardiac dysfunction in one case, seizures and cerebral vasospasm in the other). Sympathomimetics in combination with bromocriptine in patients with a bromocriptine-associated headache during the puerperium may be dangerous.

Adult↗
PubMed1990

[Bromocriptine-associated postpartum psychotic exacerbation].

2 cases are presented in which bromocriptine (Parlodel) was administered to suppress physiological lactation; parturition had precipitated deterioration in mental status and psychotic behavior. Discontinuation of bromocriptine and administration of antipsychotic medication resulted in gradual improvement in the psychotic symptoms, without complications of galactorrhea or breast engorgement. We recommend that changes in mental status be looked for when bromocriptine is given.

Adult↗
PubMed1990

Psychiatric applications of bromocriptine therapy.

Bromocriptine, an ergot alkaloid derivative that possesses both dopamine agonist and antagonist activity, has been studied in a broad spectrum of psychiatric illnesses. The literature consists primarily of case reports and small trials limited by methodological shortcomings. The authors critically review these reports, focusing on efficacy, mechanistic issues, dosing, side effects, predictors of response, monitoring parameters, and practical guidelines. Preliminary data suggest bromocriptine may have promise in the treatment of neuroleptic malignant syndrome, cocaine withdrawal, and depression. At present, the agent appears less efficacious in the treatment of tardive dyskinesia, mania, and schizophrenia; however, doses in these trials may have been excessive, producing primarily postsynaptic agonist effects. More extensive clinical trials are required to clearly define the role of bromocriptine in psychiatry.

Bromocriptine↗
PubMedDate not supplied

Bromocriptine versus progesterone therapy for infertility related to luteal phase defects in hyperprolactinemic patients.

Several anecdotal reports suggested an association of luteal phase defects (LPD) and hyperprolactinemia. Some physicians treat LPD with ovulation-inducing drugs, whereas others recommend progesterone support of the luteal phase. A study was thus initiated to evaluate in cases of LPD associated with hyperprolactinemia which therapy would be more efficacious--bromocriptine or progesterone (P). LPD was divided into two types based on follicle dynamic studies: (1) LPD associated with immature follicles and (2) pure LPD when the follicle was mature. The objective was to determine if P or bromocriptine would be more effective depending on the type of LPD. Randomized therapy with either bromocriptine (BCT) or progesterone vaginal suppositories (PVS) was given to 60 patients with pure LPD (established by endometrial biopsy in the late luteal phase) and similarly randomized therapy was given to 40 women with LPD and immature follicles. The incidence of pregnancies during an 8-month treatment period was as follows: pure LPD--23 of 50 women (77%) treated by PVS versus 5 of 30 women (17%) treated by BCT; LPD associated with immature follicles--3 of 20 women (15%) treated by PVS versus 14 of 20 women (70%) treated by BCT. Those women failing to conceive were now given the alternate therapy for the next 8 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Effect of bromocriptine and progesterone on the length of the ovarian cycle in 4- and 5-day estrous cyclic rats.

To study the effect of prolactin and progesterone on the length of the reproductive cycle in the rat, rats of different estrous cycle length (four and five days, respectively) were injected daily (09.00 h) with either bromocriptine (1 mg/rat) or 70% ethanol vehicle (0.25 ml) from the day of estrus onward, up to the appearance of the next ovulation. Each group of rats was then (16.00, metestrus) also injected with either progesterone (4 mg/rat) or 0.2 ml of olive oil. The effects of these treatments on the length of the estrous cycle was studied by both the recording of vaginal smears daily and by direct visualization of oocyte-cumulus complexes on the ensuing day of estrus (10.00 h-12.00 h). Bromocriptine treatment shortened the length of the cycle by one day in 5-day but not in 4-day cyclic rats, while progesterone treatment lengthened estrous cycles by one day in both groups of rats. Treatment with both bromocriptine and progesterone had no effect on the estrous cycle length of 5-day cyclic rats, but did prolong in one day the cycle of 4-day cyclic rats. These facts suggest that prolactin regulates the length of the ovarian reproductive cycle in the rat through its action on the secretion of progesterone by the corpus luteum.

Animals↗
PubMedDate not supplied

[The effect of prolactin and bromocriptine on testicular incretory function].

Prolactin (PRL) is synthesized by lactotropic pituitary cells. The corresponding hormonal preparations is dispensed as lactin. Bromocriptine is a dopamine agonist, dopamine being a natural inhibitor of PRL-secretion. PRL receptors in the testis are located on the interstitial cells. PRL effect on the testis depends on the age and species of animals. In the immature animals as well as in the photoperiodic ones PRL stimulates the testis development and the testicular secretion; bromocriptine decreases androgen concentration. In the postpubertal animals PRL is a melatonin antagonist in the dark time but LH synergist at the exposure to light. A high PRL concentration inhibits gonadoliberin formation, LH secretion; testosterone concentration and especially dihydrotestosterone concentration decrease (or do not change) with an elevation of estradiol level that on the whole results in feminization. The cerebral transmitters promoting or inhibiting sexual behavior are involved in the interaction with PRL. Administration of PRL, experimental or pathological hyperprolactinemia are followed by the suppression of ejaculation. Bromocriptine (parlodel) appears to be a pathogenetic therapeutic agent in hyperprolactinemia.

Aging↗
PubMedDate not supplied

[A case of toxic psychosis caused by bromocriptine].

We present a short review of literature concerning the problem of bromocriptine-induced psychosis A case of toxic psychosis following treatment on bromocriptine in an acromegalic patient who had previously undergone hypophysectomy is also reported. On two occasions after having received low doses of bromocriptine for several months, the patient developed a psychotic syndrome characterized by violent behaviour, auditory hallucinations, paranoid misinterpretation, threatening delusions and depersonalization, which lasted several weeks. On treatment with neuroleptics, the symptoms gradually remitted. In the context of the reviewed literature, an outstanding feature of the case is the absence of psychiatric history, which is not frequent, but not unlikely in the published case-reports. This reassures the authors' on the unespecificity of psychiatric syndromes, broadly discussed in our own and other colleges' references.

Acromegaly↗
PubMed1989

Successful treatment of a prolactin-producing pituitary macroadenoma with intravaginal bromocriptine mesylate: a novel approach to intolerance of oral therapy.

A 37-year-old woman with a symptomatic 18-mm prolactin-secreting pituitary adenoma could not be managed with oral bromocriptine mesylate because of unacceptable gastrointestinal side effects. However, when given the medication intravaginally, the patient was successfully treated as assessed by evident tumor shrinkage and diminished secretory activity. Serum bromocriptine levels were approximately six to eight times higher than those reported after oral administration. The vaginal route may help reduce some of the adverse effects of bromocriptine mesylate experienced during oral administration and may possibly allow lowering of the overall effective dose by avoiding first liver passage.

Administration, Intravaginal↗