Bromocriptine Reduces Pituitary Tumor Size and Hypersecretion

Abstract

Twelve patients with pituitary tumor whose prior treatment included surgery and radiotherapy in four, surgery alone in four, radiotherapy alone in one, and none in three were studied. Nine had hyperprolactinemia, two had elevated serum growth hormones, and one had no pituitary hormone excess. Visual field defects were present in six. All had pituitary-gonadal insufficiency manifested as impotence or amenorrhea. All were tested with bromocriptine, 7.5 to 25 mg daily, and followed up for eight to 27 (mean 15) months. Serum prolactin levels decreased to normal in seven of nine patients. Serum growth hormone values were normalized in both acromegalics. When hormone levels were reduced to normal, pituitary tumor size decreased. Vision was restored to normal in five of six patients, including one patient with pituitary tumor but no pituitary hormone excess. Bromocriptine corrects the physiological defects associated with pituitary tumors that have been incompletely treated with surgery, radiotherapy, or both and may be a useful primary treatment for patients with pituitary tumors.

Hyperprolactinemia Blunts Awareness of Distress and Depression: Evidence for a Specific Behavioral and Environmental Setting for Galactorrhea - Amenorrhea

“…29,30 Chemotherapy-induced tumor reduction, however, has replaced surgery as the principal initial course of management. 31,32 However, in some instances, recurrence of hyperprolactinemia invariably follows discontinuation of the treatment.…”

Management of acute hypercortisolism

“…The purpose in using these drugs is an attempt to suppress secretion of ACTH by the pituitary gland. Theoretically, these drugs should be most effective in patients with a disorder of the CRF/ACTH regulatory mechanism and in patients with Cushing's disease due to microadenomas [26][27][28][29][30][31][32].…”

“…It activates dopaminergic cells in the pituitary and may inhibit pituitary ACTH secretion in some patients with pituitary-dependent Cushing's disease. It has proven effective in the treatment of prolactin-and growth hormone-producing adenomas, but its usefulness in Cushing's disease remains to be proven [29,30].…”

Prolactinomas: Aspectos neurocirúrgicos

“…Spark et al 10 afirmam que a abordagem terapêu-tica inicial é clínica, empregando-se agonistas dopaminérgicos, em particular a bromoergocriptina, um alcalóide derivado do ergot, com vida média de 8 a 12 horas, que atua inibindo a síntese e a secreção da prolactina. De acordo com Dananberg e Dalkin 11 , em pequenos adenomas, com níveis de prolactina inferiores a 100 ng/mL, podemos conseguir cura com o tratamento clínico.…”