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Dopamine is the chemical that normally inhibits prolactin secretion, so clinicians may treat prolactinoma with drugs that act like dopamine such as bromocriptine and cabergoline. [12] This type of drug is called a dopamine agonist. [12] These drugs shrink the tumor and return prolactin levels to normal in approximately 80% of patients.
[58] [59] If the prolactinoma does not initially respond to dopamine agonist therapy, such that prolactin levels are still high or the tumor is not shrinking as expected, the dose of the dopamine agonist can be increased in a stepwise fashion to the maximum tolerated dose. [3] Another option is to consider switching between dopamine agonists.
Bromocriptine, originally marketed as Parlodel and subsequently under many brand names, [1] is an ergoline derivative and dopamine agonist that is used in the treatment of pituitary tumors, Parkinson's disease, hyperprolactinaemia, neuroleptic malignant syndrome, and, as an adjunct, type 2 diabetes.
Dopamine agonists are mainly used to treat Parkinson's disease, but also hyperprolactinemia and restless legs syndrome. [15] The side effects are predominantly collected from studies of Parkinson's disease, where dopamine agonists are commonly used as a first-line treatment with levodopa. [16]
Prolactin inhibitors are mainly used to treat hyperprolactinemia (high prolactin levels). [1] Agonists of the dopamine D 2 receptor such as bromocriptine and cabergoline are able to strongly suppress pituitary prolactin secretion and thereby decrease circulating prolactin levels, and so are most commonly used as prolactin inhibitors. [1]
These symptoms typically last anywhere from 15 minutes to an hour, but migraine pain can last longer — from four hours to three days, Cohen noted. When attacks last longer than this, it is known ...
Prolactinomas (microadenomas and macroadenomas) are most often treated with cabergoline or bromocriptine (both dopamine agonists) as the first line of treatment. [68] Medical treatment usually effectively decreases tumor size as well as alleviates symptoms. [68]
In the early stages of the disease, this can result in mild symptoms such as reduced appetite or feelings of fatigue, but as CKD progresses, "complications like high blood pressure, heart disease ...