Related Experiment Video

Updated: Jul 19, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Management of resistant prolactinomas

Agusta Olafsdottir1, Janet Schlechte

  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine at the University of Iowa in Iowa City, IA 52242, USA.

Nature Clinical Practice. Endocrinology & Metabolism
|October 7, 2006
PubMed

Insights

Dopamine agonist resistance in prolactin-secreting pituitary tumors is linked to D2 receptor loss. Cabergoline is effective when other agonists fail, with surgery or radiation reserved for refractory cases.

Area of Science:

  • Endocrinology
  • Neurosurgery
  • Oncology

Background:

  • Prolactin-secreting pituitary tumors (prolactinomas) can become resistant to dopamine agonist therapy.
  • This resistance is often associated with a loss of pituitary D2 receptors.
  • Resistance occurs in both microadenomas and macroadenomas.

Purpose of the Study:

  • To review treatment strategies for dopamine agonist-resistant prolactinomas.
  • To highlight the efficacy of different dopamine agonists and alternative therapies.

Main Methods:

  • Review of existing literature on dopamine agonist resistance in prolactinomas.
  • Analysis of treatment outcomes for various therapeutic interventions.

Main Results:

  • Cabergoline demonstrates superior efficacy compared to other dopamine agonists like bromocriptine and quinagolide.
  • Tumors resistant to other agonists frequently respond to cabergoline.
  • Treatment goals focus on restoring gonadal and neurological function, not solely on normalizing prolactin levels or reducing tumor size.

Conclusions:

  • Maximizing dopamine agonist dosage, switching agonists (especially to cabergoline), or considering surgery/radiation are key treatment options.
  • Trans-sphenoidal surgery is indicated for patients intolerant to or failing medical therapy.
  • Radiation therapy is a last resort for medically and surgically refractory prolactinomas.

More Related Videos

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection02:22

Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection

Published on: April 12, 2024

Related Concept Videos

Psychosis: Goals of Pharmacotherapy01:26

Psychosis: Goals of Pharmacotherapy

Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...
Parkinson's Disease: Treatment01:24

Parkinson's Disease: Treatment

Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
Treatment Resistent Cancers02:56

Treatment Resistent Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Pulmonary Tuberculosis V01:28

Pulmonary Tuberculosis V

Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
Drug Therapy01:28

Drug Therapy

The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications