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Drug treatment of hyperprolactinemia
P Chanson1, F Borson-Chazot, O Chabre
1Service d'endocrinologie et des maladies de la reproduction, hôpital de Bicêtre, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France. philippe.chanson@bct.ap-hop-paris.fr
Annales D'Endocrinologie
|May 29, 2007
Summary
Dopamine agonists effectively treat hyperprolactinemia in most cases. Treatment adjustments and monitoring are key for managing resistance, intolerance, and tumor size, with careful follow-up after discontinuation.
Area of Science:
- Endocrinology
- Pharmacology
- Oncology
Background:
- Hyperprolactinemia is commonly treated with dopamine agonists (DA).
- DA therapy is effective in over 80% of cases, normalizing prolactin levels and restoring ovulatory cycles.
- Treatment strategies must address drug resistance, intolerance, and tumor management.
Purpose of the Study:
- To outline the medical treatment of hyperprolactinemia using dopamine agonists.
- To detail monitoring protocols for macroprolactinomas and microprolactinomas.
- To discuss management strategies for drug-induced hyperprolactinemia and treatment discontinuation.
Main Methods:
- Review of dopamine agonist (bromocriptine, lisuride, quinagolide, cabergoline) efficacy and tolerability.
- Magnetic resonance imaging (MRI) monitoring protocols for macroprolactinomas.
- Assessment of treatment discontinuation and management of drug-induced hyperprolactinemia.
Main Results:
- Dopamine agonists normalize prolactin levels and restore ovulatory cycles in most patients.
- Cabergoline and quinagolide are generally better tolerated than bromocriptine.
- MRI monitoring is crucial for macroprolactinomas; less so for microprolactinomas.
- Discontinuation of DA therapy may lead to prolactin level increase in 20-30% of cases, especially with residual adenoma.
Conclusions:
- Dopamine agonists are the first-line treatment for hyperprolactinemia and prolactin-secreting adenomas.
- Individualized treatment adjustments and monitoring are essential for optimal outcomes.
- Careful follow-up is necessary after DA discontinuation to detect potential relapse.
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