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Long term bromocriptine therapy in Cushing's disease.
Journal of Endocrinological Investigation
|March 1, 1982
Summary
Bromocriptine can acutely inhibit ACTH secretion in Cushing's disease. Long-term use as sole therapy provided a temporary benefit, suggesting dopaminergic pathways mediate this effect on the hypothalamic-pituitary-adrenal axis.
Area of Science:
- Endocrinology
- Neuroendocrinology
Background:
- Bromocriptine is established for hyperprolactinemia and acromegaly.
- Its acute inhibitory effect on ACTH secretion in Cushing's disease is noted.
- Limited data exist on chronic bromocriptine therapy for Cushing's disease.
Observation:
- A patient with Cushing's disease experienced acute ACTH and cortisol inhibition with bromocriptine.
- Long-term administration of bromocriptine as monotherapy resulted in a transient positive response.
- Pharmacologic tests indicated dopaminergic stimulation mediated the hypothalamic-pituitary-adrenal axis inhibition.
Findings:
- Bromocriptine demonstrates acute inhibitory effects on the hypothalamic-pituitary-adrenal axis in Cushing's disease.
- Chronic bromocriptine monotherapy offers a transient therapeutic benefit.
- Dopaminergic pathways are implicated in bromocriptine's action on ACTH and cortisol secretion.
Implications:
- Bromocriptine's role in managing Cushing's disease warrants further investigation, particularly regarding long-term efficacy.
- Understanding the dopaminergic mechanism may reveal new therapeutic strategies for pituitary disorders.
- This study highlights the potential, albeit transient, utility of bromocriptine in specific endocrine conditions.