[Bromocriptine and tamoxifen--a new therapeutic approach in suppression-resistant prolactin-secreting adenomas]

In the present study the combination of tamoxifen and bromocriptine was tried for the suppression of prolactin in prolactin secreting adenomas which were resistant to suppression with bromoergocriptine alone. 10 women under treatment with 2.5-10 mg of parlodel (bromocriptine) for pituitary tumours of various sizes were additionally treated with tamoxifen 10-20 mg. (nolvadex) daily. Two patients had a previous incomplete resection for chromophobe adenomas. The other patients refused operation. Two women were also studied who did not tolerate a bromoergocriptine therapy because of side effects. In 6 of the 10 women with combination treatment a satisfactory suppression of the prolactin was observed. Four women were cleared of their amenorrhoea and galactorrhoea. One woman conceived. One woman lost her frigidity. Three women, among those the two with severe side effects from bromoergocriptine, tolerated the combined treatment well. Four women showed no success with the combined treatment. The effectiveness of the combined treatment was not correlated with the size of the tumour nor the clinical or biochemical baseline. The results lead to the conclusion that tamoxifen is capable of improving the suppression of prolactin or render the adenomas suppressible in a large number of cases.