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Treatment of hyperprolactinemia

Maya Barake, Anne Klibanski, Nicholas A Tritos
Dopamine agonists (DAs) represent a cornerstone in the management of patients with hyperprolactinemia and have an important role in the treatment of neurologic disorders, including Parkinson’s disease and restless legs syndrome. A growing body of evidence has identified impulse control disorders (ICDs) as possible adverse effects of DA therapy. A variety of ICDs may occur in patients treated with DA, including compulsive shopping, pathologic gambling, stealing, hypersexuality and punding (repetitive performance of tasks, such as collecting, sorting, disassembling and assembling objects)...
September 24, 2018: European Journal of Endocrinology
Amanpreet Kaur Kalsi, Ashutosh Halder, Manish Jain, P K Chaturvedi, J B Sharma
PURPOSE: Macroprolactinemia is characterized by predominance of macroprolactin molecules in circulation and generally has extra-pituitary origin. Macroprolactin is viewed as biologically inactive, therefore asymptomatic, and thus may not require any treatment or prolonged follow-up. In addition, data on prevalence of macroprolactinemia and its clinical manifestation are also rare. Therefore, the present study was aimed to find out prevalence of macroprolactinemia and its association, if any, with reproductive manifestations...
September 29, 2018: Endocrine
Alpesh Goyal, Mohd Ashraf Ganie
This case report describes 15-year-old identical twin sisters, who presented to us with features of polycystic ovary syndrome (PCOS). A biochemical workup revealed hyperinsulinemia and androgen excess with elevated prolactin levels. The possible etiologies for hyperprolactinemia were excluded with a detailed evaluation and it was labeled as idiopathic. Considering the fact that androgen excess could be caused by either insulin resistance or hyperprolactinemia, we decided to treat one sister with insulin sensitizer metformin and other with dopamine agonist cabergoline...
July 19, 2018: Curēus
C E Stiles, E T Tetteh-Wayoe, J Bestwick, R P Steeds, W M Drake
Context: Cabergoline is first line treatment for most patients with lactotrope pituitary tumors and hyperprolactinemia. Its use at high-dose in Parkinson's disease has largely been abandoned, because of its association with the development of a characteristic restrictive cardiac valvulopathy. Whether similar valvular changes occur in patients receiving lower doses for treatment of hyperprolactinemia is unclear, although stringent regulatory recommendations for echocardiographic screening exist...
September 11, 2018: Journal of Clinical Endocrinology and Metabolism
Pu Zhi, Yanqiong Wang, Wei Quan, Yanli Su, Hui Zhang
Hyperprolactinemia is a common side effect of antipsychotic drugs. Although changes of antipsychotic drugs or reduction of their doses can solve this problem, a modification of the treatment regimen can lead to instability in patients. Herein, we followed up a patient with elevated prolactin caused by paliperidone and found that the prolactin level was decreased after the administration of a combination with a low-dose aripiprazole. In addition, we summarized and analyzed the findings from the case and the literature review conducted...
2018: Neuropsychiatric Disease and Treatment
Martin Cloutier, Mallik Greene, Maëlys Touya, Patrick Gagnon-Sanschagrin, Annie Guerin
AIMS: Antipsychotic medications are associated with an increased risk of hyperprolactinemia, but differ in their propensity to cause this complication. This study aimed to assess the economic burden of hyperprolactinemia, and to compare its risk among adult patients using atypical antipsychotics (AAs) with a mechanism of action associated with no/low vs high/moderate prolactin elevation. METHODS: This retrospective cohort study was based on US Commercial and Medicaid claims databases...
September 26, 2018: Journal of Medical Economics
Sridevi Atluri, Vijaya Sarathi, Amit Goel, Rakesh Boppana, C Shivaprasad
Background: Recent increase in the non-specific use of prokinetics in clinical practice may alter the etiological profile of hyperprolactinemia and galactorrhea. Hence, we have studied the etiological profile of patients presenting with galactorrhea and characteristics of drug-induced galactorrhea. Materials and Methods: This retrospective study was conducted at a tertiary health care center from South India. Patients who presented with or referred for galactorrhea and/or hyperprolactinemia to the Department of Endocrinology between January 2017 and December 2017 were included in the study...
July 2018: Indian Journal of Endocrinology and Metabolism
Hong Yao, Weiwei Rui, Yong Zhang, Yanting Liu, Shaojian Lin, Hao Tang, Weiguo Zhao, Zhebao Wu
BACKGROUND AND IMPORTANCE: Metastasis to the pituitary gland is uncommon in patients with systemic disseminated cancer. Individual articles have reported cases of pituitary metastasis mimicking a prolactinoma, but no case of a prolactin-secreting tumor metastasizing to the pituitary mimicking a prolactinoma has been reported so far. CLINICAL PRESENTATION: This article reports a 67-yr-old man with a recent onset of headaches, ophthalmoplegia, hypopituitarism, and hyperprolactinemia who was initially diagnosed with prolactinoma and given bromocriptine in the local hospital...
August 20, 2018: Neurosurgery
Robert Krysiak, Witold Szkróbka, Bogusław Okopień
Long-term prolactin excess is often accompanied by numerous metabolic complications. No previous study has compared the effect of statin therapy on circulating levels of cardiometabolic risk factors in patients with elevated and normal prolactin levels. The study population consisted of 3 age-, weight-, and lipid-matched groups of young women: 19 women with untreated hyperprolactinemia (group A), 20 normoprolactinemic women receiving bromocriptine treatment (because of previous hyperprolactinemia) (group B), and 20 untreated women with prolactin levels within the reference range (group C)...
August 21, 2018: Journal of Clinical Pharmacology
Yasmin Akhtar, Angela Verardo, Janet L Crane
Background: Multiple Endocrine Neoplasia Type 1 (MEN1) is a rare autosomal dominant disease that generally presents with primary hyperparathyroidism. However, initial presentation may vary and continued reevaluation of etiology of symptoms is required for appropriate diagnosis. Case Presentation: Twelve year old female presented with altered mental status that self-resolved and hypoglycemia. Laboratory evaluation revealed pituitary dysfunction with central hypothyroidism and adrenal insufficiency in the setting of hyperprolactinemia...
2018: International Journal of Pediatric Endocrinology
Yuan Li, Yan Li, Xueyan Wang, Hongyue Xu, Chao Wang, Yanan An, Wenjing Luan, Xuefei Wang, Shulin Li, Fangxue Ma, Lihui Ni, Mingyuan Liu, Xudong Tang, Lu Yu
Cordycepin is an extract from the insect fungus Cordyceps. militaris with various biological function. In previous studies, cordycepin had been reported with excellent anti-obesity effect, but the mechanism is unclear. Evidences also showed that prolactin played an important role in body weight regulation, hyperprolactinemia can promote appetite and accelerate fat deposition. In this study, we explored the molecular mechanism of the anti-obesity effect of cordycepin. In vivo, obese rats model was induced by high fat diet for 5 weeks, the serum and liver lipids coupled with serum prolactin were reduced by treatment of cordycepin (P<0...
August 20, 2018: Current Pharmaceutical Design
Gulen Guler, Meryem Ozlem Kutuk, Halil Kara
Amenorrhea, oligomenorrhea, galactorrhoea, gynecomastia, infertility, and sexual dysfunction may arise as a consequence of hyperprolactinemia. Hyperprolactinemia is one of major side effects of treatment with antipsychotics, but aripiprazole is known as a dopamine stabilizer antipsychotic which can be used to improve hyperprolactinemia. In this report, it was described that an adolescent patient experienced amenorrhea after adding very low dose aripiprazole to ongoing fluoxetine treatment regime for major depressive disorder...
August 31, 2018: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
Bao Yang, Chenlong Yang, Yilin Sun, Jiang Du, Pinan Liu, Guijun Jia, Wang Jia, Yazhuo Zhang, Jisheng Wang, Yulun Xu, Shuo Wang
BACKGROUND: Mixed gangliocytoma-pituitary adenoma is an extremely rare tumor occurring in the sellar region, histologically composed of both gangliocytic and pituitary adenomatous architectures. The histogenesis of these tumors remains unknown, and the diagnosis, treatment, and prognosis are yet to be fully understood. METHODS: We retrospectively reviewed the clinical, radiological, and histopathological profiles from a series of 20 patients with sellar mixed gangliocytoma-pituitary adenomas...
October 2018: Acta Neurochirurgica
Omar A Mazher, Eleni Maneta, William Hall
No abstract text is available yet for this article.
October 2018: Journal of Clinical Psychopharmacology
Manuel Delgado-Alvarado, Diana Tordesillas-Gutierrez, Rosa Ayesa-Arriola, Manuel Canal, Victor Ortiz-García de la Foz, Javier Labad, Benedicto Crespo-Facorro
Patients with schizophrenia frequently present hyperprolactinemia as a consequence of antipsychotic treatment. However, an increase in circulating prolactin levels has also been shown in patients without previous treatment. Our objective was to compare prolactin levels between antipsychotic-naive first-episode psychosis (AN-FEP) patients and healthy controls (HC). As part of an FEP program (Programa Asistencial Fases Iniciales de Psicosis [PAFIP]), 270 AN-FEP patients and 153 HC were eligible for this study...
August 10, 2018: Archives of Women's Mental Health
Renata S Auriemma, Dario De Alcubierre, Rosa Pirchio, Rosario Pivonello, Annamaria Colao
Hyperprolactinaemia has been implicated in the pathogenesis of obesity and glucose intolerance and is reportedly associated with impaired metabolic profile and metabolic syndrome in approximately one third of patients. Area covered: Suppression of dopaminergic tone has been proposed as a potential mechanism responsible for weight gain and metabolic abnormalities in such patients. Dopamine receptor type 2 (D2 R) is abundantly expressed on human pancreatic β-cell and adipocytes, suggesting a regulatory role for peripheral dopamine in insulin and adipose functions...
March 2018: Expert Review of Endocrinology & Metabolism
Zhongjian Xie, Lusha Li, Wei Liu, Shiping Liu, Jianguang Luo, Eryuan Liao
Ovarian cysts are one of the most common gynecologic affections for females. The most effective therapy is surgery, but not for all conditions. An 18-year-old woman was referred to our hospital because of menstruation disorder and abdominal distension. Ultrasound and computer tomography of the abdomen revealed a giant ovarian cyst. Magnetic resonance imaging revealed profound pituitary enlargement. Laboratory studies showed severe hypothyroidism, mild anemia, hyperlipidemia, hyperprolactinemia and an elevated level of cancer antigen-125...
July 26, 2018: Journal of Obstetrics and Gynaecology Research
Garni Barkhoudarian, Sheri K Palejwala, Ronke Ogunbameru, Hua Wei, Amalia Eisenberg, Daniel F Kelly
OBJECTIVE: Invasive, medically refractory, and multiply recurrent pituitary adenomas pose a rare, but nevertheless significant, challenge for conventional management modalities. Temozolomide (TMZ) has been reported to be useful as an adjunctive treatment for some patients. We describe the efficacy of TMZ when used early in the management of invasive prolactinoma. CASE DESCRIPTION: A 56-year-old man presented with an invasive, refractory macroprolactinoma for which long-term dopamine agonists, stereotactic radiosurgery, and multiple transsphenoidal surgical resections had failed...
October 2018: World Neurosurgery
Thomas Dodsworth, David D Kim, Ric M Procyshyn, Colin J Ross, William G Honer, Alasdair M Barr
The second generation antipsychotic drug risperidone is widely used in the field of child and adolescent psychiatry to treat conditions associated with disruptive behavior, aggression and irritability, such as autism spectrum disorders. While risperidone can provide symptomatic relief for many patients, there is considerable individual variability in the therapeutic response and side-effect profile of the medication. One well established biological factor that contributes to these individual differences is genetic variation in the cytochrome P450 enzyme 2D6...
2018: Child and Adolescent Psychiatry and Mental Health
Justin Seltzer, Michelle A Wedemeyer, Phillip A Bonney, John D Carmichael, Martin Weiss, Gabriel Zada
OBJECTIVE Incidental pituitary adenomas (IPAs) are commonly discovered during cranial imaging evaluations obtained for unrelated indications. The optimal management of IPA remains controversial. The authors investigated the outcomes and safety of the surgical treatment of IPAs at their institution. METHODS Clinical outcome data for 1692 patients surgically treated for pituitary adenomas at the Keck Medical Center of USC/USC Pituitary Center over a 17-year period (1999-2016) were reviewed to identify all cases with surgically managed IPAs...
June 1, 2018: Journal of Neurosurgery
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