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Treatment of hyperprolactinemia

Paola Bozzatello, Silvio Bellino, Irene Mancini, Luisa Sandei, Enrico Zanalda, Paola Rocca
BACKGROUND AND OBJECTIVE: Clinical practice guidelines recommend antipsychotic monotherapy, including oral and long-acting formulations, in the treatment of schizophrenia. This open-label, randomized, controlled trial aimed to evaluate the efficacy and tolerability in patients with schizophrenia of once-monthly long-acting paliperidone palmitate (PP1M) compared with oral paliperidone extended release (ER), with a particular focus on satisfaction, subjective well-being, and service engagement. METHODS: Seventy-two consecutive outpatients with schizophrenia (DSM-5) were randomly assigned for 6 months to: (1) PP1M (50-150 mg equivalent) or (2) paliperidone ER (6-12 mg/day)...
December 6, 2018: Clinical Drug Investigation
Yu Peng Wu, Yi Bao Wang, Zhe Bao Wu
BACKGROUND: Germinomas are sensitive to radiotherapy and chemotherapy. However, there has been no report involving in the potential therapeutic effect of dopamine agonists (DAs) such as bromocriptine on germinomas. CASE DESCRIPTION: A 20-year-old female was presented with bitemporal visual disturbance and amenorrhea. Magnetic resonance imaging demonstrated a huge sellar tumor with upward extension and invasion of the parasellar region. The blood tests showed an exceedingly high level of prolactin...
November 10, 2018: Clinical Neurology and Neurosurgery
Robert Krysiak, Witold Szkróbka, Bogusław Okopień
BACKGROUND: Elevated prolactin levels are associated with increased cardiometabolic risk. No previous study has compared the effect of hypolipidemic therapy on plasma levels of lipids and other cardiometabolic risk factors in patients with and without hyperprolactinemia. METHODS: The study included three age-, weight-, blood pressure- and lipid-matched groups of premenopausal women: 18 women with untreated hyperprolactinemia, 19 women with bromocriptine-treated hyperprolactinemia and 20 drug-naïve women with normal prolactin levels...
September 6, 2018: Pharmacological Reports: PR
Isadora C Furigo, Miriam F Suzuki, João E Oliveira, Angela M Ramos-Lobo, Pryscila D S Teixeira, João A Pedroso, Amanda de Alencar, Thais T Zampieri, Daniella C Buonfiglio, Paula G F Quaresma, Patricia O Prada, Paolo Bartolini, Carlos R J Soares, Jose Donato
Previous studies have shown that bromocriptine mesylate (Bromo) lowers blood glucose levels in adults with type 2 diabetes mellitus. However, the mechanism of action of the anti-diabetic effects of Bromo is unclear. As a dopamine receptor agonist, Bromo can alter brain dopamine activity affecting glucose control. However, Bromo also suppresses prolactin (Prl) secretion, and Prl levels modulate glucose homeostasis. Thus, the objective of the present study was to investigate whether Bromo improves insulin sensitivity via inhibition of Prl secretion...
November 20, 2018: Endocrinology
Kimberly E Vanover, Robert E Davis, Yun Zhou, Weiguo Ye, James R Brašić, Lorena Gapasin, Jelena Saillard, Michal Weingart, Robert E Litman, Sharon Mates, Dean F Wong
Dopamine D2 receptor occupancy (D2 RO) is a key feature of all currently approved antipsychotic medications. However, antipsychotic efficacy associated with high D2 RO is often limited by side effects such as motor disturbances and hyperprolactinemia. Lumateperone (ITI-007) is a first-in-class selective and simultaneous modulator of serotonin, dopamine and glutamate in development for the treatment of schizophrenia and other disorders. The primary objective of the present study was to determine D2 RO at plasma steady state of 60 mg ITI-007, a dose that previously demonstrated antipsychotic efficacy in a controlled trial, administered orally open-label once daily in the morning for two weeks in patients with schizophrenia (N = 10) and after at least a two-week washout period from standard of care antipsychotics...
October 26, 2018: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Adriana G Ioachimescu, Maria Fleseriu, Andrew R Hoffman, T Brooks Vaughan Iii, Laurence Katznelson
BACKGROUND: Dopamine agonists (DAs) are the main treatment for patients with hyperprolactinemia and prolactinomas. Recently, an increasing number of reports emphasized DAs' psychological side effects, either de- novo or as exacerbations of prior psychiatric disease. METHODS: Review of prospective and retrospective studies (PubMed 1976- September 2018) evaluating the psychological profile of DAs-treated patients with hyperprolactinemia and prolactinomas. Case -series and case reports of psychiatric complications were also reviewed...
October 1, 2018: European Journal of Endocrinology
Ebony Gilbreath, LakshmiKripa Jagannathan, Madhan Subramanian, Priya Balasubramanian, Katrina Linning, Sheba MohanKumar, Puliyur MohanKumar
Women are chronically exposed to estrogens through oral contraceptives, hormone replacement therapy or environmental estrogens. We hypothesized that chronic exposure to low levels of estradiol-17β (E2) can induce inflammatory and degenerative changes in the tuberoinfundibular dopaminergic (TIDA) system leading to reduced dopamine synthesis and hyperprolactinemia. Young (Y; 3-4 months) and middle-aged (MA; 10-12 months) Sprague-Dawley rats that were intact or ovariectomized (OVX), were either sham-implanted or implanted with a slow-release E2 pellet (20ng E2/day for 90 days)...
November 1, 2018: Journal of Endocrinology
Erdal Eren, Ayça Törel Ergür, Şükriye Pınar İşgüven, Eda Çelebi Bitkin, Merih Berberoğlu, Zeynep Şıklar, Firdevs Baş, Servet Yel, Serpil Baş, Elif Söbü, Abdullah Bereket, Serap Turan, Halil Sağlam, Zeynep Atay, Oya Ercan, Tülay Güran, Mehmet Emre Atabek, Hüseyin Anıl Korkmaz, Aylin Kılınç Uğurlu, Ayşehan Akıncı, Esra Döğer, Enver Şimşek, Emine Demet Akbaş, Ayhan Abacı, Ülkü Gül, Sezer Acar, Eda Mengen Uçaktürk, Melek Yıldız, Edip Ünal, Ömer Tarım
OBJECTIVE: We aimed to study the characteristics on admission, diagnosis, treatment, and follow-up of hyperprolactinemic cases in a large multicenter study. METHODS: We reviewed 233 hyperprolactinemic patients under 18 years of age who were followed by different centers. The patients were divided as having microadenomas, macroadenomas, drug-induced hyperprolactinemia, and idiopathic hyperprolactinemia. Complaints of the patients and their treatment (medication and/or surgery) responses were evaluated in detail...
November 5, 2018: Journal of Clinical Research in Pediatric Endocrinology
Lijin Ji, Na Yi, Qi Zhang, Shuo Zhang, Xiaoxia Liu, Hongli Shi, Bin Lu
Objective To assess the current management of prolactinoma among endocrinologists in China. Methods An online survey of a large sample of endocrinologists was conducted in China. The questionnaire included 21 questions related to controversial issues about the management of prolactinomas. Doctors in the endocrinology department of a university-affiliated hospital or a comprehensive secondary hospital in 12 cities from East, West, South, North and Middle China were surveyed. Results A total of 290 valid questionnaires were collected, and the response rate was 40%...
October 1, 2018: Endocrine Connections
Sandra Pekić, Milica Medic Stojanoska, Vera Popovic
<br>Hyperprolactinemia is not a common finding in post-menopausal women. Prolactinomas detected after menopause are usually macroadenomas. Due to atypical clinical features they may remain un-recognized for a long period of time. Interestingly the growth potential of prolactinomas remains after menopause. Most tumors are invasive and present with high prolactin levels. They respond to medical treatment with dopamine agonists both in terms of prolactin normalization, tumor shrinkage and improvement in pituitary function...
October 22, 2018: Neuroendocrinology
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)...
December 1, 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...
December 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
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