PERSISTING SUPPRESSION OF PROLACTIN SECRETION AFTER LONG-TERM TREATMENT WITH BROMOCRIPTINE IN PATIENTS WITH PROLACTINOMAS

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Abstract
The effect of bromocriptine withdrawal after long-term treatment on prolactin levels was investigated in 37 patients with prolactinomas. In 10 patients with macroprolactinomas and postoperative excessively high prolactin levels, persisting suppression of prolactin secretion after bromocriptine withdrawal was observed. This effect was not observed in patients with microprolactinomas or macroprolactinomas with only moderately elevated prolactin levels. The degree of persisting suppression correlated to the height of prolactin levels before treatment and to the duration of bromocriptine therapy. The rise of prolactin levels after bromocriptine withdrawal was not correlated with withdrawal time. The persisting suppression of prolactin levels is apparently a sequence of reduction in tumor size. This anti-proliferative action of bromocriptine seems to be specific for the prolactin secreting cells in macroprolactinomas with high proliferation rate and high prolactin turnover. These findings offer new possibilities in the management of patients with macroprolactinomas.