Abstract
We have studied the effects of the chronic administration of the dopamine agonist lisuride (L) in 21 acromegalics (group 1) and in 25 patients with pathological hyperprolactinemia (group 2). Before starting the treatment plasma levels of PRL and/or GH were determined during acute tests with L (0.3 mg po) or TRH (0.2 mg iv). L was given in doses ranging between 0.4 and 2.4 mg/day. GH and/or PRL were determined at monthly intervals. TRH (6 patients of group 1 and 10 of group 2) was repeated during L therapy. In 10 patients of group 1 GH levels were reduced below 10 ng/ml by L therapy; in the remaining patients GH levels were reduced by 50% of the pretreatment values or they were unchanged. The correlation (p<0.01) found between GH levels during acute and chronic L administration indicates that GH changes after acute test are predictive of the outcome of the treatment. In all patients PRL was reduced during the therapy to at least 50% of the basal values and in most patients PRL fell to the normal range. No correlation was found between PRL levels during acute and chronic L administration. During the therapy TRH still increased GH levels in most patients whereas it failed to raise PRL. The withdrawal of L was followed by a rapid return of GH to the pretreatment values whereas PRL showed a slower increase. In acromegalics whose GH was lowered by L there was also a marked amelioration of clinical and metabolic parameters. The lowering of PRL was accompanied by the resumption of ovulatory menses even in patients with tumoral hyperprolactinemia. Mates reported improvement in sexual performance. An improvement of visual field occurred in 1 patient. In 1 patient with a large prolactinoma serial computerized tomography scans performed during 2 yr of treatment showed a marked reduction of the tumor size.
Similar content being viewed by others
References
Liuzzi A., Verde G., Chiodini P.G. Dopaminergic control of growth hormone secretion in acromegaly. Triangle 270: 41, 1978.
Silvestrini F., Liuzzi A., Chiodini P.G. Prolacting and pituitary tumours. In: Martini L., James V.H.T. (Eds.), Current topics in experimental endocrinology. Academic Press, New York, 1978, p. 131.
Liuzzi A., Chiodini P.G., Oppizzi G., Botalla L., Verde G., De Stefano L., Colussi G., Graf K.J., Horowski R. Lisuride hydrogen maleate: evidence for a long lasting dopaminergic activity in humans. J. Clin. Endocrinol. Metab. 46: 196, 1978.
Herrmann W.M., Horowski R., Dannehl K., Kramer U., Lurati K. Clinical effectiveness of lisuride hydrogen maleate: a double blind trial versus methysergide. Headache 17: 54, 1977.
Johnson A.M., Loew D.M., Vigouret J.M. Stimulant properties of bromocriptine on central dopamine receptors in comparison to apomorphine, D-amphetamine and L-dopa. Br. J. Pahrmacol. 56: 59, 1976.
Horowski R. Differences in the dopaminergic effects of the ergot derivatives bromocriptine, lisuride and D-LSD as compared with apomorphine. Eur. J. Pharmacol. 51: 157, 1978.
Horowski R., Riedel C. Hypothermic action of lisuride in rats and differences to bromocriptine in the antagoniste effect of neuroleptics. Acta Pharmacol, in press.
Liuzzi A., Chiodini P.G., Botalla L., Silvestrini F., Müller E.E. Growth hormone releasing activity of TRH and GH lowering effect of dopaminergic drugs in acromegaly. Homogeneity in the two responses. J. Clin. Endocrinol. Metab. 39: 871, 1974.
Molinatti G.M., Massara F., Pennisi F., Scassellati G.A., Strumia E., Vancheri L. Radioimmunoassay of hGH. J. Nucl. Biol. Med. 13: 26, 1969.
Mitoma C., Smith T.E., Davidson J.D., Udenfriend S., Da Costa F. Sjodersma A. Improvement in methods for measuring hydroxyproline: application to human urine. J. Lab. Clin. Med. 53: 971, 1959.
Chiodini P.G., Liuzzi A., Botalla L., Oppizzi G., Müller E.E., Silvestrini F. Stable reduction of plasma growth hormone (hGH) levels during chronic administration of 2-Br-alpha-ergocryptine (CB 154) in acromegalic patients. J. Clin. Endocrinol. Metab. 40: 705, 1975.
Sachdev Y., Tunbridge W.M.G., Weightman D.R., Gomez Pan A., Duns A., Hall R. Bromocriptine therapy in acromegaly. Lancet 2: 1164, 1975.
Cassar J., Mashiter K., Joplin J.F. Bromocriptine treatment of acromegaly. Metabolism 26: 539, 1977.
Belforte L., Camanni F., Chiodini P.G., Liuzzi A., Massara F., Molinatti G.M., Müller E.E., Silvestrini F. Long-term treatment with 2-Br-alpha-ergocryptine in acromegaly. Acta Endrocinol (Kbh.) 85: 235, 1977.
Wass J.A., Thorner M.O., Morris D.V., Rees L.H., Stuart Mason A., Jones A.E., Besser G.M. Long-term treatment of acromegaly with bromocriptine. Br. Med. J. 1: 875, 1977.
Podvalova I., Dlabac A. Lysenil, a new antiserotonin agent. Res. Clin. Stud. Headache 3: 325, 1972.
Quadri S.K., Meites J., Lu K.H. Ergot-induced inhibition of pituitary tumor growth in rats. Science 16: 417, 1972.
Mac Leod R.M., Lehmeyer J.E. Suppression of pituitary tumor growth and function by ergot alkaloids. Cancer Res. 33: 849, 1973.
Lloyd H.M., Meares J.D., Jacobi J. Effects of oestrogen and bromocriptine on in vivo secretion and mitosis in prolactin cells. Nature 255: 497, 1975.
Von Werder K., Fahlbusch R., Landgraf R., Pickardt C.R., Rjosk H.K., Scriba P.C. Treatmer of patients with prolactinomas. J. Endocrinol. Invest. 1: 47, 1978.
Thorner M.O., Besser G.M. Bromocriptine treatment of hyperprolactinemic hypogonadism. Acta Endrocinol. (Kbh.) (Suppl.) 216: 131, 1978.
Vaidya R.A., Aloorkar S.D., Rege N.R., Moskau B.T., Jahargiz R.P., Steth A.R., Pandya J.K. Normalization of visual fields following bromocriptine treatment in hyperprolactinemic patients with visual field constriction. Fertil. Steril. 29: 632, 1978.
Besser G.M., Wass J.A., Thorner M.O. Acromegaly. Results of long-term treatment with bro mocriptine. Acta Endocrinol. (Kbh.) (Suppl.) 26: 187, 1978.
Chiodini P.G., Liuzzi, A., Verde G., Cozzi R., Silvestrini F., Marsili M.T., Horowski R., Passerini F., Luccarelli G., Borghi P.G., Size reduction of a prolactin secreting adenoma during a long-term treatment with a dopamine agonist, lisuride. International Symposium on Pituitary Microadenomas, Milan, October 12–14, 1978. Ed. Serono Symposia, Abstract 64.
Liuzzi A., Chiodini P.G., Verde G., Cozzi R., Botalla L., Silvestrini F., Horowski R. Medical treatment of acromegaly. 6th Int. Congr. Endocrinol., Melbourne, February 9–16, 1980, Abstract S 162.
Mc Gregor A.M., Scanion M.F., Hall K., Cook D.B., Hall R. Reduction in size of a pituitary tumor by bromocriptine therapy. N. Engl, J. Med. 300: 291, 1979.
Wass J.A.H., Thorner M.O., Charlesworth M., Moult P.J.A., Dacie J.E., Jones A.E., Besser G.M. Reduction of pituitary-tumour size in patients with prolactinomas and acromegaly treated with bromocrip tine with or without radiotherapy. Lancet 2: 66, 1979.
Pasteels J.L., Danguy A., Frerotte M., Ectors F. Inhibition of prolactin secretion by ergocornine and 2-Br-alpha-ergocryptine: direct action on the pituitary in culture. Ann. Endocrinol. (Paris) 32: 188, 1971.
Mac Leod R.M. Influence of dopamine, serotonin and their antagonists on prolactin secretion. Prog. Reprod. Biol. 2: 54, 1977.
Author information
Authors and Affiliations
Additional information
Supported Dy grant no. 79.00695.96 of CNR.
Rights and permissions
About this article
Cite this article
Verde, G., Chiodini, P.G., Liuzzi, A. et al. Effectiveness.of the dopamine agonist lisuride in the treatment of acromegaly and pathological hyperprolactinemic states. J Endocrinol Invest 3, 405–414 (1980). https://doi.org/10.1007/BF03349379
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03349379