Clinical response to CB-154 and the pituitary response to thyrotropin-releasing hormone-gonadotropin-releasing hormone in patients with galactorrhea-amenorrhea

Abstract

Ten patients with galactorrhea and amenorrhea were treated with 2-bromo-alpha-ergocryptine (CB-154). All patients had normal anteroposterior and lateral x-rays of the sella turcica and normal or low gonadotropin levels. Before treatment, serum prolactin (PRL) levels were between 80 and 1575 ng/ml. Prior to initiating therapy, six patients were further evaluated by the intravenous administration of thyrotropin-releasing of a pituitary etiology in all patients. During treatment, PRL levels were measured at monthly intervals. After 1 month, serum PRL concentrations were reduced between 13% and 99%. In eight subjects there was complete cessation of galactorrhea. During treatment, nine patients resumed ovulatory menstrual cycles and three patients conceived. After discontinuing therapy, five of seven subjects had a recurrence of galactorrhea, amenorrhea, and hyperprolactinemia.

PIP: Clinical and pituitary effects of 2-bromo-alpha-ergocryptine (CB-154) in 10 patients with galactorrhea-amenorrhea syndrome are reported. Pretreatment testing with hormones suggested a pituitary disorder in all cases. 1 month after treatment with 3 daily doses of CB-154 (2 mg), prolactin concentrations decreased between 13-99%. Galactorrhea was completely suppressed in 8 patients, 9 patients had a return to normal ovulatory menstrual cycles, and 3 conceived. However, once treatment was discontinued, 5 of 7 patients had a recurrence of galactorrhea, amenorrhea, and hyperprolactinemia.