Long-term pergolide treatment of hyperprolactinemic patients previously unsuccessfully treated with dopaminergic drugs.
Nine hyperprolactinemic patients (seven women aged 25-57 and two men aged 23-51 years) were treated with the dopamine agonist drug, pergolide mesylate, for a period ranging from 4 months to 5 years. All patients had previously received different dopamine agonist drugs; additionally two of the group had undergone surgery and radiation therapy. Group 1 comprised five patients who were given pergolide in an attempt to avoid the marked side effects of bromocriptine and lisuride that had been given earlier. Group 2 comprised four patients treated with pergolide following failure to respond to other dopamine agonist drugs (bromocriptine, lisuride). In group 1, pergolide, at a dose of 25-50 micrograms/day, caused a decrease in the prolactin level to the normal value, restored menstruation, and very few side effects were noted. In group 2, pergolide was administered in a gradually increasing dose, the patients receiving a maximum of 200 micrograms/day. At this dose, there was a significant decrease in the prolactin level in two patients compared with only a slight decrease in the remaining two patients. This study illustrates the efficacy of pergolide in treating hyperprolactinemic patients unable to tolerate other dopaminergic agents (bromocriptine, lisuride).